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1、Unit 10Health Care System The United States is one of the wealthiest countries in the world and its medical expenditure is also among the highest, but still many American citizens are inadequately insured or not insured at all. What is the root of this problem? This unit looks into the problems with

2、 the American medical system and suggests ways and strategies to change the situation. Unit ContentsLead-inText AText BText CListeningSpeakingWritingUnit 10 Health CareSystem Lead-inIssues to be coveredSuggested answers Unit 10 Health CareSystem Lead-inSuggested answersTask : Listen to a talk about

3、American health care system and answer the following questions.What is the annual expenditure of the US on health care?2. What are the researchers findings about the health care performance of the US?3. What is the major cause of the problem discussed in the talk?Unit 10 Health CareSystem the rising

4、 number of uninsured citizens in AmericaThe US has poorer performance in preventable deaths thanother industrialized nations.$ 2.1 trillionText A Critical reading and thinking Topics for presentation Useful expressions Difficult sentences Language building-up Medical terminology Signpost language Fo

5、rmal English Vocabulary testSuggested answersUnit 10 Health CareSystem Text A Critical reading and thinkingTopics for presentation1 Give a brief explanation of Medicare and Medicaid. Medicare for people age 65 or olderpeople under age 65 with certain disabilities people of all ages with End-Stage Re

6、nal Disease (permanent kidney failure requiring dialysis or a kidney transplant) Medicaid available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state lawUnit 10 Health CareSystem 2 Compare the American model and the European

7、 model. Topics for presentationText A Critical reading and thinkingUnit 10 Health CareSystem American modelEuropean modelFatterUnder more stressLess activeMore vacationsFewer possessionsText A Topics for presentation3 What are the problems with the fragmented American health care system? Critical re

8、ading and thinkingComplicated rules: it needs a genius to know the rules for treating or taking care of each patient without getting questioned by the insurance companies or othersInvolvement of private and public bureaucracies in deciding which patient can get what treatmentUnhappiness of Americans

9、 about health care systemNeed to cover allNeed to get more value for the money spent currently on health careUnit 10 Health CareSystem Text A Topics for presentation3 What are the problems with the fragmented American health care system? Critical reading and thinkingMoney is also part of the problem

10、. The governments inability to subsidize the coveredAmericans unwillingness to pay more taxes and pour more money into the broken healthcare systemUnit 10 Health CareSystem Text A Useful expressionsThe American medical system is highly fragmented.Americans are more comfortable with fragmentation tha

11、n other nationalities.Even Americans who are covered think the U.S. medical system is broken.The majority of them want to tear it up and start over.As a nation, we are suspicious about a “single” anything like a single-payer system for health insurance. Critical reading and thinkingUnit 10 Health Ca

12、reSystem Text A Topics for presentation4 Why is “rationalizing the medical system” the key to the present problem? Critical reading and thinkingBenefits to gain by rationalizing the system Saving money Delivering better care to more peopleBlanket allocation of care being never a good ideaUnit 10 Hea

13、lth CareSystem Text A Useful expressionsAmericans are not very excited about paying more taxes and pouring more money into a healthcare system they rightly feel is broken in the first place.The answer hinges on what we economists call rationalizing the healthcare system.Critical reading and thinking

14、Unit 10 Health CareSystem Text A Topics for presentationCritical reading and thinking5 Briefly summarize the four strategies. 1 Wire up the medical system by adopting IT.2 Undertake a sustained study of comparative effectiveness by tracking effectiveness of care over time.3 Do a better job of managi

15、ng chronic diseases, especially the prevention of them.4 Change the incentives in medicine by paying doctors for what they do well and make insurance companies focus more on taking care of the sick.Unit 10 Health CareSystem Text A Topics for presentationCritical reading and thinking5 Briefly summari

16、ze the four strategies. Knowledge of subject matterDoctors will be much more efficient when they have computerized their patients medical records and can get away from writing everything on small scraps of paper that have to be physically transferred from place to place.Unit 10 Health CareSystem Tex

17、t A Topics for presentationCritical reading and thinking5 Briefly summarize the four strategies. Knowledge of subject matterUnit 10 Health CareSystem Managing Chronic: PreventionDiabetes: the poster childkidney diseaseloss of limbsvision deficitText A Useful expressionsto undertake a sustained study

18、 of comparative effectivenessAre newer procedures really worth much relative to older procedures?If we can track effectiveness of care over time, we can get a handle on the new drugs, the spiffy diagnostics, new medical devices, and treatment protocols to determine which really deliver better result

19、s.Critical reading and thinkingUnit 10 Health CareSystem 6 Do you support “the other voices”? Why? Text A Topics for presentationCritical reading and thinkingThe “Other Voices”More should be done to limit demand for healthcare.Americans are wasteful of their healthcare.Cover the things that are medi

20、cally necessaryUnit 10 Health CareSystem (The answer may vary. )6 Do you support “the other voices”? Why? Text A Topics for presentationCritical reading and thinkingKnowledge of Subject MatterUnit 10 Health CareSystem because most of us receive them (health care dollars) as a benefit, not as a bill.

21、If healthcare were like other markets, healthcare would work better.People need help managing their chronic illness; leaving them adrift is not the way to go.6 Do you support “the other voices”? Why? Text A Topics for presentationCritical reading and thinkingKnowledge of Subject MatterUnit 10 Health

22、 CareSystem the medically necessary list is long, and the optional list is far too small.In healthcare, it is very difficult to draw bright lines between what is medically valuable and what is not.Some things are valuable for some patients and not for others. Allocating medical care is very difficul

23、t proposition, no matter where and how it is proposed.Text A Useful expressionspeople take charge of what they get and what they buy This idea does not work for me. I am not a big fan of putting consumers in charge of paying money for their healthcare Critical reading and thinkingUnit 10 Health Care

24、System Text A Difficult sentencesWe know, for example, that people are very bad at undertaking actions with costs in the short term and benefits only down the road (witness saving for retirement).例如,我們知道人們很不愿意做眼下要付出代價、而長期會獲益的行為(例如為退休存錢。Critical reading and thinkingUnit 10 Health CareSystem Have a wh

25、ole picture! Text A Text AnalysisCritical reading and thinkingQualities of a true physicianmuch of the knowledge many of the skillscaringinquisitivenesscivic-mindednessUnit 10 Health CareSystem A Brief Glance at the Medical System of AmericaText A Text AnalysisCritical reading and thinkingAlmost US$

26、2 trillion per year on healthcare, nearly one in every seven dollars in the economyNot automatic medical coverage for all citizensHealth insurance as a perk most often tied to their job, or as a result of a government programs such as Medicare and MedicaidUnit 10 Health CareSystem To Sum Up : Text A

27、 Text AnalysisCritical reading and thinkinggetting the money and knowledge rightget the healthcare system flowing in the right directiondeliver a healthier America and gradually reduce the average cost of family health insurance making it easier to cover everyone in the countrymaking the U.S. system

28、 the best and most sensible healthcare system in the world.Unit 10 Health CareSystem Text A Suggested answersTask 1 Overview: Summarize the main ideas in Text A by completing the following diagrams. Critical reading and thinkingUnit 10 Health CareSystem Text A Suggested answersUnit 10 Health CareSys

29、tem Introduction of problem(P1)Solution to problem (P3-P8)The current US healthcare system leads to many people _.The American healthcare system needs to be _with a set of strategies.Strategy 1:_the medical system.Analysis of problem (P2)The US medical system is highly _. Strategy 2:Undertake a sust

30、ained study of _.Strategy 3:Focus more on _and _. Strategy 4:Change the _ in medicine.Refutation of other voices Conclusion Rationalizing healthcare can make people healthier and cut _.uninsuredfragmentedrationalizedWire up comparative effectivenesschronic diseases preventionincentivescostText A Tas

31、k 1/ Medical terminology Match each definition with its corresponding English term and Chinese equivalent.EnglishChinese Definition1the amount and type of protection that an insurance agreement gives you2a U.S. governmental health assistance program to help pay the hospital and medical coast for the

32、 poor3having the quality of doubling 4capacity to produce strong physiological or chemical effectscoverage承保范圍,承保險別(美國)醫(yī)療補(bǔ)助制度Medicaid二重的,雙重的duplicativeeffectiveness有效Suggested answersLanguage building-up2Unit 10 Health CareSystem Text A EnglishChinese Definition5the act of placing a person in a hosp

33、ital and medical cost for the poor 6the branch of medical science that deals with diagnosis 7the act of preventing 8the plan for a course of medical treatment 9lasting for a long period of time or marked by frequent recurrence, as certain diseases prevention預(yù)防hospitalization住院diagnostics診斷學(xué)treatment

34、 protocol治療方案Task1 / Medical terminologyMatch each definition with its corresponding English term and Chinese equivalent.Suggested answers2Language building-upchronic慢性的Unit 10 Health CareSystem Text A Language Building-up Signpost LanguageListing Listing is a common writing pattern. It presents a l

35、ist of items in no specific order since the order is unimportant. Here are some signpost words or expressions that typically signal a listing pattern for your reference:Words that signal a listing pattern: and, also, another, in addition, in addition to first, second, third firstly, secondly, finall

36、y, lastly The first reason the secondWords that predict a listing pattern: categories, kinds, types, ways, examples, groups, parts, etc.Unit 10 Health CareSystem Text A Task 2 / Signpost language In Text A, the author puts forward a list of solutions to the problems of the American health care syste

37、m. Pay attention to how he signifies the order of the list and complete the following sentences. Compare your answers with the original sentences in the text. _ thing we can do is wire up the medical system. (Para.4)A _ important strategy is to undertake a sustained study of comparative effectivenes

38、s. (Para.5)A _ strategy is to do a better job of managing chronic diseases, spending more time and energy on prevention. (Para.6)4 That leads to the _ set of reforms to change the incentives in medicine. (Para. 7 )Language building-upSuggested answerssecondOneUnit 10 Health CareSystem third fourthTe

39、xt A Task 3 / Formal EnglishReplace the underlined words and expressions in the following sentences with more formal ones. _1 It is ironic that the United States, a nation that spends the most money per person on health care, (Para.1)_2 The difference in our health care outcomes is a product of both

40、 public health and social issues. (Para.1)_3 , we will know what really needs to be done for individual patients, and patients will be involved with their care. (Para.4)_4 A second important strategy is to begin a sustained study of comparative effectiveness. (Para.5) Language building-upSuggested a

41、nswersUnit 10 Health CareSystem per capita varianceengagedundertakeText A Task 3 / Formal EnglishReplace the underlined words and expressions in the following sentences with more formal ones. _5 If we can track effectiveness of care over time, we can understand the new drugs, the spiffy diagnostics,

42、 new medical devices, and treatment protocols to determine which really deliver better results. (Para.5)_ 6 We can give insurance companies incentives to focus more on taking care of the sick than on coming up with reasons to insure only the healthy. (Para.7)_ 7 The common feature in these strategie

43、s for changing the American medical system is getting the money and knowledge right. (Para.11) Language building-upSuggested answersUnit 10 Health CareSystem get a handle onrationales commonalityGroup presentation Text A Additional activityThe embolic stroke accounts for about 15-20% of all strokes

44、in the U.S. Work in a small group and explore the media and literature for information about the embolic stroke in the following aspects:1. definition2. signs and symptoms3. causes4. treatment5. preventionUnit 10 Health CareSystem medical _ (醫(yī)療保險支付范圍)medical and _ (醫(yī)療保險和醫(yī)療救助)a(n) _ system (單一支付者系統(tǒng))t

45、o _ the uncovered (補(bǔ)助無保險的人)to _care (提供醫(yī)療)_ tests (重復(fù)的檢查)a(n)_study (長期的研究)vision _ (視力缺陷) Text A Language Building-up Vocabulary Test coverage Medicaidsustainedsingle-payerdeficitssubsidizevaluedeliverUnit 10 Health CareSystem Text BCritical reading and thinkingLanguage building-upSuggested answers

46、Unit 10 Health CareSystem Text B Group discussion:Additional activityThink out the occasions where waiting matters and share your experience with the class if any.Queuing for food when starvinga ticket homeWaiting for your date to show upOthers?Unit 10 Health CareSystem Text B Critical Reading and T

47、hinking1 patients condition before hospitalization In excellent health except for mild heart diseaseIrregular heartbeat Slightly short of breath Pulse as high as 130Stable blood pressureWrite down the information on the following topics. Then compare your answers with your partner.Unit 10 Health Car

48、eSystem Text B Useful expressions she decided to forgo a call to 911 the most highly regarded academic medical centers on the West CoastCritical reading and thinkingUnit 10 Health CareSystem Text B Critical Reading and Thinking2. the initial diagnosis and ensuing treatment Initially diagnosed with r

49、apid atrial fibrillation Intravenous heparin for anticoagulation Electrical cardioversion the following day if a transesophageal echocardiogram(TEE) confirmed the absence of an atrial thrombus Write down the information on the following topics. Then compare your answers with your partner.Unit 10 Hea

50、lth CareSystem Text B Useful expressionsshe was diagnosed with rapid atrial fibrillationGiven her age, the emergency department (ED) staff and the consulting cardiologist decided to admit her to the hospital.no inpatient bed was availableshortly before noonthe cardiologist stopped by to let her know

51、 thatwould undergo TEE and cardioversion the following Monday. Critical reading and thinkingUnit 10 Health CareSystem Text B Critical Reading and Thinking3. critical condition of the patientA massive embolic strokeOcclusion of the right common carotid artery and the intracranial branchesSigns of mid

52、dle cerebral artery syndromeInternal carotid artery being tore during operationRapid intracranial bleeding and brain-stem herniationIntubated in the ICU without evidence of neurologic recoveryWrite down the information on the following topics. Then compare your answers with your partner.Unit 10 Heal

53、th CareSystem Text B Useful expressionsWithin moments, signs of middle cerebral artery syndrome developed.For the next 2 days, the patient lay intubated in the ICU without evidence of neurologic recovery.life support was withdrawnprevented the development of the thrombus that subsequently broke loos

54、eHad cardioversion been performed shortly after the patient entered the ED, she might be alive and healthy today.If cardioversion had been performed an academic surgeonbecause I practice in a different city,His words stung, but they were true.Critical reading and thinkingUnit 10 Health CareSystem Te

55、xt B Critical Reading and Thinking4 causes of ED crowding in hospitalsThe number of patientsThe number of the doctorsSeverity of the conditionsInefficiency of hospital operationWrite down the information on the following topics. Then compare your answers with your partner.Unit 10 Health CareSystem T

56、ext B Useful expressionsThe factors that contribute to ED crowding and its consequences have been amply documented in reports by the Institute of Medicine, become so commonplace that it is accepted as the norm . (習(xí)以為常)Critical reading and thinkingUnit 10 Health CareSystem Text B Useful expressionsTh

57、e factors that contribute to ED crowding and its consequences have been amply documented in reports by the Institute of Medicine, become so commonplace that it is accepted as the norm . (習(xí)以為常)Critical reading and thinkingUnit 10 Health CareSystem Text B Critical Reading and Thinking5. the urgent hea

58、lth care issues nowadays Background: successful aging of the population as a whole less urgent: to elucidate the molecular basis of high blood pressure critical points: more social, health care issues the shortage of primary care physicians the lack of accessible health care and providers in certain

59、 areas of the country; and the yawning disparity between racial and economic backgrounds of those who become doctors and those who are their patientsWrite down the information on the following topics. Then compare your answers with your partner.Unit 10 Health CareSystem Text B Critical Reading and T

60、hinkingDefibrillation for out-of-hospital cardiac arrestSurgical management of traumatic injuriesInitiation of antibiotic treatment for meningitis and other deadly infectionsPercutaneous coronary intervention for acute myocardial infarction with ST-segment elevation Write down the information on the

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