2-2 case study.docx - What are alternaTve ways to use...

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What are alternative ways to use system-wide incentives to encourage delivery of high-quality, prevention-oriented primary care? Quality requires prevention. Prevention means looking beyond medical treatment of sick individuals to community-based public health efforts to prevent disease, improve functioning and well-being, and reduce health disparities. Private health insurance attaches funding only to individual patients and thus separates the funding role and control from that of representing broader societal interests. Insurance companies discovered risk factors, such as hypertension, yet they used this insight primarily to exclude high-risk individuals. This fragmenting of the community places both sick people and the social causes of disease outside the boundaries of medical care. Although rhetorically "prevention is cheaper than cure," many preventive measures probably increase costs. This, combined with high patient turnover rates and short-term financial orientation, gives private insurers little incentive to invest in prevention. Health care financing should facilitate problem solving at the community level. Community-based approaches to health promotion rest on the premise that enduring changes result from community-wide changes in attitudes and behaviors as well as ensuring a healthy environment. Stores that refuse to sell
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