Chapter 1 pp 2426 how have historical cultural and

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Chapter 1 (pp. 24–26) How have historical, cultural, and socioeconomic factors influenced thecurrent healthcare delivery system in the U.S.? The US healthcare delivery system has been shaped bytwo main beliefs and values. First, belief in science led to the application of the scientific method to medicine. The medical model of healthcare delivery is founded on advances in science and technology. In turn, the medical model has led to the tremendous growth in medical science and technological innovation. As a result, healthcare delivery in the United States has beenpreoccupied almost exclusively with combating disease,whereas the holistic aspects of health and use of alternative therapies have been deemphasized. Deliveryof health care has suffered from a dichotomy between health promotion and disease prevention on the one hand and diagnosis and treatment of disease on the other. Few attempts have been made to integrate diagnosis and treatment with health education and disease prevention.Second, health care has largely been viewed as an economic good (or service), not as a public resource. Self-determination and individual capabilities to obtain health services have largely determined the production and consumption of health care—what services will be produced, where, and in what quantity, and who will have access to those services. Thus, we find a clear distinction in the types of services between poor and affluent communities, and between rural and urban locations. The value and belief system also governs the training and general orientation of healthcare providers, type of health delivery settings, financing, and access.Healthcare personnel have been trained to concentrate on physical symptoms. Medical practice has emphasized treatment rather than health education and
other means for reducing high-risk behaviors. The concern with non-health has funneled most research efforts away from the pursuit of health into development of sophisticated medical technology.Medical specialists who use the latest technology have been held in higher esteem than general practitioners and health educators. The desirability of health delivery institutions, such as hospitals, is often evaluated by theiracquisition of advanced technology.In contrast, commitment of resources to the preservation and enhancement of health and well-being have lagged far behind. Medical practice, in general, has also been directed at keeping the individual healthy rather than keeping the entire community healthy. Financing of health care through individual health insurance coverage has made access to health care a social privilege.

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