Monday, April 26, 1999
Announcements:

• Exam is next Monday, May 3, at 8:00 am. SECTION 2 is in 108 Forum. Study chapters 10-13 and lecture notes

1. Population

1. Population Pyramid (review)

1. Great Depression Cohort
2. Baby-Boom Cohort (1946-64) – had economic opportunity
3. Baby-Bust Cohort (1970-79)
4. Baby Boom Echo Cohort (1985-95)
5. Easterlin – economic factors determine family size

1. Urbanization

1. Factors Related to Urbanization

1. Result of the Industrial Revolution and technological advancement
2. Rapid Population Growth
3. Migration to Urban centers looking for jobs
4. Larger cities are in LDC’s

1. Agglomerates – Cities that are geographically located by each other. Example: St. Paul and Minneapolis in Minnesota
2. Global Cities – the result of the global economy – all countries are inter-dependant. They are centers of manufacturing, distribution, investment banking, financial trading, and they are sources of coordination. Examples: New York, London, Tokyo
3. Patterns of City Growth

1. Concentric Circle Model – goes in circles, business district in center – every circle has an identity; farther away from the center of the city, there are less social problems
2. Sector Theory – Large cities made up of sectors – Business district is in the middle. There are low-rent and high-rent sectors
3. Multiple Nuclear Theory – Each center specializes in a certain area. Each sector provides different services by joining together
4. All of these theories have the same main idea – urbanization is linked to the population problem

1. Health Care in the USA and other MDC’s

1. Health Care is a valued resource
2. Consistent with the ideology of a country
3. Sweden, Great Britain, Canada, Germany, Japan – In Democratic Socialist countries the government provides universal health care to its citizens

1. All provide health care to everyone regardless of their income
2. Protect citizens from financial hardship
3. Encourages preventive health care

1. Sweden – Compulsory Comprehensive System of Health Care – it covers everyone no matter what their situation is
2. Canada

1. Single Payer, Universal Health Care – government funded – All expenses for permitted services are paid for by the government
2. Government pays hospital physicians and other employees, but some physicians operate privately
3. Federal Government sets fees annually
4. Not true socialized medicine
5. Some physicians practice outside the government system
6. Provides Health Care for everybody at a total cost 1/3 less than the USA
7. Canada spends 9% of its Gross Domestic Product (GDP) on Health Care while the USA spends 15% of its GDP on Health Care, yet the USA does not provide comprehensive health care to all its citizens
8. Strengths

1. Spend 9% of GDP on health care and everybody is covered
2. Quality health care to everyone at controlled costs
3. Encourages people to seek preventive medicine
4. No insurance companies are dictating what they should do
5. Health costs: Lower physician and hospital costs
6. Infant Mortality Rate is lower than in the USA

1. Weaknesses

1. Heavy taxation
2. A lot of delays – Example: Bad access to surgery – some people must wait several months for surgery

1. USA

1. Insurance companies lead the resistance against National Health Care
2. Americans are unwilling to pay higher taxes
3. The USA offers no comprehensive health care
4. Direct Fee System (Fee-for-Service)
5. The USA pays 40% of health care costs, while European countries pay 75% percent of health care costs
6. Inequality in Health Care
7. Private Insurance Program – 61% of Americans receive health care from employers while 35% have private coverage
8. Public Insurance Programs – Medicare, Medicaid, and Free Health Care for War Veterans. Medicare and Medicaid cover 33 million people
9. HMO – Health Maintenance Organization – managed care designed to guide the process of patients health care. They regulate doctors, patients, treatments, and organize payment plans. Big institutions manage all aspects of your health care. The original intent of HMO’s were to lower the cost of health care but in the last few years premiums have gone up. There is a fixed fee for comprehensive health care. Several weaknesses are:

1. Doctors have lost autonomy
2. Patients have fewer options

1. The High Cost of Health Care

1. Health Care costs are very high - $1 Billion spent annually on Health Care
2. 44% of Health Care costs are from hospitals
3. Lots of the best technology out there
4. Ambulatory care
5. Increased number of Specialists

1. Why has the cost increased so much?

1. Corporatization of Health Care – seen as a commodity for product-making. Medical-Industrial Complex – health care for profit
2. Defensive Medicine – give conceivable diagnostic tests to protect themselves from malpractice
3. Medicalization of Deviance – alcoholism and drug abuse are now treated as if they were medical problems

1. Unequal Access to Health Care; Class, Race (Medical Apartheid)