The Quality of Healthcare in the United States

Healthcare in the United States is modern and scientific. Physicians, clinics, and pharmaceutical companies seek the newest and most advanced treatments. Patients expect their doctors to use the most modern methods of diagnosis and treatment so that their symptoms can be identified and their illnesses treated quickly and effectively. Technology plays an important role in specialty care and in the diagnosis and treatment of illness.

The philosophy of U.S. healthcare emphasizes identifying physical symptoms, finding their causes, and treating them. Medical care in the United States is based on the idea that illness is a physiological condition. Historically, U.S. healthcare providers have not been trained to consider the relationships among mind, body, and spirit; healthcare in this country has, instead, focused on isolating problems and finding treatments for specific physical conditions. More recently, medical and nursing schools have begun to provide limited training on holistic health care. Some physicians, nurses, and other healthcare professionals now consider possible emotional causes for certain physical symptoms. The type of holistic approach to medicine often found in other parts of the world is not commonly available in the United States.

Hospital emergency rooms are reserved for critical medical emergencies. They are prepared to provide treatment for life-threatening and critical situations, such as uncontrolled bleeding, broken bones, high fevers, dehydration, unconsciousness, and seizures. If you seek care in a hospital emergency room for minor problems, you will probably have a long wait, impersonal care, and a large bill.

U.S. healthcare is very expensive. Healthcare costs, including hospital and clinic charges and doctors’ fees, are determined by market economics. Treatment is provided on a “fee for service” basis. Payment is often due when the service is rendered, using personal funds or previously-purchased medical insurance.

Medical insurance is essential in the United States. There is no universal national healthcare insurance plan in the country. Americans must arrange for their own medical insurance; most do so through their employers, or by purchasing private policies for themselves and their families.

No insurance plan covers every expense. Some types of treatment will be excluded from coverage (for instance, dental services, plastic surgery, eye prescriptions, etc.) and, even for expenses that are included, you will be expected to share the cost by paying a portion of the bill.

Questions:

1. What is the idea of holistic healthcare? Do you know any countries where this approach is adopted? What is your attitude to this approach?

2. Why could you be unsatisfied with the service provided at hospital emergency room if you seek help for minor health problems? Is the situation similar or different to that of Russia?

3. What healthcare expenses is a person to meet himself/ herself? Why do Americans need medical insurance? Does it cover all medical expenditures of a person?

4.25. a) Work with a partner and describe a usual visit to a doctor in a Russian clinic. b) Read the text and compare the Russian procedure with the one in the USA? What would strike a Russian as the most unusual thing to do while visiting an American doctor? c) How are medications sold in the USA? Compare it with the situation in Russia?

When you visit a doctor or clinic, the procedures may be unfamiliar to you. In the United States, doctors and other healthcare professionals value efficiency and thoroughness, often more than expressing personal concern. You may first be asked to provide information about yourself and your ability to pay for the services. You may meet with a nurse or physician’s assistant, who will probably take your temperature, blood pressure, weight, and other measurements; she or he will probably ask you many questions about the reason for your visit. In some cases, the nurse or physician’s assistant will conduct the examination and provide treatment.

If so, it is because your condition is a common one, the treatment routine, and the practitioner is fully trained to provide the appropriate care. Nurses, physicians, and other medical professionals will expect you to explain your symptoms and conditions objectively, even if you are uncomfortable or intimidated. Always give complete and detailed information. If you have questions about your condition, treatment, or medical options, ask the doctor or the nurse. They expect and value your interest and questions. It is common in the United States for patients to ask about the medical procedures, options, treatments, and cost of care, and to express preferences about which treatment and medications are prescribed.

Different countries have different laws about which medications may be sold without a doctor’s prescription. In the U.S., medications available without a prescription at pharmacies, supermarkets, and other retailers are called “over-the-counter” medications.

4.26. Work in a small group. Think of the idea of ‘being healthy’. What does it mean? The questions below will help you define this notion.

1. Are you a member of a health spa/ gym?
2. Do think that you need to lose weight? (Are you overweight?)
3. Is your diet healthy? What does it consist of?
4. Do you catch a cold more than once a year?
5. Do you have any bad habit (like drinking or smoking)?
6. Do you ever get headaches? Do you know anyone who suffers from migraine headaches?
7. Do you ever read magazines or news articles about health? If yes, what subject(s) do you find the most interesting?
8. Do you exercise? What kind of exercise do you do? How often do you exercise?
9. Do you go for regular medical check-ups? How often do you go to the doctor’s?
10. Do you go to the dentist’s twice a year?
11. Do you have a lot of stress? What is the usual cause of your stress? How do you reduce stress in your life?
12. Do you have any allergies?
13. Do you have any scars? How did you get them? Hoe do you feel about them?
14. Do you take medicine when you are sick?
15. Do you take vitamins or mineral supplements?
16. Do you think pets are good for a person’s health?
17. Do you think that the tobacco companies should be held reasonably responsible for a person’s addiction to nicotine?
18. Do you usually get enough sleep? Do you take any sleeping pills?
19. Have you ever been hospitalized? (Have you ever been in the hospital?)

4.27. Thomas Gray once said that ‘Health is heaven’s best treasure”. Everybody should be responsible for keeping this treasure, but we all should be kept responsible for keeping the treasure of national health. What do you think about this problem? Work in a small group, answer the questions below. Present your group’s opinion to class.

1. Who do you think is responsible for the care of your health - you yourself, your parents, or your doctor and medical people?

2. What do you think is the most serious health problem in Russia? What can

be done about it? Can this problem be solved within the national program on

healthcare which is under way at the moment?

3. What do you think of the health service in this country? What is it like? How

can it be improved?

4. If you had enough authority, what would you do to improve Russians’ health?

5. What do you think about abortion?

6. What do you think of cosmetic surgery? Do you know anyone who has had cosmetic surgery? Would you ever consider having cosmetic surgery?

7. Would you consider donating your organs after your death?

8. Do you think nuclear power is safe?

9. What kind of pollution is the riskiest?

10. How could you comment these words of Henry Louis Mencken about health: “Simply a state in which the individual happens to be perfectly adapted to his environment. Obviously such states cannot be common, for the environment is in constant flux.” Does it mean that we cannot speak about the health of nation?

11) What do you know about the SARS virus or AIDS? Is our society treating these and other plagues adequately?

12) What do you think about vaccination? Can it help in treating diseases?

	4.28. a) What is alternative medicine? Have you ever turned to alternative therapies? b) Read the descriptions of various kinds of alternative therapies and answer the questions below. Do you know any other alternative therapies?

Iridologists examine the eye for irritation or deposits in nerve fibres, which they say correspond to inflammation or infection in the body. They also claim to detect inherent weaknesses, and can discover whether a person has a predisposition for certain illnesses.

Aromatherapy uses essential oils from plants, which are diluted with carrier oil before being rubbed into the skin. Different plants are supposed to have different healing properties. Like other massages, it’s soothing, pleasant and relaxing.

Homeopathy is based on the principle of using the similar or the like to treat the like. A German doctor, Samuel Hahnemann, found that using substances at extreme dilutions and shaking them violently produced a correspondingly more powerful effect. This process of potentizing (= enhancing)has become the key feature of homeopathy.

In acupuncture, needles are inserted at an acupuncture point, then aligned with energy pathways called ‘meridians’, which connect internal organs with points along the body’s surface. The needles are rotated clockwise or counterclockwise, according to whether energy is to be stimulated or damped down.

Questions:

1. What makes those various treatments different from more conventional medicine? What treatment could be offered in their place?

2. Choose one alternative therapy which you find particularly interesting. Make a list of the reasons why you would or would not want to try it, then discuss your reasons with a partner.

4.29. Read the text and be ready to hold a Q&A session: ask each other questions and answer them basing on the text or your personal knowledge of acupuncture. Have you ever turned to this therapy?