US Healthcare Systems

Book
The United States Health Care System: Combining Business,
Health, and Delivery
Third Edition
Austin, Anne and Wetle, Victoria
2017.0 Pearson
Healthcare Workforce
Q.1 What do you see as the biggest workforce challenge(s) for
hospitals today? Are the issues any different for other types of
healthcare organizations? What strategies are being used by
hospitals for recruiting and retaining staff?
Government Programs
Q.2 What are the roles of government-sponsored healthcare
programs such as Medicare, Medicaid, Veterans Affairs (VA),
Indian Health Services (IHS), and Prison Health Services? How
do they impact access, cost, and quality? Do these government
programs do a good job of meeting the healthcare needs of the
populations they are intended to serve?
Q.3 Write reply for below articles.
Professor and classmates, the roles of the government sponsored
healthcare programs is to ensure that more than $500 billion
invested annually in these programs is used wisely to reduce the
burden of illness, injury and disability and to improve the
health and functioning of the population. Their role is to also
make sure that access to all these programs is available for the
entire US in a low cost while offering high quality care. The
government controls the prices through negotiation and
regulation, it lowers administrative costs and forces hospitals
and doctors to provide the same standard of service at a low
cost. I believe that the government’s role is one that is changing
over time due to it focusing on patient centered care. It
basically means that access, cost and quality is respectful and

responsive to individual patient preferences, needs and values.
Its funding changes as the needs of patients care changes. We
see that now money might be saved by telemedicine starting to
become more and more popular. Before you would need to take
your parent or a senior person to the doctor for a check up for
example, but now you can do a virtual visit over the computer if
it isn't something urgent and thus it saves more money than
having to go into the clinic, it also reduces exposure to other
people who might be sick if they go into the clinic.
Q.4 Write reply for the below articles.
What are the roles of government-sponsored healthcare
programs such as Medicare, Medicaid, Veterans Affairs (VA),
Indian Health Services (IHS), and Prison Health Services? How
do they impact access, cost, and quality? Do these government
programs do a good job of meeting the healthcare needs of the
populations they are intended to serve?
The government sponsored health care programs such as
Medicare, medicaid, Veteran's Affairs ,Indian health services all
of the health care services to provide the health care services to
injury, accident, illness ,disability and to improve the
population of reputed country with a healthy population.
This services provides the health services by the paying the
insurance policy from patients, the patient this provides the
health to one third American's. The government has a invested
annually to this program.
The federal government drives the strongest leader ship
positions to provide the safety and quality of health care
services., beneficial to 100 millions of population are benefits
of health care services .
The leadership is resulting the provides the safety and quality
health care services.
The major roles if government sponsored health services are:
1. To provides health services to all part of country and to make
the disease free country.
2. To market this health services in people who are long so far
from medical services and those who have didn't any medical

services.
3. Provides long term health insurance policy by paying a
suitable premium, and provides medical insurance to the
patients.
4. Run the Health care programs in villages such as health
education, campus, vaccinations, check up of some diseases
from a campus process.
5. To motivate the peoples about health and guide the people's
for any specific diseases in society for it's precautions,
symptoms, treatment etc.
6. To organized the health campus for seniors and disabled
persons who have deformity in any part of body and advice for
treatment .
7. Women's and children's campus are organized for cure a some
types of diseases and provide the information about nutrition,
vitamins and minerals .
8. Promotion of health and public policy .
These services access their services by providing the health care
services to regulation of public health by promoting health.
They offered the medical policies from a paying facilities to the
customers.
Quality of these services is meet to high, assuring the limits of
all health care service provider regulations act, and depends
working facilities on the proper situations.
These government programs do a good job of meeting the health
care needs of the population by providing the quality, assured,
proper, beneficiary health services to all types and populations.
https://www.homeworklib.com/question/1247585/what-are-the-
roles-of-government-sponsored
B
ook

Third Edition
2017.0 Pearson
Q.1
What do you see as the biggest workforce challenge(s) for
hospitals today? Are the issues
any different for other types of healthcare organizations? What
strategies are being used by
hospitals for recruiting and retaining
staff?
Government
Programs
Q.2
What are the roles of government
-
sponsored healthcare programs such as Medicare,
Medicaid, Veterans Affairs (VA), Indian Health Services (IHS),
and Prison Health
Services?
How do they impact access, cost, and

quality? Do these government programs do a
good job of meeting the healthcare needs of the populations
they are intended to serve?
Q.3 Write reply for
below articles
.
healthcare programs is to
ensure
that more than $500 billion invested annually in these programs
is used wisely to reduce the
health and functioning of the
population. Their role is to also make sure that access to all th
ese programs
is
available for the
government controls the prices
through negotiation and regulation, it lowers administrative
costs and forces hospitals and
doctors to provide the same standard of service at a
low cost. I believe that the
government’s
role
is one that is changing over time due to it focusing on patient
centered care. It basically means
that access, cost and quality is respectful and responsive to
individual patient preferences, needs
and values

. Its funding changes as the needs of patients care changes. We
see that now money
might be saved by telemedicine starting to become more and
more popular. Before you would
need to take your parent or a senior person to the doctor for a
check up for exampl
e, but now you
can do a virtual visit over the computer if it isn't something
urgent and thus it saves more money
than having to go into the clinic, it also reduces exposure to
other people who might be sick if
they go into the clinic.
Q.4 Write reply for
the below
articles
.
What are the roles of government
-
sponsored healthcare programs such as Medicare, Medicaid,
Veterans Affairs (VA), Indian Health Services (IHS), and Prison
Health Services?
How do they
impact access, cost, and quality? Do these governme
nt programs do a good job of meeting the
healthcare needs of the populations they are intended to serve?
Medicare, medicaid, Veteran's Affairs
,Indian health services all of the health care services to
provide the health care services to injury,
accident, illness ,disability and to improve the population of

reputed country with a healthy
population.
Book
Third Edition
2017.0 Pearson
Q.1 What do you see as the biggest workforce challenge(s) for
hospitals today? Are the issues
any different for other types of healthcare organizations? What
strategies are being used by
hospitals for recruiting and retaining staff?
Government Programs
Q.2 What are the roles of government-sponsored healthcare
programs such as Medicare,
Medicaid, Veterans Affairs (VA), Indian Health Services (IHS),
and Prison Health
Services? How do they impact access, cost, and quality? Do
these government programs do a
good job of meeting the healthcare needs of the populati ons
they are intended to serve?
Q.3 Write reply for below articles.
healthcare programs is to ensure
that more than $500 billion invested annually in these programs
is used wisely to reduce the
health and functioning of the
population. Their role is to also make sure that access to all
these programs is available for the

government controls the prices
through negotiation and regulation, it lowers administrative
costs and forces hospitals and
doctors to provide the same standard of service at a low cost. I
believe that the government’s role
is one that is changing over time due to it focusing on patient
centered care. It basically means
that access, cost and quality is respectful and responsive to
individual patient preferences, needs
and values. Its funding changes as the needs of patients care
changes. We see that now money
might be saved by telemedicine starting to become more and
more popular. Before you would
need to take your parent or a senior person to the doctor for a
check up for example, but now you
can do a virtual visit over the computer if it isn't something
urgent and thus it saves more money
than having to go into the clinic, it also reduces exposure to
other people who might be sick if
they go into the clinic.
Q.4 Write reply for the below articles.
What are the roles of government-sponsored healthcare
programs such as Medicare, Medicaid,
Veterans Affairs (VA), Indian Health Services (IHS), and Prison
Health Services? How do they
impact access, cost, and quality? Do these government programs
do a good job of meeting the
healthcare needs of the populations they are intended to serve?
Medicare, medicaid, Veteran's Affairs
,Indian health services all of the health care services to provide
the health care services to injury,
accident, illness ,disability and to improve the population of
reputed country with a healthy
population.

Theoretical Approaches to Human Service Work
Chapter Four
Learning Objectives (slide 1 of 2)
LO 1: Understand the differences between a person who
conducts counseling versus one who conducts psychotherapy
LO 2: Learn the important place that theory plays in the
development of a manner in which to practice counseling
LO 3: Understand how one’s view of human nature is the floor
plan to the development of and use of one’s theory
LO 4: Gain knowledge about four major conceptual
orientations, the theories that accompany them, and how they
impact the work of the human service professional
LO 5: Learn the stages that a person goes through in developing
an integrative or eclectic approach to helping
©2017 Cengage Learning
‹#›
LO 6: Examine how the ethical and professional issues of
confidentiality, dual and multiple relationships, and supervision
are critical to the helping relationship
LO 7:Embrace the importance of adhering to a counseling
theory yet being flexible enough to adapt and change that theory
over one’s career
‹#›
Counseling or Psychotherapy?CounselingPsychotherapyShort
term
Surface Issues

Here and now
Conscious
Focused IssuesLong term
Deep-seated issues
There and then
Unconscious
Life stories
In truth, texts do not draw a stark distinction between
“counseling” and “psychotherapy.”
‹#›
4
Why Have a Theory?
It is heuristic - researchable and testable
Provides a comprehensive system of doing counseling
Helps us to understand our clients and decide which techniques
to apply
Help us to predict change
Theories undergo continuous revision as research allows us
better understanding
‹#›
5
Views of Human Nature
Views of human nature drive one’s theory. Most theories can be
placed into 4 conceptual orientations: psychodynamic,
cognitive-behavioral, existential-humanistic, and postmodern.
Each orientation has a different view of human nature.

Everyone develops a view of human nature based on personal
beliefs.
Developing a view of human nature is understanding why
people do the things they do.
What is the impact of early child-rearing on personality
development?
What is the impact of instincts, genetics, and social forces on
personality development?
Is a person born good, bad, or neutral?
What are your own religious beliefs about the nature of a
person?
Do you believe people can change? Can a person choose their
circumstances?
Do you belief that life is predetermined?
Do you believe in the unconscious?
Do Activity 4.1 to determine your view of human nature
‹#›
6
Conceptual Orientation 1 —
The Psychodynamic Approach (slide 1 of 2)
Common themes in the View of Human Nature of
Psychodynamic Approaches
A person is affected by both his or her conscious and
unconscious.
Early child rearing is important in developing personality.
Interacting with the past is an important part of the therapeutic
process.
Three popular approaches:

Psychoanalysis: Freud, instincts are strong motivators. Early
child-rearing practices are applied through the oral, anal, and
phallic psychosexual stages. We develop defense mechanisms to
manage our instincts.
Analytical psychology: Jung. The major goal is to help a person
become whole. We have psychological types: sensation-
intuition; thinking-feeling; extroverted introverted. Is the
foundational theory of the Myers-Briggs Type Indicator. We
have a conscious, personal unconscious, and collective
unconscious that stores our archetypes.
Do Activity 4.2 to determine your “psychological type”
‹#›
7
The Psychodynamic Approach (slide 2 of 2)
Three popular approaches (Cont’d) :
Individual psychology: Adler, early childhood experiences and
memories build personality. We all experience feelings of
inferiority. How we deal with those feelings lead us to adaptive
of or maladaptive behaviors. More optimistic than other
psychodynamic theories.
More recent theories are based on the same basic premises—
(e.g., Neo-Freudians such as Object Relations theorists and Erik
Erikson)
Human services professional’s use the psychodynamic
approach?
Although HS students don’t do psychoanalysis, it can offer them

a conceptual framework for understanding deep-seated problems
This knowledge helps the HS professional have empathy for
individuals who, in the past, may have seen “evil,” misguided,
or “bad.”
Also helps us understand “transference,” and
“countertransference”
‹#›
8
The Existential-Humanistic Approach (slide 1 of 2)
Common themes in the View of Human Nature of Existential-
Humanistic Approaches
Antideterministic and more focused on conscious behavior
Phenomenological perspective : stresses the subjective reality of
the client
Optimistic—people can change
Inborn tendency to self-actualize
Maslow’s hierarchy of needs
Existential Therapy (Frankl, May)
The world has no inherent meaning or purpose; each person
creates it for themselves
All have the ability to live authentically and experience fully
Anxiety, feeling dread, and struggles in life are a natural part of
living
We can choose to find meaningfulness in our lives
‹#›

9
The Existential-Humanistic Approach (slide 2 of 2)
Person-Centered Counseling (Rogers)
Born with inborn tendency to actualize
However, tendency is sometimes thwarted by significant others
who want us to be something other than what we are but
conditions of worth lead to anxiety
Empathy, unconditional positive regard, and congruence by
helper helps client understand real self
Gestalt theory (Perls)
Born with capacity to embrace infinite number of personality
dimensions
Mind, body, and soul operate in unison
Parental dictates, social mores, and peer norms can prevent a
person from attaining a need and result in resistances or
blockages of experience
Goal: to understand our blacked experiences: experience =
awareness = reality
Human services professional’s use the existential-humanistic
approach
Gives us key relationship skills to work with clients (UPR,
Empathy, Congruence)
Gives us a model for what to work on (e.g., Maslow)
Normalizes many problems—struggles are part of life
‹#›
10

The Cognitive-Behavioral Approach (slide 1 of 2)
Common themes in the View of Human Nature of Cognitive-
Behavioral Approaches
Conditioning:
Classical conditioning (Pavlov)
Operant conditioning (Skinner)
Social learning (Modeling—Bandura)
More recently—cognitive perspective has been included
Assumptions that underlie this approach—Read 9 assumptions
on pp. 81-82
Behavior Therapy
Classical conditioning, operant conditioning, and modeling can
change person
Hundreds of techniques: e.g., positive reinforcement, token
economies, relaxation exercises, many more!
Rational Emotive Behavior Therapy (REBT) (Ellis)
Born with potential for rational or irrational thinking
Belief about activating event yields consequence
Irrational beliefs yields negative consequences
Change irrational beliefs to rational beliefs through cognitions
and behaviors
‹#›
11
The Cognitive-Behavioral Approach (slide 2 of 2)
Cognitive Therapy (Beck)
Born with predisposition to certain ways of living (genetics,
environment, interaction)
Core beliefs (embedded) yield automatic thoughts

Change automatic thoughts then core beliefs, and you change
person
Reality Therapy (Glasser)
Five needs: survival, love and belonging, power, freedom, and
fun
Quality world contains pictures in our mind of people, things,
and beliefs most important to meeting our needs
Choices we make based on these pictures can be bad or good
Caring, nonblaming language reflects positive choices, negative
blaming language reflects poor choices
Can reevaluate behaviors, thoughts, feelings and physiology and
make new choices
Human services professional’s use the existential-humanistic
approach
Many behavioral techniques used in wide range of setting by HS
professionals
Cognitive techniques help us understand how our clients
react…but we don’t tend to do “cognitive therapy”
‹#›
12
The Postmodern Approach (slide 1 of 2)
Common themes in the View of Human Nature of Postmodern
helpers
Question scientific methods and belief that there is one correct
answer
Belief in social constructionism (we construct our reality)

Language passed down through culture and society deeply
impacts the person
Oppressed people particularly impacted through the language
used in society
Narrative therapy (White)
Reality socially constructed through the power of language
We develop problem-saturated stories or narratives
Be humble, listen, and deconstruct stories and construct new
positive stories
Solution
-focused brief therapy (de Shazer & Berg)
Pathology, not inherent within people
No objective reality (don’t look “inside” person to find
problem)
Focus on finding solutions to quickly (less than 6 sessions)
Miracle question: Suppose that one night while you were asleep,
there was a miracle and the problem was solved. How would
you know? What would be different?
‹#›

13
The Postmodern Approach (slide 2 of 2)
Gender Aware Approaches
Feminist therapy and men’s issues therapy
Gender central to the helping relationships
Problems viewed as related to societal context
Collaborative and equal relationship and at one’s sex-role
identity and perceptions of self
Human services professional’s use a postmodern approach?
HSP tend to be collaborative with clients and do not use their
“power” to oppress clients
Focus on advocacy and social justice (HSP believe that societal
issues negatively impact many of their clients)
‹#›
14
Other Conceptual Approaches
Other approaches include:

EMDR (Eye Movement Desensitization Therapy)
Complementary and alternative approaches
Motivational interviewing
Positive psychology www.positivityratio.com/single.php
Brief approaches to counseling (see Comparison of Brief and
Long-term, Fact sheet 4.2, p. 86)
‹#›
15
Eclecticism or Integrative Approaches to Counseling
Drawing on a number of different orientations to develop your
own theory
First, develop your own view of human nature
Then, develop your personal technique
Chaos stage: haphazard combination of different approaches
Coalescence stage: drift toward one particular approach that
attracts you
Multiplicity: thorough knowledge of one approach and learning
others to work out what works for a particular client
Development of metatheory: what beliefs underlie everything
you do

‹#›
16
Ethical, Professional, and Legal Issues
The Importance of Supervision
What is it?
Characteristics of a good supervisor?
Supervision should be ongoing
Good supervision helps us evaluate ourselves and our skills
Confidentiality and the Helping Relationship
Read vignette, bottom of p. 88
When to break confidentiality and when to not break
confidentiality (read p. 89)
Confidentiality—an ethical guideline, not a legal one
Difference between privileged communication and
confidentially?
Dual or Multiple Relationships
When is it all right to have a client who is a friend, relative,
lover?

Read from NOHS ethics standards, p. 90
‹#›
17
Are You an Effective Human Services Professional?
Yes, if you
Have reflected on a variety of approaches and made a
commitment to one approach.
Never stop exploring and adapting.
Are dedicated to personal and professional growth.
‹#›
18
Summary
Contrast between counseling and psychotherapy

Creating a view of human nature
Four conceptual orientations
Psychodynamic approach
Existential-humanistic approach
Cognitive-behavioral approach
Postmodern approach
Other popular approaches
Integrating and developing your own approach
Ethical issues
Confidentiality
Supervision
Dual relationships
Personal commitment
‹#›
19
Standards in the Profession: Skill Standards,
Credentialing, Program Accreditation,
and Ethical Standards

Chapter Three
LO 1: Understand the importance that Skill Standards have in
producing positive client outcomes
LO 2: Understand the different types of credentialing, identify
the importance of credentials, and specify credentials in the
human service and related fields
LO 3: Understand the process of program accreditation and
appreciate why accreditation can lead to more effective human
service professionals
LO 4: Explore the development of ethical codes and understand
their importance when working with the public
‹#›
LO 5: Become familiar with different ethical decision-making
models in order to be effective in this sometimes complex
decision-making process
LO 6: Embrace the notion of lifelong learning and being
competent as noted in the NOHS ethical code

LO 7: Understand the importance of actively supporting
standards such as program Skill Standards, credentialing,
accreditation, and ethical standards
‹#›
Skill Standards
12 competency areas (see Activity 3.1)
Participant empowerment
Communication
Assessment
Community and service networking
Facilitation of services
Community and living skills and supports
Education, training, and self-development
Advocacy
Vocational education and career support
Crisis intervention
Organizational participation
Documentation
‹#›

4
Credentialing (slide 1 of 7)
Credentialing has many benefits for both the consumer and
helper
Credentialing delimits the field
Credentialing identifies competence
Credentialing increases professionalism
Credentialing leads to parity
Credentialing offers protection of the public
The two most common types of credentials are certification and
licensure
‹#›
Certification
Formal recognition that an individual has met predetermined
standards of professionalism
Attests to competence, but does not define the scope or practice
of a professional

Often requires a fee to maintain
May require continuing education to maintain
‹#›
6
Licensure
Generally regulated by the states
In mental health, may involve becoming an LPC, an LCSW, a
doctorate in psychology (licensed psychologist) or a medical
degree (licensed physician and/or board-certified psychiatrist)
Can define the scope of professional responsibilities
Makes it easier to obtain third-party (insurance) reimbursement
Requirements for licensure may vary from state to state
‹#›
7

Credentialing in the Human Services
2008 – Center for Credentialing and Education (CCE), with
NOHS and CSHSE, developed the Human Service – Board
Certified Practitioner (HS-BCP) credential
Certification can be earned by anyone with an associate’s,
bachelor’s, or master’s degree
The post-educational requirements differ based on the degree
(See Table 3.1)
After passing the exam, those with the HS-BCP must earn 60
hours of continuing education every 5 years
‹#›
8
Selected Credentials in Related Helping Professions
Substance abuse counselor and other state credentials
Master Addiction Counselor (MAC)
Administered by the National Board for Certified Counselors
(NBCC)

Credentialing for a master’s degree in counseling
Certified or licensed school counselor
Certified Rehabilitation Counselor (CRC)
Licensed Professional Counselor (LPC)
National Certified Counselor (NCC)
Certified Family Therapist (CFT)
Licensed Marriage and Family Therapist (LMFT)
‹#›
9
Credentialing for a master’s degree in social work
Academy of Certified Social Workers (ACSW)
Qualified Clinical Social Worker (QCSW)
Diplomate in Clinical Social Work (DCSW)
Licensed Clinical Social Worker (LCSW)
Credentialing as a school psychologist and as a counseling or
clinical psychologist

Different state requirements to become a licensed psychologist
Some states authorize prescription privileges for people with
this license
‹#›
10
Credentialing as a psychiatrist
Earns a medical degree (MD) and is a licensed physician
Can become board certified in psychiatry
Credentialing as a psychiatric-mental health nurse
Psychiatric mental health nurse
Basic
Advanced
Advanced Practice Registered Nurse (APRN)

‹#›
11
Program Accreditation
Accreditation is a rigorous process that involves a self-study, a
visit from an accreditation team, and recommendations to the
board of directors of the accrediting body
Benefits to students and programs (see pp. 56-57)
Accreditation in HS began in 1979 and there are currently about
45 programs with full accreditation
Movements are being made to get more accredited programs
through CSHSE
‹#›
12
Ethical Standards (slide 1 of 2)
The Development of Ethical Codes
First began in the mid 20th century with the APA code of ethics

(1953)
Purposes of the ethical code:
Protect consumers and further professional standing of the
organization
Making a statement about maturity and identity of the
profession
Guiding professionals toward behaviors and actions that reflect
underlying professional values
Offering a framework for the sometimes difficult ethical
decision-making process
Serving as a measure of defense if the professional is sued for
malpractice
‹#›
13
Ethical Standards (slide 2 of 2)
The Development of Ethical Codes
Drawbacks of the ethical code:
Does not address some issues and offers no clear way of
responding to other issues

Periodically has conflicts within the same code, between two
related codes, between the code and the law, or between the
code and a helper’s value system
Sometimes difficult to enforce code violations
Does not include the public in code construction and does not
always take public’s interest into account
Has a difficult time keeping up with and addressing “cutting
edge” issues
‹#›
14
Ethical Decision Making (slide 1 of 3)
Problem-Solving Model (Corey, et al. (2015)
Identify problem or dilemma
Identify potential issues involved
Review relevant ethical guidelines
Know applicable laws and regulations
Obtain consultation
Consider possible and probably courses of action
Enumerate consequences of various decisions
Decide on the best course of action

‹#›
15
Principle and Virtue Ethics Model (Kitchener)
Autonomy protects independence, self-determination, and
freedom of choice for clients
Nonmaleficence is the concept of “do no harm”
Beneficence relates to the promoting the good of society
Justice involves equal and fair treatment to all clients
Fidelity is related to maintaining trust and being committe d to
clients
Veracity being truthful and genuine with the client within the
counseling relationship
‹#›

16
Developmental Models (Kohlberg; Perry; Kagen)
Lower-level helpers
Dualism – black and white thinking; concreteness; rigidity;
oversimplification; stereotyping; self-protectiveness;
authoritarianism
Higher-level helpers
Relativism (commitment in relativism) – more complex
thinking; open to differing opinions; flexible; empathetic;
sensitive to the context of an ethical dilemma; nondogmatic
‹#›
17
Ethical, Professional, and Legal Issues:
Competence and Qualifications as a Professional
A human service professional must maintain competence and
have a thirst for ongoing knowledge

Lifelong learning is essential
Be a member of professional associations
Subscribe to and read professional journals
Attend workshops and participate in continuing education
Obtain appropriate credentials
‹#›
18
The Effective Human Service Professional: Professionally
Committed, Ethically Assured
Commitment to growth and competence must be real, not just
lip service
Just know ethical guidelines and commit self to ethical
behaviors
Supports standards of accreditation, credentialing, and Skill
Standards
‹#›

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