Health care or healthcare is the treatment and prevention of illness Illness is a state of poor health. Illness is sometimes considered a synonym for disease. Others maintain that fine distinctions exist. Some have described illness as the subjective perception by a patient of an objectively defined disease. Health care is delivered by professionals in medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions, dentistry Dentistry, which is a part of stomatology, is the branch of medicine that is involved in the evaluation, diagnosis, prevention, and surgical or non-surgical treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely, nursing Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from birth to death, pharmacy Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs. The word derives from the Greek φάρμακον , "drug, medicine" (the earliest form of the word is the Mycenaean Greek pa-ma-ko, attested in Linear B syllabic and allied health Allied health professions are clinical and administrative health care professions distinct from medicine, dentistry, and nursing. Allied health professionals make up 60 percent of the total health workforce. They work in health care teams to make the healthcare system function by providing a range of diagnostic, technical, therapeutic and direct.

The social and political issue of access to healthcare in the US 62% of all personal bankruptcies in the United States were medical. Medical impoverishment is almost unheard of in wealthy countries other than the US. The United States spends a greater portion of total yearly income in the nation on health care than any United Nations member state except for East Timor , although the actual use of health care has led to public debate and confusing use of terms such as health care (medical management of illness), health insurance Health insurance, like other forms of insurance, is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may (reimbursement of health care costs), and the public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The (the collective state and range of health in a population). The term health care industry is not often used as described in this lemma, outside the USA.

Health care industry

The delivery of modern health care depends on an expanding group of trained professionals The word professional traditionally means a person who has obtained a degree in a professional field. The term professional is used more generally to denote a white collar working person, or a person who performs commercially in a field typically reserved for hobbyists or amateurs coming together as an interdisciplinary team An interdisciplinary field is a field of study that crosses traditional boundaries between academic disciplines or schools of thought, as new needs and professions have emerged.^[1][2]

The health-care industry Industry refers to the production of an economic good within an economy. There are four key industrial economic sectors: the primary sector, largely raw material extraction industries such as mining and farming; the secondary sector, involving refining, construction, and manufacturing; the tertiary sector, which deals with services (such as law incorporates several sectors that are dedicated to providing services and products dedicated to improving the health of individuals. According to market classifications of industry such as the Global Industry Classification Standard The Global Industry Classification Standard is an industry taxonomy developed by Morgan Stanley Capital International (MSCI), and Standard & Poor's (S&P) for use by the global financial community. The GICS structure consists of 10 sectors, 24 industry groups, 68 industries and 154 sub-industries into which S&P has categorized all major and the Industry Classification Benchmark The Industry Classification Benchmark is a company classification system developed by Dow Jones and FTSE. It is used to segregate markets into sectors within the macroeconomy. The ICB uses a system of 10 industries, partitioned into 19 supersectors, which are further divided into 41 sectors, which then contain 114 subsectors the health-care industry includes health care equipment & services and pharmaceuticals, biotechnology Biotechnology is a field of applied biology that involves the use of living things in engineering, technology, medicine, and other useful applications. Modern use similar term includes genetic engineering as well as cell- and tissue culture technologies. The concept encompasses a wide range of procedures for modifying living organisms according to & life sciences. The particular sectors associated with these groups are: biotechnology, diagnostic substances, drug delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic laboratories, nursing homes, providers of health care plans and home health care.^[3]

According to government classifications of Industry, which are mostly based on the United Nations system, the International Standard Industrial Classification The International Standard Industrial Classification of All Economic Activities is a United Nations system for classifying economic data. The United Nations Statistics Division describes it in the following terms:, health care generally consists of hospital activities, medical and dental practice activities, and other human health activities. The last class consists of all activities for human health not performed by hospitals or by physicians or dentists. This involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratiories, pathology clinics, ambulance, nursing home, or other para-medical practitioners in the field of optometry, hydrotherapy, medical massage, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc.^[4]

Research

Top impact factor The impact factor, often abbreviated IF, is a measure reflecting the average number of citations to articles published in science and social science journals. It is frequently used as a proxy for the relative importance of a journal within its field, with journals with higher impact factors deemed to be more important than those with lower ones academic journals An academic journal is a peer-reviewed periodical in which scholarship relating to a particular academic discipline is published. Academic journals serve as forums for the introduction and presentation for scrutiny of new research, and the critique of existing research. Content typically takes the form of articles presenting original research, in the health care field include Health Affairs Health Affairs is a peer-reviewed health care policy academic journal founded in 1981. The journal has 10,000 domestic and international subscribers and is highly influential in the field; the Washington Post has described it as "the bible of health policy". According to the journal's homepage, it "is consulted by 55% of staff and Milbank Quarterly The Milbank Quarterly is a peer-reviewed journal for the health care sector. It is published four times per year by Wiley-Blackwell and the Milbank Memorial Fund, an endowed national foundation funded by Elizabeth Milbank Anderson that supports research of issues related to health policy. All articles since 1997 are available online via the. The New England Journal of Medicine The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is the oldest continuously published medical journal in the world, and is the most widely read, cited, and influential general medical periodical in the world, British Medical Journal BMJ is a partially open access medical journal. It is among the most influential and widely read peer-reviewed general scientific journals in the field of medicine in the world, and the Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world are more general journals.

Biomedical research Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are (or experimental medicine Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are), in general simply known as medical research Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are, is the basic research Basic research or fundamental research is research carried out to increase understanding of fundamental principles. Many times the end results have no direct or immediate commercial benefits: basic research can be thought of as arising out of curiosity. However, in the long term it is the basis for many commercial products and applied research, applied research Applied research is research that is applied, accessing and using some part of the research communities' accumulated theories, knowledge, methods, and techniques, for a specific, often state, commercial, or client driven purpose. Applied research is often opposed to pure research in debates about research ideals, programs, and projects, or translational research Translational research is another term for translative research and translational science, although it fails to disambiguate itself from forms of research that are not scientific , which are currently considered outside its scope. Translational research is a way of thinking about and conducting scientific research to make the results of research conducted to aid the body of knowledge in the field of medicine Medicine is the science and art of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are termed clinical trials Clinical Trials are conducted to allow safety and efficacy data to be collected for health interventions . These trials can take place only after satisfactory information has been gathered on the quality of the non-clinical safety, and Health Authority/Ethics Committee approval is granted in the country where the trial is taking place, and all other research that contributes to the development of new treatments. The latter is termed preclinical research Pre-clinical development is a stage of research that begins before clinical trials can begin, and during which important feasibility, iterative testing and safety (also known as Good Laboratory Practice or "GLP") data is collected if its goal is specifically to elaborate knowledge for the development of new therapeutic strategies. A new paradigm to biomedical research is being termed translational research Translational research is another term for translative research and translational science, although it fails to disambiguate itself from forms of research that are not scientific , which are currently considered outside its scope. Translational research is a way of thinking about and conducting scientific research to make the results of research, which focuses on iterative feedback loops between the basic and clinical research domains to accelerate knowledge translation from the bedside to the bench, and back again.

In terms of pharmaceutical R&D spending, Europe Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally divided from Asia to its east by the water divide of the Ural Mountains, the Ural River, the Caspian Sea, the Caucasus region (Specification of borders) and the Black Sea to the southeast. Europe is bordered by the spends a little less that the United States (€22.50bn compared to €27.05bn in 2006) and there is less growth in European R&D spending.^[5][6] Pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States.^[6][7] However, the United States dominates the biopharmaceutical Biopharmaceuticals are medical drugs produced using biotechnology. They are proteins (including antibodies), nucleic acids (DNA, RNA or antisense oligonucleotides) used for therapeutic or in vivo diagnostic purposes, and are produced by means other than direct extraction from a native (non-engineered) biological source field, accounting for the three quarters of the world’s biotechnology revenues and 80% of world R&D spending in biotechnology.^[5][6]

World Health Organization

The World Health Organization The World Health Organization is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the (WHO) is a specialized United Nations The United Nations Organization or simply United Nations (UN) is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and the achieving of world peace. The UN was founded in 1945 after World War II to replace the League of agency which acts as a coordinator and researcher for public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The around the world. Established on 7 April 1948, and headquartered in Geneva Geneva (Arpitan: Genèva, IPA: [ˈd͡zənɛva]; French: Genève, IPA: [ʒənɛv]; German: Genf, IPA: [ˈɡɛnf] ; Italian: Ginevra; Romansh: Genevra) is the second-most-populous city in Switzerland (after Zürich) and is the most populous city of Romandie (the French-speaking part of Switzerland). Situated where the Rhône River exits Lake Geneva (, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the League of Nations The League of Nations was an inter-governmental organization founded as a result of the Treaty of Versailles in 1919–1920, and the precursor to the United Nations. At its greatest extent from 28 September 1934 to 23 February 1935, it had 58 members. The League's primary goals, as stated in its Covenant, included preventing war through collective. The WHO's constitution states that its mission "is the attainment by all peoples of the highest possible level of health." Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the peoples of the world. Examples of its work include years of fighting smallpox Smallpox is an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning spotted, or varus, meaning "pimple". The term "smallpox" was first used in Europe. In 1979 the WHO declared that the disease had been eradicated - the first disease in history to be completely eliminated by deliberate human design. The WHO is nearing success in developing vaccines against malaria Malaria is a mosquito-borne infectious disease caused by a eukaryotic protist of the genus Plasmodium. It is widespread in tropical and subtropical regions, including parts of the Americas , Asia, and Africa. Each year, there are approximately 350–500 million cases of malaria, killing between one and three million people, the majority of whom and schistosomiasis and aims to eradicate polio within the next few years. The organization has already endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe from October 3, 2006, making it an international standard.^[8]

The WHO is financed by contributions from member states and from donors. In recent years the WHO's work has involved more collaboration, currently around 80 such partnerships, with NGOs and the pharmaceutical industry, as well as with foundations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. Voluntary contributions to the WHO from national and local governments, foundations and NGOs, other UN organizations, and the private sector (including pharmaceutical companies), now exceed that of assessed contributions (dues) from its 193 member nations.^[9]

Economics

Health economics is a branch of economics concerned with issues related to scarcity in the allocation of health and health care. Broadly, health economists study the functioning of the health care system and the private and social causes of health-affecting behaviors such as smoking.

A seminal 1963 article by Kenneth Arrow, often credited with giving rise to the health economics as a discipline, drew conceptual distinctions between health and other goals.^[10] Factors that distinguish health economics from other areas include extensive government intervention, intractable uncertainty in several dimensions, asymmetric information, and externalities.^[11] Governments tend to regulate the health care industry heavily and also tend to be the largest payer within the market. Uncertainty is intrinsic to health, both in patient outcomes and financial concerns. The knowledge gap that exists between a physician and a patient can prevent the patient from accurately describing his symptoms or enable the physician to prescribe unnecessary but profitable services; these imbalances lead to market failures resulting from asymmetric information. Externalities arise frequently when considering health and health care, notably in the context of infectious disease. For example, making an effort to avoid catching a cold, or practicing safer sex, affects people other than the decision maker.

The scope of health economics is neatly encapsulated by Alan William's "plumbing diagram"^[12] dividing the discipline into eight distinct topics:

• What influences health? (other than health care)
• What is health and what is its value
• The demand for health care
• The supply of health care
• Micro-economic evaluation at treatment level
• Market equilibrium
• Evaluation at whole system level; and,
• Planning, budgeting and monitoring mechanisms.

Consuming just under 10 percent of gross domestic product of most developed nations, health care can form an enormous part of a country's economy. In 2001, health care consumed 8.4 per cent of GDP across the OECD countries^[13] with the United States (13.9%), Switzerland (10.9%), and Germany (10.7%) being the top three.

The United States and Canada account for 48% of world pharmaceutical sales, while Europe, Japan, and all other nations account for 30%, 9%, and 13%, respectively.^[6] United States accounts for the three quarters of the world’s biotechnology revenues.

Systems

Social health insurance is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every country, state or municipality with a government health care system a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as two-tier health care. The scale, extent, and funding of these private systems is variable.

A traditional view is that improvements in health result from advancements in medical science. The medical model of health focuses on the eradication of illness through diagnosis and effective treatment. In contrast, the social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier. It defines illness from the point of view of the individual's functioning within their society rather than by monitoring for changes in biological or physiological signs.^[14]

The United States currently operates under a mixed market health care system. Government sources (federal, state, and local) account for 45% of U.S. health care expenditures.^[15] Private sources account for the remainder of costs, with 38% of people receiving health coverage through their employers and 17% arising from other private payment such as private insurance and out-of-pocket co-pays. Opponents of government intervention into the market generally believe that such intervention distorts pricing as government agents would be operating outside of the corporate model and the principles of market discipline; they have less short and medium-term incentives than private agents to make purchases that can generate revenues and avoid bankruptcy. Health system reform in the United States usually focuses around three suggested systems, with proposals currently underway to integrate these systems in various ways to provide a number of health care options. First is single-payer, a term meant to describe a single agency managing a single system, as found in most modernized countries as well as some states and municipalities within the United States. Second are employer or individual insurance mandates, with which the state of Massachusetts has experimented. Finally, there is consumer-driven health, in which systems, consumers, and patients have more control of how they access care. This is argued^{[by whom?]} to provide a greater incentive to find cost-saving health care approaches. Critics of consumer-driven health say that it would benefit the healthy but be insufficient for the chronically sick, much as the current system operates. Over the past thirty years, most of the nation's health care has moved from the second model operating with not-for-profit institutions to the third model operating with for-profit institutions; the greater problems with this approach have been the gradual deregulation of HMOs resulting in fewer of the promised choices for consumers, and the steady increase in consumer cost that has marginalized consumers and burdened states with excessive urgent health care costs that are avoided with consumers have adequate access to preventive health care.

A few states have taken serious steps toward universal health care coverage, most notably Minnesota, Massachusetts and Connecticut, with recent examples being the Massachusetts 2006 Health Reform Statute^[16] and Connecticut's SustiNet plan to provide quality, affordable health care to state residents.^[17]

Politics

The politics of health care depends largely on which country one is in. Current concerns in England, for instance, revolve around the use of private finance initiatives to build hospitals which it is argued costs taxpayers more in the long run.^[18] In Germany and France, concerns are more based on the rising cost of drugs to the governments. In Brazil, an important political issue is the breach of intellectual property rights, or patents, for the domestic manufacture of antiretroviral drugs used in the treatment of HIV/AIDS.

The South African government, whose population sets the record for HIV infections, came under pressure for its refusal to admit there is any connection with AIDS^[19] because of the cost it would have involved. In the United States 12% to 16% of the citizens are still unable to afford health insurance. State boards and the Department of Health regulate inpatient care to reduce the national health care deficit. To tackle the problems of the perpetually increasing number of uninsured, and costs associated with the US health care system, President Barack Obama says he favors the creation of a universal health care system.^[20] However, New York Times opinion columnist Paul Krugman said that Obama's plan would not actually provide universal coverage,^[21] and Factcheck.org alleges that Obama's predicted savings were exaggerated.^[22] In contrast, the state of Oregon and the city of San Francisco are both examples of governments that adopted universal healthcare systems for strictly fiscal reasons.

Health care by country

Health care systems are composed of individuals and organizations that aim to meet the health care needs of target populations. There are a wide variety of health care systems around the world. In some countries, the health care system planning is distributed among market participants, whereas in others planning is made more centrally among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has often been evolutionary rather than revolutionary.

See also

• Acronyms in healthcare
• Alliance for Healthy Cities
• Consumer Health Coalition
• Elderly care
• Health care politics
• Health care provider
• Health care proxy
• Health disparities
• Health informatics
• Health law
• Health promotion
• Health science
• Healthcare reform
• Managed care
• Medical ethics
• Medical savings account
• Nightingale's environmental theory
• Nurse-managed health center
• Philosophy of healthcare
• School health services
• Youth health

Notes

1. ^ Princeton University. (2007). health profession. Retrieved June 17, 2007, from Princeton University
2. ^ United States Department of Labor. (February 27, 2007). Health Care Industry Information. Retrieved June 17, 2007, from Employment & Training Administration (ETA) - U.S. Department of Labor
3. ^ "Yahoo Industry Browser - Healthcare Sector - Industry List". http://biz.yahoo.com/p/5conameu.html.
4. ^ Welcome to the United Nations: It's Your World
5. ^ ^{a b} "Europe’s competitiveness". European Federation of Pharmaceutical Industries and Associations. http://www.efpia.org/content/Default.asp?PageID=388. Retrieved February 15, 2010.
6. ^ ^{a b c d} "The Pharmaceutical Industry in Figures" (pdf). European Federation of Pharmaceutical Industries and Associations. 2007. http://www.efpia.eu/Content/Default.asp?DocID=7024. Retrieved February 15, 2010.
7. ^ "2008 Annual Report". Pharmaceutical Research and Manufacturers of America. http://www.phrma.org/files/attachments/2008%20Profile.pdf. Retrieved February 15, 2010.
8. ^ Xinhua - English
9. ^ "Implementation of budget resolutions". World Health Organization. 1999-12-16. http://ftp.who.int/gb/pdf_files/EB105/ee17a1.pdf. Retrieved 2007-06-20.
10. ^ Arrow, K. (1963) Uncertainty and the welfare economics of medical care. American Economic Review, 53:941-73.
11. ^ Phelps, Charles E. (2002) Health Economics 3rd Ed. Addison Wesley. Boston, MA
12. ^ Williams A (1987) "Health economics: the cheerful face of a dismal science" in Williams A (ed.) Health and Economics, Macmillan: London
13. ^ OECD data
14. ^ Bond J. & Bond S. (1994). Sociology and Health Care. Churchill Livingstone. ISBN 0-443-04059-1.
15. ^ CMS Annual Statistics, United States Department of Health and Human Services
16. ^ About.com's Pros & Cons of Massachusetts' Mandatory Health Insurance Program
17. ^ http://www.aarp.org/states/ct/advocacy/articles/in_historic_vote_legislature_overrides_sustinet_veto.html
18. ^ PFI hospital 'costing £20m more' BBC report on research findings showing that PFI can cost taxpayers more in the long run
19. ^ BBC News: Controversy dogs Aids forum
20. ^ The Time Has Come for Universal Health Care | U.S. Senator Barack Obama
21. ^ Krugman, Paul (February 4, 2008). "Clinton, Obama, Insurance". The New York Times. http://www.nytimes.com/2008/02/04/opinion/04krugman.html.
22. ^ Obama's Inflated Health Savings

External links

• HR3200: America's Affordable Health Choices Act of 2009

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