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1、学术英语 医学,Health Care System,Unit 10,Health Care System The United States is one of the wealthiest countries in the world and its medical expenditure is also among the highest,but still many American citizens are inadequately insured or not insured at all.What is the root of this problem?This unit loo
2、ks into the problems with the American medical system and suggests ways and strategies to change the situation.,Unit Contents,Lead-in,Text A,Text B,Text C,Listening,Speaking,Writing,Unit 10 Health CareSystem,Lead-in,Issues to be coveredSuggested answers,Unit 10 Health CareSystem,Lead-in,Issues to be
3、 covered,the status quo of American healthcare system2.the problems existing in the American healthcare system and strategies to be taken to address those problems3.the consequences incurred by long waits in emergency department4.the four basic models of health care system5.embolic stroke in terms o
4、f its signs and symptoms,causes,treatment and prevention,Unit 10 Health CareSystem,Lead-in,Suggested answers,Task:Listen to a talk about American health care system and answer the following questions.,What is the annual expenditure of the US on health care?2.What are the researchers findings about t
5、he health care performance of the US?3.What is the major cause of the problem discussed in the talk?,Unit 10 Health CareSystem,the rising number of uninsured citizens in America,The US has poorer performance in preventable deaths thanother industrialized nations.,$2.1 trillion,Text A,Critical readin
6、g and thinking Topics for presentation Useful expressions Difficult sentences Language building-up Medical terminology Signpost language Formal English Vocabulary testSuggested answers,Unit 10 Health CareSystem,Text A Critical reading and thinking,Topics for presentation,1 Give a brief explanation o
7、f Medicare and Medicaid.,Medicare for people age 65 or olderpeople under age 65 with certain disabilities people of all ages with End-Stage Renal Disease(permanent kidney failure requiring dialysis or a kidney transplant)Medicaid available only to certain low-income individuals and families who fit
8、into an eligibility group that is recognized by federal and state law,Unit 10 Health CareSystem,2 Compare the American model and the European model.,Topics for presentation,Text A Critical reading and thinking,Unit 10 Health CareSystem,Text A,Topics for presentation,3 What are the problems with the
9、fragmented American health care system?,Critical reading and thinking,Complicated rules:it needs a genius to know the rules for treating or taking care of each patient without getting questioned by the insurance companies or othersInvolvement of private and public bureaucracies in deciding which pat
10、ient can get what treatmentUnhappiness of Americans about health care systemNeed to cover allNeed to get more value for the money spent currently on health care,Unit 10 Health CareSystem,Text A,Topics for presentation,3 What are the problems with the fragmented American health care system?,Critical
11、reading and thinking,Money is also part of the problem.The governments inability to subsidize the coveredAmericans unwillingness to pay more taxes and pour more money into the broken healthcare system,Unit 10 Health CareSystem,Text A,Useful expressions,The American medical system is highly fragmente
12、d.Americans are more comfortable with fragmentation than other nationalities.Even Americans who are covered think the U.S.medical system is broken.The majority of them want to tear it up and start over.As a nation,we are suspicious about a“single”anything like a single-payer system for health insura
13、nce.,Critical reading and thinking,Unit 10 Health CareSystem,Text A,Topics for presentation,4 Why is“rationalizing the medical system”the key to the present problem?,Critical reading and thinking,Benefits to gain by rationalizing the system Saving money Delivering better care to more peopleBlanket a
14、llocation of care being never a good idea,Unit 10 Health CareSystem,Text A,Useful expressions,Americans are not very excited about paying more taxes and pouring more money into a healthcare system they rightly feel is broken in the first place.The answer hinges on what we economists call rationalizi
15、ng the healthcare system.,Critical reading and thinking,Unit 10 Health CareSystem,Text A,Topics for presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,1 Wire up the medical system by adopting IT.2 Undertake a sustained study of comparative effectiveness by tracking e
16、ffectiveness of care over time.3 Do a better job of managing chronic diseases,especially the prevention of them.4 Change the incentives in medicine by paying doctors for what they do well and make insurance companies focus more on taking care of the sick.,Unit 10 Health CareSystem,Text A,Topics for
17、presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,Knowledge of subject matterDoctors will be much more efficient when they have computerized their patients medical records and can get away from writing everything on small scraps of paper that have to be physically t
18、ransferred from place to place.Are you for or against electronic health record(EHR)?Why?,Unit 10 Health CareSystem,Text A,Topics for presentation,Critical reading and thinking,5 Briefly summarize the four strategies.,Knowledge of subject matter,Unit 10 Health CareSystem,Text A,Useful expressions,to
19、undertake a sustained study of comparative effectivenessAre newer procedures really worth much relative to older procedures?If we can track effectiveness of care over time,we can get a handle on the new drugs,the spiffy diagnostics,new medical devices,and treatment protocols to determine which reall
20、y deliver better results.,Critical reading and thinking,Unit 10 Health CareSystem,6 Do you support“the other voices”?Why?,Text A,Topics for presentation,Critical reading and thinking,The“Other Voices”More should be done to limit demand for healthcare.Americans are wasteful of their healthcare.Cover
21、the things that are medically necessary,Unit 10 Health CareSystem,（The answer may vary.）,6 Do you support“the other voices”?Why?,Text A,Topics for presentation,Critical reading and thinking,Knowledge of Subject Matter,Unit 10 Health CareSystem,because most of us receive them(health care dollars)as a
22、 benefit,not as a bill.If healthcare were like other markets,healthcare would work better.People need help managing their chronic illness;leaving them adrift is not the way to go.,6 Do you support“the other voices”?Why?,Text A,Topics for presentation,Critical reading and thinking,Knowledge of Subjec
23、t Matter,Unit 10 Health CareSystem,the medically necessary list is long,and the optional list is far too small.In healthcare,it is very difficult to draw bright lines between what is medically valuable and what is not.Some things are valuable for some patients and not for others.Allocating medical c
24、are is very difficult proposition,no matter where and how it is proposed.,Text A,Useful expressions,people take charge of what they get and what they buy This idea does not work for me.I am not a big fan of putting consumers in charge of paying money for their healthcare,Critical reading and thinkin
25、g,Unit 10 Health CareSystem,Text A,Difficult sentences,We know,for example,that people are very bad at undertaking actions with costs in the short term and benefits only down the road(witness saving for retirement).例如，我们知道人们很不愿意做眼下要付出代价、而长期会获益的行为（例如为退休存钱。,Critical reading and thinking,Unit 10 Health
26、 CareSystem,Have a whole picture!,Text A,Text Analysis,Critical reading and thinking,Qualities of a true physicianmuch of the knowledge many of the skillscaringinquisitivenesscivic-mindedness,Unit 10 Health CareSystem,A Brief Glance at the Medical System of America,Text A,Text Analysis,Critical read
27、ing and thinking,Almost US$2 trillion per year on healthcare,nearly one in every seven dollars in the economyNot automatic medical coverage for all citizensHealth insurance as a perk most often tied to their job,or as a result of a government programs such as Medicare and Medicaid,Unit 10 Health Car
28、eSystem,To Sum Up:,Text A,Text Analysis,Critical reading and thinking,getting the money and knowledge rightget the healthcare system flowing in the right directiondeliver a healthier America and gradually reduce the average cost of family health insurance making it easier to cover everyone in the co
29、untrymaking the U.S.system the best and most sensible healthcare system in the world.,Unit 10 Health CareSystem,Text A,Suggested answers,Task 1 Overview:Summarize the main ideas in Text A by completing the following diagrams.,Critical reading and thinking,Unit 10 Health CareSystem,Text A,Suggested a
30、nswers,Unit 10 Health CareSystem,uninsured,fragmented,rationalized,Wire up,comparative effectiveness,chronic diseases,prevention,incentives,cost,Text A,Task 1/Medical terminology Match each definition with its corresponding English term and Chinese equivalent.,coverage,承保范围，承保险别,（美国）医疗补助制度,Medicaid,
31、二重的，双重的,duplicative,effectiveness,有效,Suggested answers,Language building-up,2,Unit 10 Health CareSystem,Text A,prevention,预防,hospitalization,住院,diagnostics,诊断学,treatment protocol,治疗方案,Task1/Medical terminologyMatch each definition with its corresponding English term and Chinese equivalent.,Suggested
32、 answers,2,Language building-up,chronic,慢性的,Unit 10 Health CareSystem,Text A Language Building-up,Signpost Language,Listing,Unit 10 Health CareSystem,Text A,Task 2/Signpost language,In Text A,the author puts forward a list of solutions to the problems of the American health care system.Pay attention
33、 to how he signifies the order of the list and complete the following sentences.Compare your answers with the original sentences in the text.,_ thing we can do is wire up the medical system.(Para.4)A _ important strategy is to undertake a sustained study of comparative effectiveness.(Para.5)A _ stra
34、tegy is to do a better job of managing chronic diseases,spending more time and energy on prevention.(Para.6)4 That leads to the _ set of reforms to change the incentives in medicine.(Para.7),Language building-up,Suggested answers,second,One,Unit 10 Health CareSystem,third,fourth,Text A,Task 3/Formal
35、 English,Replace the underlined words and expressions in the following sentences with more formal ones.,_1 It is ironic that the United States,a nation that spends the most money per person on health care,(Para.1)_2 The difference in our health care outcomes is a product of both public health and so
36、cial issues.(Para.1)_3,we will know what really needs to be done for individual patients,and patients will be involved with their care.(Para.4)_4 A second important strategy is to begin a sustained study of comparative effectiveness.(Para.5),Language building-up,Suggested answers,Unit 10 Health Care
37、System,per capita,variance,engaged,undertake,Text A,Task 3/Formal English,Replace the underlined words and expressions in the following sentences with more formal ones.,_5 If we can track effectiveness of care over time,we can understand the new drugs,the spiffy diagnostics,new medical devices,and t
38、reatment protocols to determine which really deliver better results.(Para.5)_ 6 We can give insurance companies incentives to focus more on taking care of the sick than on coming up with reasons to insure only the healthy.(Para.7)_ 7 The common feature in these strategies for changing the American m
39、edical system is getting the money and knowledge right.(Para.11),Language building-up,Suggested answers,Unit 10 Health CareSystem,get a handle on,rationales,commonality,Group presentation,Text A,Additional activity,The embolic stroke accounts for about 15-20%of all strokes in the U.S.Work in a small
40、 group and explore the media and literature for information about the embolic stroke in the following aspects:1.definition2.signs and symptoms3.causes4.treatment5.prevention,Unit 10 Health CareSystem,medical _(医疗保险支付范围)medical and _(医疗保险和医疗救助)a(n)_ system(单一支付者系统)to _ the uncovered(补助无保险的人)to _care(
41、提供医疗)_ tests(重复的检查)a(n)_study(长期的研究)vision _(视力缺陷),Text A Language Building-up,Vocabulary Test,coverage,Medicaid,sustained,single-payer,deficits,subsidize,value,deliver,Unit 10 Health CareSystem,Text B,Critical reading and thinkingLanguage building-upSuggested answers,Unit 10 Health CareSystem,Text
42、B,Group discussion:,Additional activity,Think out the occasions where waiting matters and share your experience with the class if any.Queuing for food when starvinga ticket homeWaiting for your date to show upOthers?,Unit 10 Health CareSystem,Text B,Critical Reading and Thinking,1 patients condition
43、 before hospitalization,In excellent health except for mild heart diseaseIrregular heartbeat Slightly short of breath Pulse as high as 130Stable blood pressure,Write down the information on the following topics.Then compare your answers with your partner.,Unit 10 Health CareSystem,Text B,Useful expr
44、essions,she decided to forgo a call to 911 the most highly regarded academic medical centers on the West Coast,Critical reading and thinking,Unit 10 Health CareSystem,Text B,Critical Reading and Thinking,2.the initial diagnosis and ensuing treatment,Initially diagnosed with rapid atrial fibrillation
45、 Intravenous heparin for anticoagulation Electrical cardioversion the following day if a transesophageal echocardiogram(TEE)confirmed the absence of an atrial thrombus,Write down the information on the following topics.Then compare your answers with your partner.,Unit 10 Health CareSystem,Text B,Use
46、ful expressions,she was diagnosed with rapid atrial fibrillationGiven her age,the emergency department(ED)staff and the consulting cardiologist decided to admit her to the hospital.no inpatient bed was availableshortly before noonthe cardiologist stopped by to let her know thatwould undergo TEE and
47、cardioversion the following Monday.,Critical reading and thinking,Unit 10 Health CareSystem,Text B,Critical Reading and Thinking,3.critical condition of the patient,A massive embolic strokeOcclusion of the right common carotid artery and the intracranial branchesSigns of middle cerebral artery syndr
48、omeInternal carotid artery being tore during operationRapid intracranial bleeding and brain-stem herniationIntubated in the ICU without evidence of neurologic recovery,Write down the information on the following topics.Then compare your answers with your partner.,Unit 10 Health CareSystem,Text B,Use
49、ful expressions,Within moments,signs of middle cerebral artery syndrome developed.For the next 2 days,the patient lay intubated in the ICU without evidence of neurologic recovery.life support was withdrawnprevented the development of the thrombus that subsequently broke looseHad cardioversion been p
50、erformed shortly after the patient entered the ED,she might be alive and healthy today.If cardioversion had been performed an academic surgeonbecause I practice in a different city,His words stung,but they were true.,Critical reading and thinking,Unit 10 Health CareSystem,Text B,Critical Reading and
