2103 Ppt

8/9/2019 2103 Ppt

1/42

CC2434 Sociology for Health Studies

Semester Two 09/10

Lecture 9

Comparative Health Care Systems

8/9/2019 2103 Ppt

2/42

Importance of the Comparative Health CareSystems

An understanding of the diversity of approaches that exist to

meet health care needs An understanding of the variety of factors that have shaped the

development of these approaches An understanding of the norms, values, cultural and national

outlook of those countries

Increasing Pressure of Demandsfor Quality Health Care

Rising Costs of ProvidingHealth Care

To search for alternatives among both developed anddeveloping countries

8/9/2019 2103 Ppt

3/42

8/9/2019 2103 Ppt

4/42

Classification of Health CareSystems

PrivateProvision

Public Provision

(capitalism)

(statesocialism)

different types of healthcare systems

8/9/2019 2103 Ppt

5/42

Types of SystemsRole of Government

Fee-for-Service

Socialized Medicine

Decentralized National

Health

Socialist Medicine

Regulation limited direct indirect direct

Payments toProviders

limited direct indirect direct

Ownership of Facilities

privateand public

private andpublic

private andpublic

public

Public Access notguaranteed

guaranteed guaranteed guaranteed

Private Care dominant limited limited unavailable

Example US Canada Japan China

Types of Health Care Systems

8/9/2019 2103 Ppt

6/42

8/9/2019 2103 Ppt

7/42

Socialized Medicine: Canada Basic elements of socialized medicine

directly controls the financing and organization of health service in a capitalist

economy directly pays providers owns most of the facilities guarantees equal access to the general population allows some private care for patients willing to be responsible for their own expenses

Major characteristics of the Canadian health care system: National Health Insurance Program

comprehensive services (except dental care, private hospital rooms andeyeglasses, etc)universal coverage (available to all)portable coveragethe plans had to be publicly financed and administered by an agency accountableto the provincial government

relatively high income tax the provincial governments are the nation's purchaser of health services, paying a set

fee to doctors for patient care and providing a set budget for operating costs tohospitals

8/9/2019 2103 Ppt

8/42

8/9/2019 2103 Ppt

9/42

Socialist Medicine: China Basic elements of socialist medicine

the state controls, organizes, finances, and allocates health care directlyto all citizens free of charge

Major characteristics of the Chinese health care system: after 1949: Patriotic Health Movement, the revival of traditional Chinese

medicine, and the training of barefoot doctors

The Cultural Revolution (1966-76): a serious setback of theimprovement of health care system

before the Economic Reform: cooperative medical care system after the Economic Reform: dissolution of the cooperative medical care

system towards fee-for-service basis and health insurance the accessibility of health care is low especially in the rural areas

a designation of a significantly revised cooperative medical care system

8/9/2019 2103 Ppt

10/42

mp ca ons o e ompara ve eaCare Systems

Five criteria of assessing the quality of health services (Maxwell, 1984) Efficiency

the relationship between the actual and the theoretically possibleamount of energy used to achieve a desired outputthe development of "performance indicators" , e.g. average lengthof hospital stay, turnover interval between cases occupying a bed

Accessibility

the availability of health care services Equity

the equality of access: the extent to which different social groupshave access to health servicesthe equality of health status: the extent to which different socialgroups enjoy similar levels of health

To Strive for theBalance betweenEfficiency and

Health Careas a Right or

Privilege?

8/9/2019 2103 Ppt

11/42

Social Acceptabilitythe consumers' views about their health

care Relevance to Health Needs

the appropriateness of health care services

Defects and solutions related to private medicineand public medicine

private medicine: adjusted by public regulation(equity)public medicine: regulated by privatization(efficiency)

8/9/2019 2103 Ppt

12/42

Conclusion: The ConvergenceHypothesis

Central argument: there is a globalization of medicine in the modern period whereby a world-

economic system has become the basis for a number of commoninstitutional responses to illness and mortality

"the hypothesis does not imply that medical systems, which develop out of the particular historical and cultural background of a nation and its dominantethos, will not continue to have distinct social and cultural characteristicsreflecting the ideological orientations and socio-cultural context of a country"(Mechanic 1975)

can be regarded as a macro-process in which a narrowing of system optionstake place

Types of convergence: controlling costs and increasing efficiency and effectiveness reducing inequalities

initiatives to promote health primary health care patient choice and voice linkage between health and social services developing information systems to monitor and measure the activities and

outcomes of health care

8/9/2019 2103 Ppt

13/42

Creative and Critical Thinking

Lecture 6Deductive Reasoning (II)

8/9/2019 2103 Ppt

14/42

The ambiguity of

1. Possible ( ) (logical possibility)

2. Probable ( ) (empirical probability)

( ) ( ) (=)

8/9/2019 2103 Ppt

15/42

What strong arguments are A strong ( ) argument:

Invalid ( )Given that the premise(s) is(are) true, it is verylikely ( ) that the conclusion is true .

E.g.99.9% CCT

CCT

Peter bought one ticket in a fair lottery with ten milliontickets.So Peter is not going to win the lottery.

8/9/2019 2103 Ppt

16/42

What strong arguments are

(>50%

8/9/2019 2103 Ppt

17/42

Deductive Argument () A deductive argument is an argument in which the conclusion is

claimed to be justified by (or to follow from) the premise(s) with(logical) necessity ( ), or

it is claimed to be (logical) necessary that the conclusion is true if allthe premises are true.

180

All whales are mammals. All mammals are animals. Hence, allwhales must be animals.

Alan is a father. Therefore, it is necessary that Alan is amale.Please note that:

Deductive arguments valid arguments

8/9/2019 2103 Ppt

18/42

Inductive Argument ( ) An inductive argument is an argument in which the conclusion is

claimed to be justified by (or to follow from) the premise(s) with acertain degree of probability ( ), namely > 0.5 , or

The conclusion is claimed to be probably true ( ), (i.e., morelikely to be true than false) if all the premises are true.

-95% of our students wear glasses. Joe is our student.Therefo re, Joe probably( ) wears glasses.

Mary is a six-year-old girl. Therefore, it is very likely thatMary cannot finish 100m in 15 seconds.

Contexts always play an important role In determining whether anargument is inductive.

8/9/2019 2103 Ppt

19/42

Deductive Vs InductiveDeductive ( ):

Alan is a father.--------------------------------------------Therefore, (necessarily) Alan is a male.

Inductive ( ):

Most university students get a pass in English in A Level.Peter is a university student.------------------------------------------------------------Therefore, (probably) Peter gets a pass in English in A Level.

8/9/2019 2103 Ppt

20/42

Deductive or InductiveWhat makes an argument deductive or inductive is the

type of support the premises are supposed to provide for the conclusion.

Deductive ( ):1. The conclusion is claimed to follow from its premises with (logical)

necessity ( ).2. This necessity is not a matter of degree. (logical absolute)

Inductive ( ):

1. The conclusion is claimed to follow from its premises only with acertain degree of probability ( ).2. This probability comes as a matter of degree.

8/9/2019 2103 Ppt

21/42

Key Differences between Deductive andInductive Arguments

The claimer intends to show:

8/9/2019 2103 Ppt

22/42

Prepared by Sky Lau 22

Deductive Inductive

If all the premises are true, then the

conclusion must be true ( ).

If all the premises are true, then the

conclusion is probably true ( ),i.e., more likely to be true than false.

The conclusion followsnecessarily ( ) from thepremises. i.e., the premisesprovide conclusive ground for thetruth of the conclusion.

The conclusion follows probably () from the premises. i.e., the

premises provide good but not conclusive ( , )evidence for the truth of theconclusion.

If we accept all the premises, wemust accept the conclusion (toavoid inconsistency).

If we accept all the premises, it ismore reasonable for us to accept theconclusion.

8/9/2019 2103 Ppt

23/42

The Definitions of Good and BadDeductive Argument

Generally speaking, good deductive argument =sound deductive argument.

Bad deductive argument = unsound deductiveargument.

8/9/2019 2103 Ppt

24/42

Basic concepts:Conditional Statement

Conditional statement: Statement with the structure If p then q

p, q- "p" and "q" represent statements.- so, conditional statement is a kind of

compound statement .- p: Antecedent- q: Consequent

8/9/2019 2103 Ppt

25/42

Some Basic Valid and InvalidDeductive Argument Forms

The validity of a deductive argument is solelydetermined by the logical form of theargument.

The discipline which clarifies and describes thevarious logical forms of statements andarguments is called formal logic

Now we shall introduce 2 valid and 2 invalid

deductive argument forms. But before that, lets clarify some basic concepts

first.

8/9/2019 2103 Ppt

26/42

Basic concepts:Conditional Statement

Conditional statement: Statement with thestructure:

If p then q

p, q"p" and "q" represent statements.

- so, conditional statement is a kind of

compound statement .- p: Antecedent- q: Consequent

8/9/2019 2103 Ppt

27/42

8/9/2019 2103 Ppt

28/42

A Characteristic of ConditionalStatement

Note that:"If p, then q" "If not-p, then not-q" . E.g., "If you are pretty, then I will love you" "If you are not

pretty, then I will not love you".

"If p, then q" "If not-q, then not-p" E.g., "if you are pretty, then I will love you" "if I do not love

you, then you are not pretty".

"If not-q, then not-p" is the contraposition of "If p,then q".

8/9/2019 2103 Ppt

29/42

"Unless" and "Only if"

"I won't kiss you unless ( ) you giveme a ring"

p: I won't kiss you. q: You give me a ring. "If not-p, then q" "If not-q, then p" Antecedent: not-p (I will kiss you) not-q

(You do not give me a ring). Consequent: q (you give me a ring) I won't

kiss you.

8/9/2019 2103 Ppt

30/42

"Unless" and "Only if" You can win the prize only if you give me

ten dollars. p: You can win the prize q: you give me ten dollars "If p, then q" "If not-q, then not-p" Antecedent: p (You can win the prize) not-q

(You do not give me ten dollars).

Consequent: q (you give me ten dollars)not-p( you cannot win the prize)

8/9/2019 2103 Ppt

31/42

Exercises (i)(ii)

You can pass the exam only if you work hard.You cannot pass the exam unless you work hard.

8/9/2019 2103 Ppt

32/42

8/9/2019 2103 Ppt

33/42

Basic concepts:Sufficient Condition

In a conditional statement "If p then q":

When p is true, q must be true.

- The truth of p is sufficient for the truth of

q.- p is the sufficient condition for q.

8/9/2019 2103 Ppt

34/42

Basic concepts:Necessary Condition

P Q necessarycondition :

P Q

8/9/2019 2103 Ppt

35/42

Basic concepts:Necessary Condition

"If p then q" "If not-q, then not-p".

When q is false, p cannot be true.E.g. "if Einstein is a man, then Einstein is mortal" "If Einstein is not mortal, Einstein is not a man"

- The truth of q is necessary for the truth of p.- q is the necessary condition for p.

8/9/2019 2103 Ppt

36/42

Conditional Statement, Necessary andSufficient Conditions

Accordingly, for a conditional statement,The antecedent is a sufficient condition for the

consequent, andThe consequent is a necessary condition for theantecedent.

8/9/2019 2103 Ppt

37/42

Hypothetical Syllogism ( )

Syllogism means an argument with exactly two premises andone conclusion

Hypothetical Syllogism is a syllogism containing at least oneif-then statement as premise.

The following are four most common hypothetical syllogisms:1. Modus Ponens: If A then B. A. Therefore, B .2. Modus Tollens : If A then B. Not B. Therefore, not A.

3. Denying the antecedent : If A then B. Not A. Therefore, not B.4. Affirming the consequent : If A then B. B. Therefore, A.

8/9/2019 2103 Ppt

38/42


Affirming AntecedentModus Ponens

If p then qpq Valid

e.g. If he has time, he will help you.He has time.He will help you.

8/9/2019 2103 Ppt

39/42


Denying ConsequentModus Tollens

If p then qNot qNot p

Valid

e.g. If he had time, he would help you.He does not help you.He does not have the time.

8/9/2019 2103 Ppt

40/42


Denying AntecedentIf p then qNot pNot q

Invalide.g. If you study hard, you will pass the exam.

You did not study hard.You did not pass the exam.

8/9/2019 2103 Ppt

41/42


Affirming ConsequentIf p then qqp

Invalide.g. If your son is naughty, he will be punished.

He is punished.He is naughty.

8/9/2019 2103 Ppt

42/42

References

An Concise Introduction to Logic , PatrickJ. Hurley, 9th Edition.

http://philosophy.hku.hk/think/arg/induction.php

Documents

2103 Ppt