Question 1

Which of the following statements is most true about the choices of healthcare consumers?&#10;A) They have free choice of health insurance plans&#10;B) They have free choice of providers&#10;C) They have free choice to seek healthcare&#10;D) They have free choice of treatments as patients

Accepted Answer

A person's independent choice is to seek healthcare. When they become a patient, most decisions about their care are in the hands of insurers and providers. Although they consent to care and may be offered alternatives, they rarely have free choice.

Question 2

What is most likely to be the primary consideration for young, healthy employees selecting a health insurance plans during an open enrollment period?&#10;A) Payroll deduction amount&#10;B) Providers included in plan&#10;C) Changing physicians&#10;D) No co-payments for preventative services

Accepted Answer

Smaller payroll deductions means more take-home pay. If they are healthy with low use of healthcare services the other choices would not be as important.

Question 3

What do all healthcare providers have in common?&#10;A) Common measures of outcomes&#10;B) Universal regulatory demands&#10;C) Competition for the same payment dollars&#10;D) Common legal structures

Accepted Answer

Regardless of type of provider, they seek payment from the same private and government insurers. Each type is regulated differently, has different outcomes and ways to measure them. They can be corporations, independent practices, for-profit, etc.

Question 4

How did healthcare insurance become an important employment benefit?&#10;A) Employers needed to control the costs of rising wages&#10;B) Employers needed to control sick days&#10;C) Workers refused to work without the benefit&#10;D) Workers preferred health insurance over other benefits

Accepted Answer

The driver was employer control of their costs related to wages and taxes on wages. A reduction in sick days because employees with insurance were thought to be healthier was considered a bonus to the decision. The role of workers in these decisions was minimal until those who belonged to collective bargaining units (unions) made benefits part of their negotiations.

Question 5

What is the major difference between Medicare and Medicaid?&#10;A) Medicaid funding comes totally from state taxes, Medicare is a federal program&#10;B) Medicaid only covers people younger than age 65; Medicare only covers people over age 65&#10;C) Medicaid insures at-risk infants and children, Medicare does not insure infants&#10;D) Medicaid is required of everyone below the poverty line; Medicare is required of people over age 65

Accepted Answer

People with low incomes can qualify for both Medicare and Medicaid when over 65. Medicaid is a program with joint federal and state funding. Medicaid insures people across the life span (including infants), Medicare does not. Many people eligible for Medicaid do not receive it for a variety of reasons - no need, no awareness, etc.

Question 6

What is IDEA/IDEIA?&#10;A) Health insurance for children above the poverty line&#10;B) Funding for children with special needs&#10;C) Major funding for pediatric rehab practices&#10;D) Linked to Medicaid in most states

Accepted Answer

IDEA/IDEIA is civil rights legislation that funds special education and accompanying school based medical services. The other answers options describe CHIP.

Question 7

Which of the following statements about Medicare beneficiaries is true?&#10;A) They must be at least 65 years old&#10;B) They must apply and be approved for benefits&#10;C) They are exempt from deductibles and co-payments&#10;D) They are eligible for Medicare if they have social security

Accepted Answer

Certain people under age 65 are eligible for Medicare. People are automatically enrolled in Medicare Part A when they turn 65 years old. Only some people enrolled in Medicare C have exemptions for deductibles and co-payments. Eligibility is linked to the parallel social security administration.

Question 8

How does Medicare Part B work?&#10;A) Requires optional deductions from social security benefits&#10;B) Benefits include long-term care and hospice care&#10;C) Providers are hospital-based and receive standardized fees&#10;D) May be available without Medicare A benefits

Accepted Answer

Medicare B is optional and individuals must have Medicare A coverage to receive it. It covers short stays in nursing homes for rehabilitation. All services are outpatient services.

Question 9

What are the two major parts of workers' compensation benefits?&#10;A) Compensation for lost income and future potential income&#10;B) Medical benefits and retraining&#10;C) Medical and compensation benefits&#10;D) No-fault insurance and partial person concept

Accepted Answer

The two broad components are medical benefits and compensation for lost wages. The other answer options are either medical or compensation or some other combination of workers' comp concepts.

Question 10

How does government-supported health insurance differ from private insurance?&#10;A) Lower cost and higher quality&#10;B) Populations eligible for benefits&#10;C) Unlimited funding for patient services&#10;D) Closed systems with isolated providers

Accepted Answer

The government as an insurer faces the same costs, access, and quality issues faced by the private sector. They do not have unlimited funding for the special populations (federal, state, local employees, military, veterans, prisoners, and Indians). Like the private sector each population is served in open, broadly-based, connected systems for coordination of benefits.

Question 11

Which of the following best describes health insurers?&#10;A) Controllers of healthcare costs&#10;B) Not-for-profit organizations serving the public&#10;C) Major effectors of healthcare costs, access, and quality&#10;D) On the periphery of healthcare policy

Accepted Answer

The answer of Which of the following best describes health...

Question 12

Which of the following statements is true about workers' compensation?&#10;A) It allows workers to sue employers when they are injured on the job&#10;B) It allows employers to establish their own benefits for injured employees&#10;C) It has eliminated work-related lawsuits&#10;D) It includes protections for both workers and employers

Accepted Answer

The answer of Which of the following statements is true...

Deck 4: Introduction to Healthcare As a Unique Insurance-Based Business