Deck 15: Health Care Reform and Health Policy in the United States

Question 1

Which of the following is NOT one of the provisions included in the 2010 U.S. health care reforms?

A) Persons with preexisting conditions can no longer be denied coverage.
B) A minimum level of benefits set by the government must be provided in all health insurance plans.
C) Businesses with three or more employees are required to provide health insurance for both full-time and part-time employees.
D) Low-income persons under 65 will be covered by an expanded Medicaid program.
E) Children may remain on their parent's health insurance plan until age 26.

Answer 1

Businesses with three or more employees are required to provide health insurance for both full-time and part-time employees.

Question 2

_________________ are managed care prepaid group practices, in which a person pays a monthly premium for comprehensive health care services.

A) Official agencies.
B) Individual practice associations.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Answer 2

Health maintenance organizations.

Question 3

In the public sector, the federal government instituted cost controls for services to _______________ patients by establishing set fees for DRGs.

A) Welfare.
B) SCHIP.
C) Medicare.
D) Medicaid.
E) None of the above.

Answer 3

Medicare.

Question 4

Medical specialties like ____________ became increasingly popular in recent years.

A) Dermatology.
B) Anesthesiology.
C) Radiology.
D) Emergency-room medicine.
E) All of the above.

Question 5

___________________ are a form of managed care health organization, in which employers who purchase group health insurance agree to send their employees to particular hospitals or doctors in return for discounts.

A) Official agencies.
B) Individual practice associations.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Question 6

In 2012, an average of ____________ per person was spent on health care in the United States, which was the highest in the world at that time.

A) $1,072.
B) $7,681.
C) $8,900
D) $13,387.
E) None of the above.

Question 7

Estimates for 2019 indicate that health costs may average _________for every man, woman, and child.

A) $5,568.
B) $7,026.
C) $10,008.
D) $13,387.
E) None of the above.

Question 8

_________________ financing is a fixed monthly sum paid by the subscriber and his or her employer that guarantees care, with little or no additional cost.

A) Pro-rated.
B) Capitation.
C) Partial.
D) Health insurance.
E) None of the above.

Question 9

One out of every _______ counties in the United States does not have a single doctor.

A) 10.
B) 20.
C) 30.
D) 40.
E) None of the above.

Question 10

________________ are public organizations supported by tax funds, which are intended to support and conduct research, develop educational materials, protect the nation's health, and provide services designed to minimize public health problems.

A) Official agencies.
B) Voluntary agencies.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Question 11

What does DRG stand for?

A) Diagnostic related groups.
B) Drug review guide.
C) DR (doctor) G (guild).
D) Dermatology rheumatology groups.
E) None of the above.

Question 12

DRGs:

A) List what the government would pay for medical procedures.
B) Help physicians diagnose the proper illness to classify a patient with.
C) Create a monthly payment schedule for physicians, depending on the number of patients they see.
D) Are organizations of physicians that regulate expenditures in clinics throughout the United States.
E) None of the above.

Question 13

What is the main health care problem in rural areas with respect to equity?

A) Quality.
B) Cost.
C) Access.
D) Pharmaceuticals.
E) All of the above.

Question 14

________________ are the manufacturers of pharmaceuticals and medical supplies and equipment, which play a major role in research, development, and distribution of medical goods.

A) Official agencies.
B) Voluntary agencies.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Question 15

What are the primary issues in debates about health care delivery in the U.S.?

A) Rising costs of services
B) Equity in the provision and distribution of care.
C) Which country to model reforms on.
D) Both A and B.
E) Both B and C.

Question 16

The more financially rewarding medical practices are those in __________ sized cities.

A) Small.
B) Rural.
C) Medium.
D) Large.
E) None of the above.

Question 17

What is the role of a managed care organization?

A) Control the cost of health care.
B) Monitor the work of doctors and hospitals.
C) Limit visits to specialists.
D) Require prior authorization for hospitalization.
E) All of the above.

Question 18

The ______________ represents the bill payer and certifies that the care to be rendered is both effective and the least costly alternative.

A) Case manager.
B) Social worker.
C) HMO.
D) Hospital administrator.
E) All of the above.

Question 19

Which is a contributor to the increase in health care expenditures?

A) Aging of the population.
B) Increases in hospital expenses.
C) Higher costs for physician services.
D) Increase in the number of prescriptions written.
E) All of the above are contributors.

Question 20

_________________ solicit funds from the general public and use them to support medical research and provide services for disease victims.

A) Official agencies.
B) Voluntary agencies.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Question 21

The idea that advertising drives up drug costs is a myth.

Question 22

The greatest single increase since 1982-84 has been in the cost of prescription drugs. This category is followed by increases in hospital costs.

Question 23

Managed care does not alter the patient-physician relationship; it exists above and beyond it.

Question 24

The medical profession in the United States has had a consistent record of ____________ to social legislation.

A) Compliance.
B) Resistance.
C) Deference.
D) Defiance.
E) None of the above.

Question 25

The Medicare program is under the overall direction of the:

A) Centers for Disease Control and Prevention.
B) Secretary of Health and Human Services.
C) American Association of Retired Persons.
D) Health and Elderly Organization.
E) None of the above.

Question 26

Almost all drugs can reduce health spending by lowering the need for hospital care.

Question 27

Sometimes not having health insurance can contribute to the death of a patient.

Question 28

In the U.S., health care tends to be viewed as:

A) A privilege based on ability to pay for a commodity.
B) A privilege based on citizenship.
C) A right granted regardless of living conditions or financial status.
D) A right based on participation in capitalist markets.
E) None of the above.

Question 29

_________________ are solo practitioners or small groups of physicians who contract independently with HMOs to provide care to patients enrolled in their plans.

A) Official agencies.
B) Individual practice associations.
C) Health maintenance organizations.
D) Preferred provider organizations.
E) Allied health enterprises.

Question 30

A feature of managed care is its reliance upon capitation financing.

Question 31

In the early to mid-1990s, private health care in the United States experienced a dramatic reorganization into managed care plans.

Question 32

This organization provides for the federal government's sharing in the payments made by state welfare agencies to health care providers for services rendered to the poor:

A) Medicare.
B) Medicaid.
C) DRGs.
D) HMOs and PPOs.
E) None of the above.

Question 33

Which is one reason medical students tend to specialize rather than go into general practice?

A) Specialties usually represent a more manageable body of knowledge.
B) Specialties may be less demanding of personal time.
C) Specialties usually have greater prestige and better income.
D) All of the above.
E) A and C only.

Question 34

Since the early 1980s, physician costs have remained fairly stable, neither rising nor falling.

Question 35

___________ theory takes the position that social inequality leads to clash, which leads to change.

A) Structural functionalism.
B) Conflict.
C) Symbolic interaction.
D) Health lifestyles.
E) None of the above.

Question 36

A number of states have sued the federal government over the recent health care reforms on the basis that it is unconstitutional and unprecedented to require people to buy any commercial good or service as a condition of lawful residence in the U.S.

Question 37

This method of payment is consistent with the principle of the open market, in which the consumers of health care, like the consumers of other products, are free to choose which health care providers offer the best services at prices they can afford:

A) Fee-for-service.
B) Capitation.
C) Managed care.
D) Credit cards.
E) All of the above.

Question 38

The establishment of the welfare state is the latest phase in the evolution of citizens' rights in the West. Which was the first group of rights granted to citizens in the 18th century?

A) Basic.
B) Political.
C) Civil.
D) Social.
E) All of the above.

Question 39

Despite initial resistance to rationing services by the middle class, the managed care model has continued to control escalating costs for health care.

Question 40

Not having health insurance drastically undermines the ability of people to obtain health care, since they cannot pay for it and may therefore be denied it.

Question 41

Identify and discuss the three major issues in the public debate about health care delivery in the United States.

Question 42

The urban poor have historically been dependent on public hospitals and clinics rather than private hospitals and practitioners for providing patient care.

Question 43

Present arguments for and against health reform.

Question 44

The rural poor are less likely to be treated by foreign medical school graduates.

Question 45

The laws of a competitive marketplace do not apply well to medicine, because physicians define what patients need and provide their services at prices they, their employers, or the federal government set.

Question 46

Medical specialization has produced very few positive benefits.

Question 47

Primary care or family practitioners are over-represented among physicians.

Question 48

Physicians generally prefer to practice medicine in urbanized settings.

Question 49

The people who tend to utilize emergency rooms for primary care are the underprivileged.

Question 50

HMOs are oriented toward preventive and ambulatory services intended to reduce hospitalization.

Question 51

Describe the Medicare and Medicaid programs in depth, with an evaluation for each in the context of health policy.

Question 52

"The problem of equity with respect to health services is and remains a serious problem in American society." Why is this a problem, and how does it relate to policy?