Question 1

Medicare and Medicaid were enacted by the Johnson administration in 1965 as amendments to which federal law already in existence?&#10;A)Welfare Act of 1960.&#10;B)Social Security Act.&#10;C)Employee Retirement and Income Security Act.&#10;D)Managed Care Act.&#10;E)Equal Rights Act.

Accepted Answer

Medicare and Medicaid were enacted as amendments to the Social Security Act of 1935. The Social Security Act provided financial assistance for individuals over 65, but Medicare and Medicaid expanded this to provide healthcare coverage for those in need, regardless of age.

Question 2

The only disease-specific group eligible for Medicare are those suffering from AIDS.&#10;A)end-stage renal disease.&#10;B)advanced coronary artery disease.&#10;C)metastasized cancer.&#10;D)diabetes

Accepted Answer

The only disease-specific group eligible for Medicare are those suffering from end-stage renal disease, also known as kidney failure. This group is eligible for Medicare regardless of age or income level. Patients with other diseases may be eligible for Medicare if they meet certain criteria, but there are no specific disease-specific groups except for those with end-stage renal disease.

Question 3

One of the most serious weaknesses in the Medicare system is that&#10;A)patients are not able to choose their own physicians.&#10;B)the definition of an episode of illness is too restrictive.&#10;C)it provides poor insurance coverage for unusually long hospital stays.&#10;D)patients must pay a deductible every time they enter the hospital.&#10;E)Part B is voluntary.

Accepted Answer

Medicare provides limited coverage for unusually long hospital stays, which can be a serious weakness for patients who require extended hospitalization. This can result in significant out-of-pocket expenses for patients, which can be a significant financial burden.

Question 4

The most important source of funding for Medicare is&#10;A)the federal income tax.&#10;B)premiums paid by elders and deducted from their monthly Social Security checks.&#10;C)a 2.9 percent payroll tax paid by all workers, regardless of their age.&#10;D)proceeds from the Medicare Trust Fund.&#10;E)a tax on the health insurance premiums pay by all group plans.

Accepted Answer

The primary source of funding for Medicare is the 2.9 percent payroll tax, which is split between employers and employees, with each paying 1.45 percent. This tax is levied on all workers' earnings, regardless of age.

Question 5

Empirical research indicates that the expansion of Medicaid has led to a number of unintended consequences including&#10;A)an increase in the incidence of low-birth weight babies among participants.&#10;B)fewer pregnant women seeking prenatal care.&#10;C)an increase in the birthrate among the eligible population.&#10;D)all of the above.

Accepted Answer

Empirical research has shown that Medicaid expansion can lead to an increase in the birthrate among the eligible population, as it provides more access to healthcare services, including prenatal and maternity care.

Question 6

The most significant expansion of Medicaid since its inception occurred in 1997 and is referred to as&#10;A)SCHIP.&#10;B)SHIP.&#10;C)TANF.&#10;D)AFDC.

Accepted Answer

The most significant expansion of Medicaid since its inception occurred in 1997 with the creation of the State Children's Health Insurance Program (SCHIP). SCHIP provided Medicaid to low-income children who were not eligible for Medicaid due to their family's income being above the Medicaid threshold but still within a certain range. This provided healthcare coverage to millions of children who previously were uninsured. The other options listed (SHIP, TANF, AFDC) are not related to the expansion of Medicaid in 1997.

Question 7

Possibly, the most serious flaw in the Medicare system is the fact that&#10;A)the deductible is too high for most elders to afford.&#10;B)it provides no real protection against catastrophic losses resulting from unusually long hospital stays.&#10;C)the definition of an episode of illness can lead to patients paying the deductible more than once during the calendar year.&#10;D)coverage for outpatient drugs is poor.&#10;E)elders are required to pay monthly premiums to participate in Part B.

Accepted Answer

Medicare provides limited coverage for catastrophic losses resulting from long hospital stays. This leaves many elders vulnerable to significant financial strain if they require extended hospitalization, which is a major flaw in the system.

Question 8

Which of the following statements is true about the Medicaid program?&#10;A)Eligibility standards are uniform across states.&#10;B)The program is totally funded by federal tax revenues.&#10;C)Everyone in the poverty-level population is eligible for benefits.&#10;D)Almost three-fourths of total outlays are for nursing home and home health care for the elderly.&#10;E)All of the above are true.

Accepted Answer

While Medicaid eligibility standards are partially uniform across states, there are variations in eligibility criteria and benefits offered. Medicaid is jointly funded by the federal government and states, with the federal government contributing a majority of the funding but not all of it. Not everyone in the poverty-level population is automatically eligible for Medicaid, as eligibility depends on several factors such as income, age, and disability status. However, almost three-fourths of total Medicaid spending is on long-term care services, including nursing home and home health care, particularly for the elderly. Therefore, option D is the most accurate statement.

Question 9

Falling hospital admissions and shorter length of hospital stays beginning in the mid 1980s may be attributable to&#10;A)the increase in the number of out-patient visits.&#10;B)the introduction of the DRG system.&#10;C)a healthier population and a reduced incidence of certain diseases.&#10;D)a reduction in the number of staffed beds in community hospitals causing a shortage of available beds.&#10;E)an increase in the use of pharmaceutical drugs in treating the elderly.

Accepted Answer

The introduction of the DRG system (Diagnosis-Related Group) in the mid-1980s changed the way hospitals were reimbursed for services. It incentivized hospitals to reduce the length of hospital stays and increase efficiency in care delivery as they were paid a fixed amount for each patient based on their diagnosis. This led to a reduction in hospital admissions and shorter stays, as hospitals had to discharge patients sooner to avoid financial losses.

Question 10

The Medicare pay-as-you-go system is jeopardized by&#10;A)an overly generous fee schedule that pays physicians more than private insurance for most procedures.&#10;B)the changing demographics of the U.S.population with an increasing percentage over the age of 65.&#10;C)a reliance on the premiums paid by the elderly themselves to fund a majority of the total cost of the system.&#10;D)allowing physicians to balance bill their patients.&#10;E)the rising costs of long-term care.

Accepted Answer

The changing demographics of the U.S. population with an increasing percentage over the age of 65 is the primary factor jeopardizing the Medicare pay-as-you-go system. As more people become eligible for Medicare and require medical care, the costs of the system will continue to rise, putting a strain on funding sources such as premiums and taxes. The other options are factors that contribute to the overall cost of healthcare but are not the primary drivers of the Medicare pay-as-you-go system's financial challenges.

Deck 12: Policies That Enha Nce Access