Deck 10: The Delegated Welfare State

Question 1

Delegated governance helps policymakers accommodate a fundamental ambiguity at the heart of American public opinion: that Americans dislike government but ____.

A)like government programs
B)dislike the private sector more
C)dislike taxes even more
D)like their elected officials

Answer 1

like government programs

Question 2

Which form of delegated governance best describes the Affordable Care Act?

A)consumer choice
B)federal control
C)non-profit program management and service delivery
D)for-profit firm control

Answer 2

consumer choice

Question 3

The consumer-choice variant of delegated governance requires that people select their health benefits from private markets. How do the authors describe the outcome?

A)The most vulnerable beneficiaries are often the least able to navigate complex social welfare marketplaces.
B)Well-informed and active citizens make decent choices and leave bad providers.
C)Private providers are far more efficient than government providers.
D)People often make suboptimal choices and fail to revisit them later, but market forces provide needed corrections.

Answer 3

The most vulnerable beneficiaries are often the least able to navigate complex social welfare marketplaces.

Question 4

When Medicare was created in 1965, payment administration was assigned to Blue Cross and Blue Shield entities. Which form of delegated governance does this exemplify?

A)delegating program management and service delivery to nonprofit organizations or trusted professionals such as physicians
B)delegating program governance to for-profit firms to introduce market competition
C)delegating choice to consumers who receive government subsidies to purchase services from social welfare marketplaces
D)delegating to state and local governments who are charged with running publicly funded programs

Question 5

Which statement regarding the use of delegated governance in health care is accurate?

A)The United States delegates significant authority to private health insurance companies to serve as agents of cost control.
B)The United States is alone in its use of delegated governance in health care.
C)The Netherlands has taken the lead in relying on private insurers to rein in health care costs.
D)Almost all countries rely on delegated governance to commercial firms to provide publicly-funded services, including health care.

Question 6

The Medicare Part D drug plan has ____.

A)failed to induce better performance by insurance plans because very few seniors leave bad plans or use their market power
B)successfully introduced market competition through consumer choice
C)failed to broaden access to drug coverage for seniors
D)protected seniors from marketing abuses and other manipulative practices

Question 7

"Delegated governance" is best described as the delegation of responsibility for publicly funded social welfare programs to ____.

A)non-state actors
B)non-profit organizations
C)for-profit firms
D)private insurance companies

Question 8

Paul Light estimates that, in the mid-2000s, an additional 5½ contractors or grantees received federal funds for ____.

A)every federal civil servant
B)every elected politician
C)every citizen
D)every soldier

Question 9

To pass the Affordable Care Act, preserving much of the existing system of health care finance and delivery and limiting the role of the federal government was a way to keep on board ____.

A)centrist Democrats
B)centrist Republicans
C)Tea Party activists
D)left-wing Republicans

Question 10

You have learned that policymakers have delegated to insurance companies responsibility for drug coverage decisions and for price negotiations with pharmaceutical companies. What is this an example of?

A)shifting the burden of difficult decision-making
B)the permeability of Congress
C)the power of organized interests
D)addressing the fundamental ambiguity of American politics

Question 11

Members of Congress have often delegated authority to private actors as a way to build support for new social programs, due to anti-statist political forces in America and ____.

A)the power of organized interests to permeate the legislative process
B)the popularity across the board of generous government programs
C)to disperse governmental power
D)to ensure campaign contributions

Question 12

Policymakers who delegate authority to private actors tend to develop a regulatory apparatus that ____.

A)is insufficient to oversee the private entities now charged with administering publicly funded programs
B)is overly protective of consumers rather than the private entities
C)reduces consumer frustration, increasing the public's trust in government
D)provides lower costs, efficient delivery, and higher-quality services

Question 13

Delegated governance typically results in ____.

A)government that is different rather than smaller
B)a reduction in the size of government
C)government that is smaller rather than different
D)an expansion in the size of government

Question 14

The real political impact of delegated governance is to provide an immediate solution to social problems that de-rails the drive for a bigger role for government. This strategy is called ____.

A)issue preemption
B)the welfare state
C)the window of opportunity
D)privileged place

Question 15

In more recent forms of delegated governance, risk is shifted to firms and to beneficiaries in an effort to ____.

A)lead them to make wise choices about how much health care to consume
B)free them from the brunt of market forces
C)reduce the size of state and local governments
D)kick-start the economy