Deck 20: Health-Care Financing

Question 1

Prescription drug prices vary widely from pharmacy to pharmacy.

Answer 1

True

Question 2

It is estimated that the sickest 10% of the population accounts for 68% of health care expenditures.

Answer 2

True

Question 3

In 2003, out-of-pocket costs represented about 16% of America's health care dollars.

Answer 3

True

Question 4

Recently, an average cost for a semi-private room in a nursing home exceeded $160 a day.

Question 5

The average cost of hospital inpatient care is about $1,000 a day.

Question 6

Some government officials estimate that insurance fraud constitutes a $100-billion-a-year problem.

Question 7

The National Health Council believes that pursuit of a healthy lifestyle is a patient responsibility.

Question 8

In many states, HMOs have been prohibited from requiring doctors not to tell patients about treatment options that the HMO does not cover.

Question 9

Insurance companies pose a major obstacle to healthcare reform.

Question 10

Many corporations that make health insurance available to their employees self-insure their plans.

Question 11

Rising costs of medical services have led corporations to reduce health insurance benefits provided to retirees.

Question 12

Monitoring hospital bills is not a useful consumer activity.

Question 13

It is almost impossible for consumers to play important roles in reducing health care costs.

Question 14

The main reason America is said to be undergoing a "health care crisis"is a shortage of physicians.

Question 15

Surveys have found that most Americans feel that medical care quality is not compromised in the interest of profit.

Question 16

There is little reason for people with group insurance to ascertain medical and dental fees before services are rendered.

Question 17

Which of the following is a well-established guideline for reducing the cost of health care?

A) Select a primary physician before illness occurs.
B) Buy only brand-name drugs from well-known manufacturers.
C) Take a daily multivitamin pill.
D) Carefully follow the advice in television advertisements for health-related products.

Question 18

To help reduce the cost of prescription drugs, which of the following does not make sense?

A) Purchase larger quantities for long-term conditions.
B) Check prices at several outlets by telephone.
C) Consult the Physicians' Desk Reference for price information.
D) Ask physicians to prescribe generic drugs.

Question 19

The procedures to follow when considering health insurance include all the following except

A) asking the state insurance commissioner's office to review policy provisions with you.
B) determining type of coverage desired.
C) reviewing a variety of plans.
D) checking records of medical expenditures of previous years.

Question 20

Hospital costs are considerably influenced by all the following except

A) number of physicians on staff.
B) new technology.
C) unused hospital beds.
D) malpractice premiums.

Question 21

In 2003, average out-of-pocket health expenses totaled approximately

A) $225.
B) $778.
C) $1,023.
D) $2,013.

Question 22

In 2003, the largest proportion of personal health care expenditures in the United States was for

A) hospital care.
B) physicians' services.
C) drugs.
D) dentists' services.

Question 23

The least likely way for physicians to be paid for their services is

A) salary as a staff member of a hospital or group health plan.
B) insurance company profits.
C) fees for services.
D) share of profits of a group health plan.

Question 24

Which of the following is the least likely way to reduce one's hospital and surgical expenses?

A) Obtain a second opinion when elective surgery is advised.
B) Request a fee reduction by hospital before entry.
C) Shop for the hospital that charges the lowest fees.
D) Refrain from unnecessary and prolonged stays in the hospital.

Question 25

Which of the following does Consumers Union consider important in a national health insurance program?

A) universal coverage
B) cost controls
C) single-payer system
D) chiropractic benefits
E) all of the choices are correct

Question 26

The continuing rise in health care costs is attributable to all the following except

A) an increase in the number of HMOs.
B) the aging of our population.
C) the high cost of malpractice suits.
D) the increased use of high-tech equipment.
E) for fraudulent billing practices.

Question 27

How do health care expenses compare with those for food, clothing, and entertainment for the American population as a whole?

A) Health care is the largest expense.
B) Health care is the second largest expense.
C) Health care is the third largest expense.
D) Health care is lowest of the four expenses.
E) All four expenses are about equal.

Question 28

Physicians generally base their fees on all the following except

A) extent and complexity of service.
B) distance traveled by patient.
C) customary fees charged by other local physicians.
D) operating costs.

Question 29

The Canadian health insurance plan includes all the following except

A) payment by provincial governments.
B) widespread availability of high-tech equipment.
C) comprehensive care for all citizens.
D) coverage of all medically necessary services.

Question 30

The problems in America's health care system include all of the following except

A) lack of sufficient insurance coverage for many Americans.
B) shortage of hospital beds.
C) excessive paperwork for many patients and physicians.
D) high administrative costs.

Question 31

Which statement is False?

A) "Reasonable" refers to a fee in a region that meets a predetermined percentile.
B) Insurance companies and Medicare generally base fee-for-service payments on what they consider to . be usual, customary, and reasonable.
C) "Usual" refers to a physician's own charges for a period of time.
D) "Customary" refers to a range of fees charged by all physicians in a given region.
E) All of the choices are true.

Question 32

Which is not a cost-control method for medical and hospital costs?

A) increasing deductibles
B) decreasing co-payments
C) limitations on services
D) pre-existing illness exclusions
E) all of the choices are correct

Question 33

Which is not a cost-control method for medical costs and hospital costs?

A) second opinions
B) limit maximum benefits
C) requirements for inpatient diagnostic tests
D) utilization management
E) all of the choices are correct

Question 34

DRG stands for

A) diagnosis-related group
B) dedicated-recovery grading
C) diagnosis-recovery gradient
D) domestic-requirement group
E) none of these choices

Question 35

Which is not an important consideration for budgeting for health care?

A) the cost of dread-disease coverage
B) the likely out-of-pocket expenses
C) age of family members
D) extent of insurance coverage
E) all of the choices are correct

Question 36

Which is False about a DRG? It

A) pays hospitals a set fee per admission.
B) is based on the patient's diagnosis.
C) is an Incentive to shorten hospital stays.
D) is a strategy to contain Medicare costs.
E) patients have no recourse for unfair treatment.

Question 37

"Underinsured"means all of the following except

A) uninsured.
B) annual out-of-pocket medical expenses exceed 10%.
C) deductibles exceed 5%.
D) income is under 200% of poverty level and annual out-of-pocket expenses exceed 5%.
E) all of the choices are correct.