Question 1

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

Accepted Answer

The 2010 U.S. health care reforms do not require businesses with three or more employees to provide health insurance for both full-time and part-time employees. However, larger businesses (50 or more employees) are required to provide health insurance or face penalties.

Question 2

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

Accepted Answer

Health maintenance organizations (HMOs) are managed care prepaid group practices in which a person agrees to pay a monthly premium for comprehensive health care services. HMOs typically require members to choose a primary care physician who coordinates all medical care and referrals to specialists within the network.

Question 3

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

Accepted Answer

Medicare is a federal health insurance program that primarily serves individuals who are 65 or older. In an effort to control costs and promote efficiency in healthcare delivery to Medicare patients, the federal government established a system of Diagnosis-Related Groups (DRGs) with set fees for specific medical procedures and services. This incentivizes healthcare providers to provide effective and efficient care to Medicare patients.

Question 4

Medical specialties like ____________ became increasingly popular in recent years.

Accepted Answer

All of these specialties have seen an increase in popularity in recent years. Dermatology is in high demand due to the emphasis on preventative care and the increasing prevalence of skin cancer. Anesthesiology is needed for surgical procedures and pain management. Radiology is important for imaging studies and diagnosing medical conditions. Emergency-room medicine is essential for providing immediate medical care in emergency situations.

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.

Accepted Answer

Preferred provider organizations (PPOs) 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. PPOs act like an agreement between the insurer and a group of providers to give medical services to the insurer's members at reduced rates.

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.

Accepted Answer

In 2012, the United States had the highest health care expenditure per person in the world, averaging around $8,900. This figure reflects the country's significant investment in health care compared to other nations.

Question 7

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

Accepted Answer

The correct estimate for average health costs per person in 2019 is $13,387.

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.

Accepted Answer

Capitation financing is a payment model in which a fixed monthly sum is paid by the subscriber and their employer to a healthcare provider or organization (e.g., a hospital or medical group), regardless of how many services or treatments are provided. This type of financing encourages providers to focus on preventive care and overall health management, as they are incentivized to keep their patients healthy and avoid costly treatments or hospitalizations. Capitation financing often results in little or no additional costs for patients beyond their monthly payments.

Question 9

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

Accepted Answer

According to a report by the National Rural Health Association, one out of every 5 (or 20%) counties in the United States does not have a single doctor.

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.

Accepted Answer

Official agencies, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), are supported by tax funds and are designed to conduct research, develop educational materials, protect public health, and minimize public health problems. Voluntary agencies are typically non-profit organizations that rely on donations from individuals and private organizations to provide health services and education. Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are healthcare delivery systems that provide health services and coverage for members. Allied health enterprises refer to businesses that provide healthcare products and services, such as medical equipment suppliers or pharmaceutical companies.

Question 11

What does DRG stand for?

Accepted Answer

DRG stands for Diagnostic Related Groups, which is a system used by hospitals to categorize and classify patients based on their diagnoses and treatments for the purpose of reimbursement from insurance companies.

Question 12

DRGs:

Accepted Answer

DRGs, or Diagnosis Related Groups, are a system used by the government to determine how much Medicare and Medicaid will pay for medical procedures based on the patient's diagnosis. It is a way to standardize payments and cut costs by putting patients with similar diagnoses into specific groups with predetermined reimbursement rates.

Question 13

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

Accepted Answer

Access to healthcare is the main health care problem in rural areas with respect to equity. Rural areas often have fewer healthcare providers and facilities, making it difficult for residents to access healthcare services compared to those living in urban areas. This lack of access can result in delayed or inadequate treatment, negatively impacting health outcomes and exacerbating health disparities between rural and urban populations.

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.

Accepted Answer

Allied health enterprises are the manufacturers of pharmaceuticals and medical supplies and equipment that are involved in research, development, and distribution of medical goods. The other options mentioned do not directly relate to the manufacturing and distribution of medical products.

Question 15

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

Accepted Answer

The primary issues in debates about health care delivery in the U.S. are the rising costs of services and equity in the provision and distribution of care. The U.S. has some of the highest healthcare costs in the world, and there is a growing concern that many Americans cannot afford necessary medical care. Additionally, there are disparities in access to care based on income, race, and geography. These issues have led to calls for healthcare reform to make the system more affordable and equitable for all Americans. While there may be debates about which country to model reforms on, this is not a primary issue in the current debate about healthcare delivery in the U.S.

Question 16

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

Accepted Answer

Larger cities typically have higher populations and more demand for healthcare, which can lead to higher salaries and more opportunities for medical practices to generate revenue.

Question 17

What is the role of a managed care organization?

Accepted Answer

A managed care organization (MCO) is responsible for controlling the cost of healthcare, monitoring the work of doctors and hospitals, limiting visits to specialists, and requiring prior authorization for hospitalization. Therefore, all of the above options are correct.

Question 18

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

Accepted Answer

The role of a case manager is to ensure that healthcare is provided efficiently and cost-effectively while also promoting positive outcomes for the patient. In this scenario, the case manager would represent the bill payer (usually an insurance company) and work to ensure that the care being provided is both effective and cost-efficient. Social workers may assist with the coordination of care, but they typically don't have the same level of authority and decision-making power as a case manager. HMOs and hospital administrators may be involved in the provision of care, but they don't necessarily represent the bill payer in this context.

Question 19

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

Accepted Answer

All of the factors listed (aging of the population, increases in hospital expenses, higher costs for physician services, and increase in the number of prescriptions written) contribute to the overall increase in healthcare expenditures. As the population ages, there is a greater demand for healthcare services, which increases costs. Hospital expenses and physician fees have also been steadily increasing, which adds to the overall cost. Additionally, the increase in prescriptions being written and the cost of medications also contribute to the rise in healthcare expenditures.

Question 20

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

Accepted Answer

Voluntary agencies rely on donations from the public to support their mission and goals, which can include funding medical research and providing services for disease victims. Official agencies are government entities and may also fund medical research and services but are not exclusively funded by donations from the public. Health maintenance organizations and preferred provider organizations are types of healthcare insurance plans. Allied health enterprises are businesses that provide healthcare services but do not typically engage in medical research or fundraising for disease victims.

Quiz 13: Health Care Reform and Health Policy in the United States