Policy Final (Part 6)

14 Questions

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Policy Quizzes & Trivia

Policy final hogan

Questions and Answers
  • 1. 
    In the United States, approximately __% of the population obtains their health insurance from their employer; this is about ___ million people.
  • 2. 
    Approximately __% of the population receives public health care (Medicaid, Medicare and SCHIP).
  • 3. 
    Some problems with health care in the United States:   The United States is the only industrialized nation that does not have national health insurance.   Approximately __% (__ million) of all Americans are uninsured; approximately __% of the uninsured are children.
  • 4. 
    Health care costs in the US are out of control rising well above the rate of ______.
  • 5. 
    Health care costs in the US are out of control rising well above the rate of inflation.   Reasons for the high cost of health care are?
  • 6. 
    Tries to balance the need for cost containment with access and quality of service.
  • 7. 
    Four major managed care plans?
  • 8. 
    Prepaid managed care networks that guarantee patients a range of health care services for a fixed monthly fee. ____'s are based on a "_______" payment system rather than a fee-for-service system. Under this type of payment system, the cost and reimbursement rates are based on the number of people served, not the services provided.
  • 9. 
    Under ____s, employers or their insurance carriers reimburse a higher percentage of services – for example, hospital care – if employees used designated hospitals or other providers.   If patients venture outside the network, they must pay a greater share of cost.This developed as a result of competition among healthcare providers who want to keep their patient counts high and are willing to negotiate lower fees to do so. This type provides a volume discount. 
  • 10. 
    ____ plans combine features of the ____ and ____ models.    This is a managed care system in which a primary care physician controls access to the rest of the network.    Individuals can see other providers without the permission of their primary care physician, but at an increased rate.
  • 11. 
    ____s are large groups of health professionals that join together and accept the financial risks of covering their patients’ health care needs. These are run by the medical provider themselves.
  • 12. 
    Medicare has also tried to contain costs through the use of_____.
  • 13. 
    Created in 1983, the ___ system is a prospective reimbursement method in which the federal government specifies in advance what it will pay hospitals for the treatment of 487 different illnesses.   This system provides a treatment and diagnostic classification scheme, using the patient’s medical diagnosis, prescribed treatment, and age as a means for categorizing and defining hospital service.   In other words, this system determines the length of a typical patient’s hospital stay and reimburses hospitals only for that period of time.
  • 14. 
    According to lecture, what three health care system changes are considered mandatory to institute an effective universal health care system in the United States?