Public Health Care Systems
Zelda has health insurance, including prescription drug coverage, with a plan year that starts on January 1, but she has no vision or dental coverage. Her coverage includes a $750 deductible, 75:25 coinsurance, and a stop-loss point of $10,000. Zelda is working in her garden and accidentally cuts herself with old, rusty shears. After calling her doctor, she decides to go to the hospital for a tetanus shot. The vaccine and visit are $500. Assume Zelda has met her deductible for the year and that the hospital is in her network. How much will Zelda be responsible for paying?
$125
Community health centers receive no government support and provide medical care to needy people through volunteer services and donations.
false
Cost, access, and quality of health care are three completely independent components of the health care delivery system.
false
Defensive medicine is a cost-reducing strategy.
false
Hand-washing has always been used in medical settings as a known way to prevent transmission of germs from physicians to patients.
false
Health insurers typically cover all care received at alternative medicine clinics.
false
Medicare is a state-funded insurance program for the poor.
false
Medicare is designed specifically for three categories of people. Individuals with chronic heart disease are specifically covered.
false
Medicare provides coverage for assisted living facilities and nursing homes until an individual's death.
false
Morbidity refers to the rates of death within a population.
false
Outpatient public health services are most likely to be provided by proprietary hospitals.
false
Prevention of disease is a main component of the medical model of health care delivery.
false
The making of health policy is a complex process involving both private and public sectors including multiple levels of government.
true
The president can choose to veto a bill instead of signing it into law.
true
Private non-profit hospitals are to _____________ as private for-profit hospitals are to proprietary.
voluntary
Who would not be covered under Medicare
A 61-year-old veteran with minor arthritis
Who would not be covered under Medicare?
A 63-year-old woman veteran with diabetes
General hospital
A community-based hospital that provides diagnostic, treatment, and surgical services for a wide variety of medical conditions
What type of justice is based on people's willingness and ability to pay?
Market
All of the following are examples of medical technology except:
Pesticides
A law requiring people to use seat belts when riding in cars to reduce accident injuries and deaths is an example of what kind of intervention?
Policy
Which era of health care would be best described as lacking in formal medical education, rampant poor sanitation, and limited understanding of medical science?
Pre-industrial era
Franny turned 65 recently and enrolled in Medicare. She chose original Medicare (parts A and B). Which of the following would be covered by Franny's plan?
Primary care
To improve the nation's health and resolve disparities:
it is critical to address the social and medical determinants of health.
Private non-profit hospitals are to voluntary as private for-profit hospitals are to ___________.
proprietary
Teaching hospital
A for-profit hospital with a graduate residency program
Adult foster care
A small, family-run home providing room and board and personal care to nonrelated adults who are unable to care for themselves
Health care interest groups typically do not include:
Technology manufacturers
What is the minimum number of beds required at a hospital?
6
Adult day care
A daytime, community-based group program that supports adults with impaired function or cognition and provides respite to family caregivers
Which medical practitioner would not be considered a specialist?
A doctor of internal medicine with a family practice
Public hospital
A hospital operated by the government for the benefit of Native Americans
Specialty hospital
A private not-for-profit pediatric hospital
Which term is best defined as "a patient's wishes regarding continuation or withdrawal of treatment when the patient lacks decision-making capacity"?
Advance directive
Which of the following is not true regarding outpatient and inpatient care?
An inpatient visit is typically significantly less expensive than an outpatient visit
Bioethical concerns have not been raised for which of the following?
Antiseptic operations
Who is generally responsible for a hospital's operations?
Chief Executive Officer
Which of the following is not a barrier in the adoption of telemedicine?
Convenience and accessibility
In which era of health care did we experience a significant rise in the costs of health care prompted by the emergence of managed care organizations and advances in technology and information?
Corporate era
Medical providers may make up lost revenue in one area by increasing utilization or charging higher prices in other areas. What term best describes this practice?
Cost-shifting
Which term below is best defined as "congruent behaviors, knowledge, attitudes, and policies...that enables effective work in cross-cultural situations"?
Cultural competence
Which term is best described as an overnight stay in a health care facility when the patient is formally admitted by a physician's order?
Inpatient treatment
What is not true of gatekeeping?
It associated with worse health outcomes for beneficiaries.
Which of the following was true of the ACA?
It increased the number of Americans with health insurance coverage.
Which of the following statements is not true regarding Medicare?
It is a very inexpensive program only requiring a small percentage of the federal budget.
What is the purpose of a stop-loss provision in a health insurance plan?
It limits the total out-of-pocket costs for an enrollee.
What is self-insurance?
Large employers assume risks and budget for medical claims
Which of the following is an example of an environmental factor that influences health?
Living in older housing that has not been properly maintained
Which groups are most highly associated with lower overall health care usage and access?
Low SES and minority populations
Which of the following is not primarily a role of individual states?
Managing all federal health coverage
Which of the following is not characteristic of a health care system based on social justice?
Medical care distribution is based on individuals' ability to pay
All of the following are likely providers of outpatient care, except:
Neonatal intensive care unit (NICU)
Geriatrics is a medical practice for which group?
Older adults
Which of the following is not an example of primary care?
Open-heart surgery
Medicare Advantage is also known as __________________.
Part C
Which of the following is not a microperspecitve indicator of health care quality?
Patient satisfaction
Outpatient public health services are most likely to be provided by which type of organization?
Primary care providers
Which of the following is not an environmental factor that influences health?
Primary tobacco use
Which of the following is not an example of ageism?
Provide culturally competent medical care
Almshouses and pesthouses, early forerunners to hospitals, served what primary purpose?
Quarantine of contagious disease, shelter, and food
Retirement facilities
Residential homes that provide active lifestyles, independence, and security but no nursing care
Assisted living facilities
Residential homes that provide personal care, 24-hour supervision, social and recreational activities, and some nursing/rehabilitation activities
The United States Congress is made up of:
Senate and House of Representatives
Karen has her own beliefs and values. When it comes to health care, Karen believes that there is a benefit to society when everyone can receive affordable medical care. She understands that means that she might have fewer choices in what doctor she can see or the types of care that are available to her. Karen believes vulnerable populations should have health care paid for by contributions from working individuals and employers. Karen likely ascribes to what system?
Social justice
Which of the following is not considered a new morbidity?
Strep throat
Which term best defines "the use of state-of-the-art technology despite the cost"?
Technological imperative
What is the general term for the delivery of medical care when the provider and client are separated by distance?
Telemedecine
An oncologist in Dallas analyzing a scan sent from a hospital in Laredo would be example of the utilization of what technology?
Telemedicine
Who of the individuals listed below would not be eligible for medical care covered by the military or Department of Defense?
The 30-year-old independent child of a veteran
What of the following is not true regarding alternative medicine?
They are fully covered by health insurance for treatment of disease
Which of the following was the main driver of integrated delivery systems?
To counter the growing power of managed care
The process of evaluating and rating risks is known as:
Underwriting
Which term means "susceptibility to negative events that result in poor health or illness"?
Vulnerability
Which organization is not overseen by the US DHHS?
WHO
You are interning with a local health clinic and have been assigned to create educational brochures for patients newly diagnosed with type II diabetes. Most of the clinic's patients have the equivalence of a high school diploma or less education, and many of them do not speak English as their first language. Which of the following statements is not correct regarding how you should conduct your project?
You should make sure to use a lot of medical words so the patient will know it's a reliable source.
The U.S. government plays a limited role in the health delivery system. The government's role in the arena of health care delivery mainly includes:
being the responsible party for health care delivery through Medicare and Medicaid programs
A PPO plan typically costs less than an HMO and requires a referral for enrollees seeking specialty care.
false
Access to medical care is the only factor that contributes to health and well-being.
false
All products approved by the FDA have to be free of negative side effects (100% safe).
false
Part A of Medicare covers the cost of devices many older adults may need, such as glasses and hearing aids.
false
Studies have shown that NPP services are too expensive and provide lower-quality health care.
false
The evolution of the US health care system has been very straightforward and followed the clear plans outlined in the Constitution ensuring health care for all.
false
The insurance mandate of the ACA is still in effect.
false
The life expectancy for individuals diagnosed with HIV/AIDS has decreased from when HIV/AIDS was first discovered.
false
The majority of medical devices approved by the FDA are Class III.
false
The term medical technology can be applied only to medical devices.
false
U.S health care policy is cohesive and comprehensive, reflective of the seamless system of health care in America.
false
Voluntary health insurance is the same as public health insurance.
false
Public health professionals:
focus on the community as a whole rather than treating the individual.
A specialist must:
gain certification in an area of medical specialization.
Which term is best described as a government undertaking to align and distribute health care resources to promote desired health outcomes for all residents?
health planning
In the U.S., the cost of health care might be best described as:
high
One way to control the growth of technology would be to:
implement central resource planning.
Under the ______________ model, health is defined as the absence of illness or disease.
medical
Fill in the blank: MDs are to allopathy as DOs are to _____________________.
osteopathy
Anesthesia was known for decades before it became standard practice to use it in surgeries.
true
FDA approval is based on the benefits of a new product outweighing the known risks associated with the intended use.
true
In preindustrial America, untrained people could practice medicine.
true
In the U.S., it's the private sector (not the government) that is the dominant player in the health care system.
true
Medicaid is a government-based program intended to cover the eligible poor (determined by income level).
true
Medical technology is the practical application of scientific knowledge to improve the delivery of medical care.
true
Nursing home licenses are provided by state governments.
true
Outpatient services have seen growth due to reimbursement preferences and development of new technology.
true
Prior to the ACA, insurance companies could refuse to cover individuals with pre-existing medical conditions.
true
Private health insurance is the same as voluntary health insurance.
true
Public health focuses on improving population health and well-being.
true
Redistributive allocation takes money or power from one groups and gives it to another.
true
The U.S. health care system has the highest health spending in the world.
true
The US does not have publicly financed health insurance specifically for the unemployed.
true
The majority of Americans are covered through either public or private health insurance.
true
Part A Part B Part C Part D
D. Cheryl has lived a long life, but her doctor has advised Cheryl and her family that she only has a few months left to live. She needs palliative care and her family needs support on navigating end-of-life issues.- part A A.Juan has worked hard all of his life, but his employer does not provide health insurance now that he is retired at 65 years old. He is healthy and wants to prioritize preventative care, but he is concerned about having to pay out of pocket for visits to his primary care doctor and recommended immunizations. -part B B.Maria found out that BlueCross has a great HMO network in her area for people over 65; as a special bonus, they will even provide her dental and vision benefits that she can't get under her standard Medicare benefits. -part C C.Roger started receiving Medicare benefits a few years ago, but since then, he's been diagnosed with diabetes, hypertension, and depression. His treatment plan requires several daily prescription medications that are quite expensive out-of-pocket and not covered under his standard Medicare benefits. part D
Which group typically utilizes medical care the most?
Elderly people
Which of the following is the main concern of health care policy in the U.S.?
Ensuring equal access to care for underserved populations
U.S. presidents are not allowed to influence health policy.
False
Who provides the majority of long-term care services?
Family and friends
Requiring patients to get a referral from their primary care provider before seeing specialists can help lower health care costs. What term is used to describe this mechanism?
Gatekeeping
Which of the following is not an example of a behavior or lifestyle factor that may impact health?
Genetic predisposition to addiction
Which of the following is the name of the 10-year planned initiatives that focus on key national health objectives in the US?
Healthy People
What type of care is described as 'end of life care'?
Hospice
Which of the following was not a major health care issue in preindustrial America?
Hospitals provided most of the medical care