Ch8

Question 1

rationing

Answer 1

interest is renewed in rationing bc of increased healthcare spending; implies reduced access to care and decreases in acceptable quality of services offered

Question 2

access to care barriers

Answer 2

insured not approving or covering for care
preexisting conditions
physicians refuse insurance plan
childcare needs hinder ability to go to dr to seek care

Question 3

current trends

Answer 3

Given that economics in general and health care economics in particular are concerned with resource use and decision making, any discussion of the economics of health care must consider past and current health care spending.
Past spending reflects past decision making; likewise, past decisions reflect the values and beliefs held by society and policy makers that undergird policy making at any given point in time.

Question 4

the science concerned with the use of resources (producing, distributing, and consuming resources)

Answer 4

economics

Question 5

concerned with how scarce resources affect health industry

Answer 5

health economics

Question 6

affects resource allocation in healthcare

Answer 6

uninsured

Question 7

provide services to uninsured or under insured

Answer 7

safety net providers

Question 8

who is most likely to be uninsured?

Answer 8

low paying or part-time jobs, small biz, children-medicaid, elderly-medicare, those working for big companies have employer-sponsored health insurance

Question 9

primary determinant to health care

Answer 9

ability to pay for services

Question 10

healthy people 2020 goals

Answer 10

strategies to provide better access for all people

Question 11

teen mom- long term primary prevention measure to break cycle of poverty what do you do?

Answer 11

encourage education to break the cycle

Question 12

What level of prevention are most healthcare dollars spent?

Answer 12

secondary and tertiary care (only 3% is spent on primary care)

Question 13

work with legislators and insurance companies to provide coverage for health promotion to reduce the risk of disease

Answer 13

primary prevention

Question 14

provides hospital insurance and medical insurance to persons aged 65 years and older, permanently disabled persons, and persons with end-stage renal disease

Answer 14

medicare

Question 15

primarily financed by federal payroll tax that is paid by employers and employees. The proceeds for this tax go to the hospital insurance trust fund, which is managed by CMS. Available to ALL persons eligible to receive medicare

Answer 15

part a

Question 16

requires a deductible from recipients for the first 60 days or services with a reduced deductible for 61-90 days of service, based on a rate equal to a 1 day stay at a hospital.

Answer 16

Medicare Part A

Question 17

supplemental (voluntary) program available to all eligible to Medicare, but must pay a monthly premium. Majority of medicare covered persons elect for this coverage. Provides coverage for lab services, ambulation transport, prostheses, equipment, and some supplies

Answer 17

Medicare Part B

Question 18

purpose was to shift const incentives away from providing more care toward more efficient services

Answer 18

prospective payment system that came about in 1983 as hospital and medicare costs rose

Question 19

what is the basis for prospective reimbursement?

Answer 19

Diagnosis-Related Groups (DRGs)

Question 20

provides financial assistance to states and counties to pay for medical services for poor older adults, the blind, the disabled, and families with dependent children

Answer 20

Medicaid

Question 21

jointly sponsored and financed with matching funds from the federal and state govts

Answer 21

medicaid

Question 22

the federal govt finances health services for military and dependent persons through

Answer 22

TRICARE

Question 23

How poor must you be to qualify for Medicaid?

Answer 23

children under 6 and pregnant women under 133% of poverty level

Question 24

major cause of rising health care costs

Answer 24

excessive and inefficient use of services in healthcare delivery

Question 25

is a prescription drug plan that requires you to pay premiums and deductibles, though you’re not required to carry it.

Answer 25

Medicare Part D

Question 26

consolidation of A,B, D into __________which is available through a private insurer’s Medicare Advantage plan.
Medicare pays the company you choose for part of your coverage each month, but you must also pay premiums.

Answer 26

Medicare Part C