Chapter 21: Exam 2

Question 1

Authoritative decisions made in government, agencies, or organizations that are intended to direct or influence the actions, behaviors, or decisions of others.

Answer 1

Policy

Question 2

Influencing others (policies) to adopt a specific course of action (policy) to solve a societal problem. Begins with the art of influencing others (politics) to adopt a specific course of action (policy) to solve a societal problem. Is accomplished by building relationship with the appropriate policy makers- the individuals or groups that determine a specific course of action to be followed by a government or institution to achieve a desired end (policy outcome.)

Answer 2

Advocacy

Question 3

refers to policies specifically intended to direct or influence actions, behaviors, or decisions that influence the health of populations. Policies that are specifically intended to direct or influence actions, behaviors, or decisions that influence the health of populations. Can affect culture by changing knowledge, attitudes, and behaviors of individuals and groups.

Answer 3

Public Health Policy

Question 4

The U.S. economic culture supports an open market. Attempts to intervene in the market system to promote quality, supply, and equity/fairness. Universal health coverage: when all individuals and communities receive essential health services without financial hardship. The World Health Or

Answer 4

Health in all policies

Question 5

Health policy is an explicit part of professional life for public health nurses (PHN’s).
-Advocating for
-Identifying
-Interpreting
-Implementing public health laws, regulations, and policies

Answer 5

Actions to take with policy

Question 6

What is the policy process?

Answer 6

-Assessment of health status: social data, needs, and resources.
-Goals and objectives: input from stakeholders
-Explicit evaluation criteria for policy planning:

Question 7

likelihood of achieving policy goals and objectives or demonstrated achievement of them. Limits to use: estimate involve uncertain projection of future events.

Answer 7

effectiveness

Question 8

the achievement of program goals or benefits in relation to the cost. Least cost for a given benefit or the largest benefit for a given cost. Limits to use: measuring all cost and benefits is not always possible. Policy decision making reflects political choices as much as efficiency.

Answer 8

efficiency

Question 9

fairness or justice in the distribution of the policy’s cost, benefits, and risk across population subgroups. Limits to use: difficulty in finding techniques to measure equity; disagreement over whether equity means a fair process or equal outcome.

Answer 9

equity

Question 10

How do you be politically active?

Answer 10

Assuming leadership positions in the healthcare system or contacting elected officials about legislation affecting the industry. Nurses can obtain formal training in policies, become involved in city councils and committees, or even run for local office.

Question 11

“the study of decisions—the incentives that lead to them, and the consequences from them— as they relate to production, distribution, and consumption of goods and services when resources are limited and have alternative uses.” The CDC then applies this to the process for conducting cost-benefit analysis as it applies to preventive strategies.

Answer 11

Economics

Question 12

examines the financing of public health from the governmental perspective with a focus on the delivery and funding of public health goods and services. Public health economist are concerned with the cost analysis, economic evaluation, modeling, and the analysis of health-care regulation on the cost, burden, health, effectiveness, and efficiency of health programs.

Answer 12

Public health economics

Question 13

What are the types of health insurance?

Answer 13

-Preferred provider organization (PPO) plan (MOST IMPORTANT)
-Health maintenance organization (HMO) plan (MOST IMPORTANT)
-Point of service (POS) plan
-Exclusive provider organization (EPO)
-Health savings account (HSA)-qualified plan
-Indemnity plans

Question 14

Health maintenance organization is a type of health insurance that usually limits coverage to care from doctors who work for or contract with HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

Answer 14

HMO’s

Question 15

Preferred provider organization is a type of health insurance that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan’s network.

Answer 15

PPO’s

Question 16

How are HMO’s and PPO’s alike?

Answer 16

They both consist of a network. Networks are one way to lower health care cost — network providers agree to give discounts in exchange for access to a health plan’s members.

Question 17

How are HMO’s and PPO’s different?

Answer 17

Unlike HMO, a PPO offers you the freedom to receive care from any healthcare provider— in or out of your network. With HMO plan, you must stay within your network of providers to receive coverage. Under a PPO plan, patients still have a network of providers, but they aren’t restricted to seeing just this physicians. You have the freedom to visit any health care provider you wish when under a PPO plan. A PPO plan can be a better choice compared with an HMO if you need flexibility in which health care providers you see. More flexibility to use providers both in-network and out-of-network. You can usually visit specialist without a referral, including out-of-network specialists. HMO plans typically have a lower monthly premium. The main differences between PPO and HMO are the size of the health care provider network.

Question 18

are rights granted to citizens and certain non-citizens by federal law. Are either financed from Federal trust funds or paid out of the general revenues. Those paid out of the general revenues are income redistribution programs intended to address problems such as illness and poverty.

Answer 18

Entitlement programs

Question 19

What do entitlement programs include?

Answer 19

Medicaid, Medicare, Social Security, Unemployment, and Welfare Programs.

Question 20

What type of client would entitlement programs qualify for?

Answer 20

Low income Americans qualify for benefits, and the determination of this is called “means-testing.” Qualification for most welfare programs is at or below the poverty threshold. For some programs, is is at a multiple of the threshold, such as 130%.

Question 21

The state of Tennessee’s Medicaid program. It provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children and individuals who are elderly or have a disability. To get medicaid, you must see the income and resource limits. You can apply anytime needed for TennCare.

Answer 21

TennCare

Question 22

The federal health insurance program for people who are 65+. Certain younger people with disabilities, people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, called ESRD)

Answer 22

Medicare

Question 23

Women, Infants, and Children Program is the special supplemental nutrition program for women, infants, and children. It gives federal funds intended to be used to buy foods or pay for healthcare referrals and nutritional education for low-income women who are pregnant, postpartum, or breastfeeding, as well as nutritionally at-risk infants and children up to age 5.

Answer 23

WIC

Question 24

Children Health Insurance Program is an insurance program that provided low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not snout to by private insurance. In some states, CHIP covers pregnant women. Each state offers CHIP coverage and works closely with its state Medicaid program.

Answer 24

CHIP