com12 7Q Flashcards
Which is the best definition of economics?
a. Assets that can be traded for different assets
b. Income and outgo of monies
c. Science of allocation of resources
d. Study of goods, services, talents, and transportation
c. Science of allocation of resources
Economics represents the science of allocation of resources. Resources are goods or services. The other definitions do not fully describe economics.
A client living in the 1920s received health care services. Which would have been the most likely form of payment?
a. Patients paid out of their pockets for whatever care the provider charged.
b. Public health employees gave care to those who needed it.
c. There was little health care to be had, regardless of a person’s wealth.
d. Workers who belonged to a union had their bills paid by insurance.
a. Patients paid out of their pockets for whatever care the provider charged.
Until the 1930s, the predominant method of health care financing was self-payment. Health care providers charged a fee for the services they rendered, and the patient paid the out-of-pocket expense. The assumption was that those who could pay would pay and those who could not pay should receive care and pay what they could. Insurance companies did not exist in the 1920s.
Which statement best describes what happened to health care providers during the Great Depression?
a. The amount of charity care greatly increased.
b. Both hospitals and physicians went bankrupt.
c. Government funding was legislated to assist those in need.
d. Public health greatly expanded to care for those in need.
b. Both hospitals and physicians went bankrupt.
Why did employers decide to offer health insurance as an employee benefit?
a. Hospitals and physicians quit offering charity care to those who could not pay.
b. Society was focused on not having to pay for doctor visits and other needed
health benefits.
c. Teachers were role models for unions to demand insurance as a benefit.
d. To obtain and retain the limited number of persons available to work when
government rules prohibited raising wages, insurance was offered.
d. To obtain and retain the limited number of persons available to work when
government rules prohibited raising wages, insurance was offered.
The idea of paying a small fee for guaranteed health care to have sickness cured was very popular. Health care providers liked knowing they would receive payment for their services. During World War II, faced with a limited workforce and governmental restrictions on wages, employers began to see health insurance as a means of supplying workers’ benefits without granting a wage increase. Teachers were not demanding insurance as a benefit. Hospitals and physicians continued to provide charity care as they were able. Society understood that they needed to pay for health services; however, businesses realized that providing insurance was a way to keep their needed workforce.
Which best describes a flaw of indemnity plans?
a. Blue Cross and Blue Shield had a great idea, but they went bankrupt.
b. Cost sharing was expected of Blue Cross and Blue Shield enrollees.
c. Enrollees could not choose their provider or manage their own care.
d. Plans lacked any incentives to contain costs.
d. Plans lacked any incentives to contain costs.
Indemnity plans paid all the costs of covered services provided to the enrollee. The enrollee enjoyed free choice of provider and services. They preserve the enrollee’s right of choice and allow the person to manage his or her own health care. These plans became very costly because there were no incentives for cost containment. Today, cost-sharing efforts (e.g., copayments, deductibles) help contain costs. Blue Cross and Blue Shield continue to be a provider of health insurance.
Which best describes the first government step in trying to stop constantly rising costs?
a. Insurance companies were told to cease adding new members to their plan.
b. Payment reimbursement was based on diagnosis and client characteristics rather
than on treatment given.
c. Physicians were limited to a maximum amount that would be paid for any
particular service.
d. Reimbursement was based on prospective payment, that is, in advance of
admittance for care.
b. Payment reimbursement was based on diagnosis and client characteristics rather
than on treatment given.
The first efforts to control costs were made by the federal government when Medicare hospital reimbursement was based on a prospective payment system.
Which statement best describes the message that public health leaders are trying to emphasize to the public?
a. Assume responsibility for your own health by choosing healthy behaviors
b. Have a primary physician and get yearly checkups
c. Obtain immunizations and screenings when they are offered
d. Support legislative efforts to improve our medical care system
a. Assume responsibility for your own health by choosing healthy behaviors
Although there are many public health messages in the media, from quitting smoking to getting a checkup, the primary message currently being emphasized by public health, as well as all the media coverage of the constantly increasing cost for health care, is for each person to take responsibility for his or her own health through choosing healthy lifestyle behaviors. Supporting legislative efforts is not as important as the need for individuals to take responsibility for their own health.
Which action would be the least expensive approach to treating chronic diseases?
a. Choose healthy lifestyle behaviors to retain health
b. Continue media campaigns encouraging early detection and treatment
c. Encourage patients to seek care at a local neighborhood health clinic
d. Suggest self-therapies that have been demonstrated to be effective
a. Choose healthy lifestyle behaviors to retain health
The five leading causes of death and illness can be positively affected by changes in lifestyle. Healthy lifestyles can modify or even prevent most chronic illnesses. Seeking care at a neighborhood health clinic, producing media campaigns, and engaging in self-therapies are all more expensive approaches to treating chronic diseases than choosing healthy lifestyle behaviors.
Which best describes how having health insurance has affected lifestyle behaviors?
a. Health promotion disease prevention programs are attended because they are
reimbursable.
b. Health education is widespread because insurance companies promote such
education.
c. Medications and medical treatment are relied on for cure.
d. Screening is widespread because of insurance sponsorship.
c. Medications and medical treatment are relied on for cure.
Funding for behavioral changes is limited, inadequate, or unavailable. Weight loss programs or smoking cessation programs are not reimbursable treatment regimens although more expensive pharmaceutical interventions are reimbursable. Therefore, it is financially wise not to worry until illness strikes because illness care is reimbursable, whereas preventive health care is not.
Which best describes why so many Americans continue to engage in unhealthy behaviors?
a. Americans are not knowledgeable on how to change their behavior.
b. Americans believe that most illnesses can be cured with insurance footing the bill.
c. Health is not a concern to most Americans.
d. Most Americans do not know which behaviors are unhealthy.
b. Americans believe that most illnesses can be cured with insurance footing the bill.
Society sees insurance as an economic shield protecting against all disease and illness. The belief in cure rather than prevention, combined with this financial safety net, encourages society to become a passive participant in health care. The pervasive societal thought is “I don’t have to worry; I have insurance.” Americans are aware of which behaviors are unhealthy, have knowledge on how to change their behavior, and are concerned about health, but insurance has allowed them to take a passive approach to health.
Which conclusion can be drawn from reviewing how health care costs are spread over a person’s lifetime?
a. Health care expenditures increase with age.
b. Premature newborns incur more costs than other children from birth through
adulthood.
c. The majority of cost is incurred during middle age when chronic diseases strike.
d. Persons aged 85 years and above spend the most money on health care.
a. Health care expenditures increase with age.
Health care expenditures increase with age, dramatically so at older ages.
Which was a major change after Medicare began a prescription drug benefit?
a. Number of prescriptions ordered by physicians decreased
b. Medications increased without affecting patient care outcomes
c. U.S. expenditures on drugs approached the same level as that of other
industrialized nations
d. Use of drugs and their cost immediately increased
d. Use of drugs and their cost immediately increased
As with other health care services, once a funding source has been established, usage and costs increase. Thus, the number of prescriptions ordered increased. For 2016, the U.S. expenditure for pharmaceuticals was about 10% of health care expenditures, and these expenditures continue to rise.
Which best describes a current trend related to health care services?
a. Nonprofit organizations are assuming responsibilities for service from for-profit
organizations.
b. Health care organizations are offering services low in cost and higher in
reimbursement.
c. Ways to minimize reimbursement using current procedural terminology (CPT)
codes have been created.
d. Postponing computerized medical record programs increases profitability.
b. Health care organizations are offering services low in cost and higher in
reimbursement.
There is a national shift from nonprofit health care to for-profit health care as large for-profit organizations take over smaller community organizations. Because emphasis is on profit, mechanisms of achieving higher reimbursement have been developed. Coding of the patient’s illness from the CPT codes determines reimbursement. Use of computerized medical record programs almost ensures that service can be reimbursed at the highest rate possible. This has changed health care practices to the use of services that are low in cost and higher in reimbursement. High-cost services are limited or not offered.
Which action would help decrease the total health care costs in the United States?
a. Consolidate major health care facilities while expanding neighborhood primary
care clinics
b. Continue the move to computer-based medical records and other efficiencies in
informatics
c. Decrease current fraud and abuse
d. Streamline and make more consistent all documents needed for third-party
reimbursement
c. Decrease current fraud and abuse
Which statement best describes a major event that occurred in the 1960s that affected health care?
a. The amount of charity care by health care providers greatly increased.
b. Hospitals began to voluntarily pay taxes to the communities where they were
located.
c. Legislation greatly expanded funds available to train physicians, nurses, and other
health care providers.
d. The Social Security Act was amended to create Medicare and Medicaid
legislation.
d. The Social Security Act was amended to create Medicare and Medicaid
legislation.
The popularity and benefits of employer-provided insurance plans were recognized, as was the reality that some segments of society were being neglected. The 1960s, with a pervasive thrust for social justice, presented the opportunity to move toward universal health care coverage. Titles XVIII and XIX of the Social Security Act created Medicare and Medicaid, respectively. There was no increase in funding for training of health care providers, voluntary payment of taxes by hospitals, and an increase in the amount of charity care provided in the 1960s.
