Exam 2

Question 1

Draw global health diagram

Answer 1

screen shot on desktop

Question 2

Global health definition

Answer 2

Health of the entire population of
the world

Question 3

Global Health System

Answer 3

 The social response to health
conditions that affect populations
beyond the borders of one nation
state

Question 4

Global Health Governance

Answer 4

 The way the system is “organized”
and managed

Question 5

Actors in the Global Health System

Answer 5

Bilateral Organizations, Multilateral organizations, Hybrids, Civil Society Organizations(Philanthropies, ngos)

Question 6

 Bilateral Organizations examples
Countries’ organizations

Answer 6

United States Agency for International Development
(USAID)
 Centers for Disease Control and Prevention (CDC)
 UK Department for International Development
(DFID)
 Deutsche Gesellschaft für Internationale
Zusammenarbeit (GIZ)

Question 7

 Multilateral Organizations examples
world organizations

Answer 7

United Nations
 WHO
 UNICEF
 United Nations Development Programme (UNDP)
 World Bank
 International Monetary Fund

Question 8

Hybrids examples

Answer 8

 GAVI, the Vaccine Alliance
 Global Fund to Fight AIDS, TB, and
Malaria

Question 9

 Civil Society Organizations
(CSOs)/NGOs/Philanthropies
examples

Answer 9

 Save the Children
 Doctors without Borders
 Population Services International
 Bill and Melinda Gates Foundation
 Bloomberg Philanthropies

Question 10

World Health Organization
Mission, Role, and Challenges

Answer 10

Overall Mission:
 Attainment by all peoples of the highest possible level of health
Role:
 Provide technical assistance to countries
 Set international health standards and provide guidance on important health issues
 Coordinate and support international responses to health emergencies such as disease
outbreaks
 Promote and advocate for better global health
 Serve as a convener and host for international meetings and discussions on health issues
 NOT a major funder of health programs
Challenges:
 Increasing scope of responsibility without increasing budget
 Less flexible budget
 Large bureaucratic governance structure
Source: https://www.kff.org/global-health-policy/fact-sheet/the-u-s-government-and-the-world-health-organiz

Question 11

WHO financing pie chart and bar graph

Answer 11

see screenshot

Question 12

Types of oragnization of a global health system

Answer 12

network and hierarchy explain and see screenshot

Question 13

Leadership/grovernance in US

Answer 13

Legislative:
Legislation
Appropriations (spending)
Executive:
Set Priorities
Executive Orders
Regulation
Implementation
Judicial:
Interpret laws

Question 14

Federal vs. State responsibilities in US health system

Answer 14

Federal:
 Assist states with expertise and resources
 Act when problems go beyond the jurisdiction
of individual states
 Collaborate with stakeholders to create public
health goals, policies, and standards
 Develop scientific and technological tools
State:
 10th Amendment to US Constitution reserves
powers for states that are not specifically given
to federal government
 Protect and promote health through populationbased action (public health)
 Regulate insurance plans
 Screening and treatment for diseases
 Epidemiology and surveillance

Question 15

Private health system in US

Answer 15

doors screenshot

Question 16

Private health system in US vocab

Answer 16

-Premium: The amount you pay for your health insurance every month
▪ Deductible: The amount you pay for covered health care services before your insurance plan
starts to pay
▪ Coinsurance: The percentage of costs of a covered health care service you pay after you’ve paid
your deductible; usually paid after you receive the service
▪ Copayment: A fixed amount you pay for a covered health care service after you’ve paid your
deductible; usually paid before you receive the service
▪ Out-of-pocket maximum/limit: The most you have to pay for covered services in a plan year

Question 17

Money for health in us pie chart

Answer 17

screenshot

Question 18

Medicare general

Answer 18

▪ Established in 1965
▪ For adults 65 or older and some people with
disabilities
▪ ~60 million beneficiaries
▪ Funded primarily through payroll taxes but also
premiums and other sources
▪ Similar to Social Health Insurance or Bismarck model
▪ Administered by federal Center for Medicare and
Medicaid Services (CMS)

Question 19

4 parts of medicare

Answer 19

▪ Part A – Hospital Services
▪ Part B – Physician Services
▪ Part C – Medicare Advantage (private plans)
▪ Part D – Prescription Drugs

Question 20

Medicare to qualify

Answer 20

screenshot

Question 21

Medicaid general

Answer 21

▪ Established in 1965
“Means-tested” program for
▪ Low-income people
▪ Families and children
▪ Pregnant women
▪ Elderly (7.2 million dually enrolled with Medicare)
▪ “Medically needy” (4.8 million dually enrolled with Medicare)
▪ ~72 million beneficiaries
▪ Funded jointly by state and federal governments
▪ Administered by states according to federal guidelines

Question 22

Why does the US compare so poorly to other high income countries?

Answer 22

high costs and inequities
we spend the most

Question 23

High costs in US

Answer 23

Driving factors of high cost of US health care are…
Main Factors
▪ Prices of physician and hospital services
▪ Prices of pharmaceuticals
▪ Prices of diagnostic tests
▪ Administrative costs
Other Factors
▪ Social spending, health care utilization, and specialist care

Question 24

Inequities
ex: Racism agism

Answer 24

in social determinants causes inequities in coverage access and quality of care and unequal health outcomes see screenshot

Question 25

Affordable Care Act three legged stool. Needs all three

Answer 25

see screenshot

Question 26

ACA title 1 Quality ACA for all Americans

Answer 26

Private insurance reform and coverage expansion
 Three-Legged Stool
1. Guaranteed issue
2. Individual mandate
3. Subsidies
 Health insurance exchanges to allow people to comparison shop for insurance
 Required all health plans to offer a minimum essential health benefits package

Question 27

ACA title 2 Role of Public Programs

Answer 27

Medicaid expansion/CHIP
 Medicaid eligibility expanded to individuals above 138% of Federal Poverty Level
 In 2012, Supreme Court ruled that Medicaid expansion must be left to states
 As of September 2020, 39 states had adopted Medicaid expansion
 Federal financing of 90% for newly eligible Medicaid enrollees
 Maintained funding for the Children’s Health Insurance Program (CHIP)

Question 28

ACA title 3 Improving Quality and Efficiency of Healthcare

Answer 28

Medicare/delivery system reform
 Provided federal rebates to close the Medicare “donut hole” for prescription drug
coverage
 “Donut hole” – Period during which Medicare beneficiaries pay a higher amount for prescription drugs
because they’ve reached an annual limit but haven’t yet hit the catastrophic coverage limit
 Created the Center for Medicare and Medicaid Innovation (CMI) to test innovative
payment and service delivery models to reduce costs and enhance quality
 Implemented strategies to transform the health system towards value-based care and
away from fee-for-service
 Value-based purchasing programs linking Medicare payment to higher quality care
 Supports the creation of Accountable Care Organizations and Patient-Centered Medical Homes