finance

Question 1

Health Care Costs are rising because?

Answer 1

Increasing use of costly high tech equipments
High cost of treating illnesses such as cancer
Aging of population
Fraudulent practices by some providers
Large number and high cost of malpractice suits
Administrative costs of complying with governmental regulations
Wasteful duplication of services
Greater insurance coverage led consumers to demand more and better services and doctors to recommend more services
Practice of testing that is medically unnecessary but is ordered to protect the physician against malpractice suits

Question 2

Physicians generally base their fees on

Answer 2

The nature, extent and complexity of service + time + The office overhead + The experience and expertise of physician + the area of practice + The experience and expertise of physician + Economic status of patient.

Question 3

Physician directories that include fee information are not useful because:

Answer 3

They quickly become outdated
Many physicians refuse to provide information
Fees don’t reflect the quality of care

Question 4

The incidence of dental caries and periodontal disease can be substantially and cost-effectively reduced through:

Answer 4

fluoridation of water
topical application of fluoride
plaque control measures.

Question 5

Consumer may be able to reduce hospital and surgery cost by:

Answer 5

Getting second opinion when elective surgery is advised
Not extending hospital stay for the sake of convenience
Comparing prices when hospitalisation is needed
Choosing providers who have contracts with patient’s insurers
Monitoring hospital bills carefully

Question 6

give an example of provider strategies to control the cost

Answer 6

Provider strategies include merging hospitals, use health professionals who deliver services less expensively, and use electronic medical records systems.

Question 7

give an example of employer strategies to control the cost

Answer 7

Employer strategies include requiring employees to pay part of the premium cost or cutting retiree’s benefits

Question 8

give an example of consumer strategies to control the cost

Answer 8

Acquire a primary physician before you are ill
Use preventive measures
Have periodic health examinations
Find out in advance about fees and payment policies
Check hospital bills carefully and dispute errors

Question 9

what is the difference between insurance fraud and abuse

Answer 9

Fraud involves billing for services that are not rendered

Abuse involves multiple services that are not medically necessary

Question 10

conspiracies to provide unnecessary services in order to create large insurance claims.

Answer 10

Personal Injury Mills

Question 11

How to spot Personal Injury Mill?

Answer 11

• Participants are advised their care won’t cost anything because their insurance will pay for it
• Participants in minor accidents are advised that they have been injured more seriously than they think
• Multiple diagnostic tests are recommended with little or no explanation of the results

Question 12

Privatization advantages include…

Answer 12

privatization will assist in speeding up decision-making, reducing the government’s annual expenditure on health care, producing new financial sources for the MOH and improving health care services

Question 13

Informed: A consumer who knows his/her rights, where to go for certain issues and who can protect them.

Answer 13

informed consumer

Question 14

A consumer who is very cautious about certain products and services, and search about it very well.

Answer 14

Skeptical consumer

Question 15

A consumer who is firm and confident when making decisions.

Answer 15

Assertive consumer

Question 16

requirements to implement

Answer 16

Laws ensuring that products are safe and effective and that health professionals are competent.
Government agencies that enforce the laws and keep the public informed.
Organisation that serve as consumer advocates and provide trustworthy information about health services and products.
Education of consumers
Action by consumers to register complaints

Question 17

United States FDA Tasks

Answer 17

Set performance standards, conduct inspections, surveys, and analyses measures to compliance within these standards
Evaluate drugs, biologics and devices that require premarket clearance
Initiates enforcement actions when necessary
Helps inform and educate industry, health professionals and the public

Question 18

what is the difference between misbranded and adulterated?

Answer 18

Adulterated: poisonous substances that are not good for health, filthy substances prepared and packed under unsanitary conditions or unsafe color additives.
Misbranded: when the label is false and misleading, the food is offered for sale under the name of another product

Question 19

identify Drugs categories:

Answer 19

New: contains any new chemical or substance not been used previously, new dosages of ingredients…
Investigational: drugs intended solely for research use by qualified experts effectively and safely
Prescription dispensed when prescribed by licensed health professional
Non prescription those considered safe for consumer use when label directions and warning are followed

Question 20

The key points of product-related consumer protection laws are

Answer 20

Disclosure of ingredients
Complete instructions for use, including warnings about potential adverse effects
Premarketing proof of safety and that product is effective for its intended purpose
Duty to track products to discover any unanticipated adverse effects
Premarket proof Truthfulness in advertising

Question 21

Consumer protection agencies in Saudi Arabia:

Answer 21

Consumer Protection Association
Saudi Food and Drug Authority
Ministry of Commerce and Investment 
Ministry of Health
SAMA, ministry of environment, water and agriculture, Saudi commission for tourism and national heritage,

Question 22

what are the types of medical insurance?

Answer 22

Comprehensive medical insurance

Basic health insurance

Question 23

arrangement whereby the patient and the insurance company needs to make payment.

Answer 23

Co-insurance

Question 24

a business agreement formalized by a written contract that details both benefits and obligations.

Answer 24

health insurance policy

Question 25

It refers to nursing, medical and social services provided to an individual over a prolonged period

Answer 25

Long-term care insurance

Question 26

t or f
Dental care costs that are covered by insurance are much more predictable than medical care costs and can fit within most budgets

Answer 26

true

Question 27

t or f
People whose teeth and gums are healthy do not need dental insurance if the annual cost of dental checkups and cleaning will be less than the cost of dental insurance

Answer 27

true

Question 28

t or f

Long term, dental and disability care are usually covered by health insurance.

Answer 28

false

Long term, dental and disability care are not usually covered by health insurance.