Lesson 5

Question 1

Policy

Answer 1

Based on values, and the first step in forming policy is identification of the issue. Therefore, it would seem rational to define health as the starting point for any policy annexed to health care issues.
Denotes a course of action to be followed by a government, business, or institution to obtain a desired effect.

Question 2

CDC (Centers for Disease Control)

Answer 2

Protects the public health of the nation providing leadership and direction in prevention and control of disease and responding to public health emergencies

Question 3

FDA (Food and Drug Administration)

Answer 3

Assures the safety, efficacy and security of drugs, medical devices, food supply, cosmetics and products the emit radiation.

Question 4

HRSA (Health Resources and Services Administration)

Answer 4

Provides equitable healthcare to the nation’s highest need communities.

Question 5

IHS (Indian Health Services)

Answer 5

Part of the public health service that provides American Indians and Alaska natives with comprehensive health services.

Question 6

NIH (National Institute of Health)

Answer 6

Medical research and funding for medical research

Question 7

OGA (Office of Global Affairs)

Answer 7

Global health diplomacy

Question 8

CMS (Centers for Medicare and Medicaid Services)

Answer 8

Centers for Medicare and Medicaid Services

Question 9

SAMHSA (Substance Abuse and Mental Health Services Administration)

Answer 9

Substance Abuse and Mental Health Services

Question 10

ASPR (Administration for Strategic Preparedness and Response)

Answer 10

Prepare for, respond to, and recover from disasters and public health emergencies.

Question 11

ACL (Administration for Community Living)

Answer 11

Older adults and people with disability

Question 12

Department of education

Answer 12

Involved in health education and school health

Question 13

Department of agriculture

Answer 13

Administers meat and milk. Provides funds for women; infants and children programs (WIC)
Food stamp program (SNAP)
School based nutrition program

Question 14

U.S. Enviornmental protection agency

Answer 14

Protects human health and the environment

Question 15

Occupational safety and health administration

Answer 15

Safe working conditions

Question 16

U.S. Department of veteran’s affairs

Answer 16

Provides various benefits to veterans and their beneficiaries.

Question 17

FEMA (Federal Emergency Management Agency)

Answer 17

Provides assistance during and after disasters.

Question 18

Tribal sovereignty

Answer 18

The ability to govern, protect, and enhance the health, safety and welfare of tribal citizens within tribal territory.

Question 19

IHS

Answer 19

Agency within US department of Human and Health services. Responsible for providing federal health services to American Indian and Alaksa Natives. They are eligible to participate in all public, private, and state health programs available to the general population. Continue to use IHS, tribal, and/or urban Indian health programs. Enroll in a qualified health plan through the marketplace. Access coverage through Medicare, Medicaid, and the children’s health insurance program.

Question 20

Medicare

Answer 20

Federal entitlement program to provide health care to the growing population of those 65 years of age or older, people who are disabled, have end stage renal disease or have been diagnosed with amyotrophic lateral sclerosis

Question 21

Medicare Part A (hospital insurance)

Answer 21

Includes inpatient care in hospitals/skilled nursing facilities, hospice care, some home health care. Must pay a deductible for health services. Does not pay for all health care costs of enrollees. Copayment required after 60 days.

Question 22

Medicare Part B (out of pocket costs)

Answer 22

Purchased by monthly fee. Helps pay for out-of-pocket costs for physician services, hospital outpatient care, durable medical equipment, and other services, including some health care and many preventative services. Premiums prorated based on income. Enrollees must pay deductibles.

Question 23

Medicaid

Answer 23

title xix of the social security acts- provides coverage for health and other related services for the nation’s most economically disadvantaged populations. Provides universal health care coverage for children, women, the disabled, and impoverished elders and adults below poverty line. Federal government sets baseline eligibility requirements and state governments can alter those eligibility requirements. Eligibility for this program depends on the size and income of the family. Must include inpatient and outpatient hospital care, pregnant related care, vaccines for children, family planning services, rural health clinics, home health care, lab and x ray services, and EPSDT. Care by pediatric and family nurse practitioners is covered.

Question 24

CHIP

Answer 24

Children under 18 also eligible for children’s health insurance program (CHIP). Providers health coverage to eligible children through both Medicaid and separate CHIP programs. Children eligible for CHIP are in families with incomes too high to qualify for Medicaid, but too low to afford private coverage. Is managed by states according to federal requirements but funded by both. Must provide well baby and well child visits. Dental, Behavioral health, Vaccines.

Question 25

Dual eligibility

Answer 25

A person who has Medicare but is unable to pay for premium’s would be eligible for Medicaid.

Question 26

Federal Government

Answer 26

Financing of healthcare (Medicare and Medicaid), Regulation activities (approval of drugs), Setting standards (air quality, healthy people 2030).
Public health policy at the federal level: Authority for protecting the public. Strongly influences health policy in the state. Voluntary but incompliance may impact funding from federal government

Question 27

WA State Government

Answer 27

Financing and delivery of services and oversight of insurance. Develops programs for the state’s citizens. Regularity bodies like nursing commission and medical commission governs those professions: licenses and disciplinary actions
State public health: tracking data, develop policies that influence public health in the state. Each state has different rules and guidelines for their citizens.

Question 28

Local government

Answer 28

Develop rules and guidelines for its community members. Receive funds and develop programs from the state and federal programs; must follow guideline established by those programs.
Local public health offices:
Follow the guidelines established by the state public health office. Develop programs and guidelines offered by the state/federal government. Track local diseases and data. Authority to enforce community to follow state mandates.

Question 29

Private Health Care Subsystem

Answer 29

Services provided in clinics, physicians’ offices, hospitals, hospital ambulatory centers, skilled care facilities and homes. (Solo practice, single specialty group model, multispecialty group practice, integrated health Maintenace model, community health center).

Question 30

Private Health Care

Answer 30

Managed care has become dominant in health care. Capitated payments for care, health care providers integrated into the system such as health maintenance and organizations (kaiser), solo practice fading, more advanced nurse practitioners (ANPs) and Physician assistants (PAs) assume primary practice roles in various settings.

Question 31

HMO (Health Maintenace Organization)

Answer 31

limits coverage to a network of providers.

Question 32

PPO (Preferred Provider Organization)

Answer 32

Provides coverage through a network of selected healthcare providers. Offer a balance of lower costs and more flexibility.

Question 33

POS (Point of Service)

Answer 33

Combined elements of HMO and PPO. If individual goes outside the network, he or she will be responsible for most cost unless referred by the PCP.

Question 34

HDHP (High deductible health plans)

Answer 34

Encourage employees to select plans with lower premiums but more pronounced up front cost sharing.

Question 35

HSA (Health savings account)

Answer 35

Tax free contributions that employees make to a fund to cover their healthcare expenses.

Question 36

Affordable Care Act (Obama Care)

Answer 36

health care reform enacted into law March 2010.
3 primary goals:
- Affordable health insurance available to more people, less costs for household with income between 100-400% FPL.
- Expansion of the Medicaid program 41 states have expanded 10 states have not
- Support innovative medical care delivery methods designed to lower the costs of health care.

Question 37

Healthcare economics and preventative care

Answer 37

Deals with healthcare cost and spending. Tries to understand how individuals, healthcare providers, insurers, private, and government organizations drivers those costs.