Module 6

Question 1

Though uninsured can be treated bc EMTALA (emergency medical treatment and labor act) it still isn’t good bc

Answer 1

Often not timely and appropriate care

Question 2

Misconceived notions of uninsured populations

Answer 2

Young people, part time workers, immigrants

Question 3

People who are actually uninsured

Answer 3

1 fulltime worker (specific hard jobs like construction, agriculture, services), us citizens (41% white and 37% hispanic ), poor/low income

Question 4

Greatest risk of becoming uninsured

Answer 4

Poor, non-U.S. citizens (new immigrants,Hispanic/indigenous, any age

Question 5

People choose to be uninsured because

Answer 5

Cost is too high, lost job/change employers

Question 6

Who chooses to self insure

Answer 6

Large employers & individuals who believe selves to be low risk

Question 7

Health expenditure of GPD percentage

Answer 7

18

Question 8

Consequences of uninsurance

Answer 8

Inefficient utilization (delayed treatment), poor health, loss of workforce productivity

Question 9

Incentives

Answer 9

Not always financial, but often are. There are different implications depending on positions (patient, doctor, hospital etc)

Question 10

Unintended consequence

Answer 10

A consequence negatively impacting one party caused by a policy shift

Question 11

ACA signed into law

Answer 11

March 2010

Question 12

provisions of ACA

Answer 12

Child covered until 26, limits prohibited, prohibited ban, introduced preventative service with no copay,

Stop rejection of health reasons, health insurance exchange available rebates

Question 13

Individual mandate of ACA

Answer 13

Fine for not having insurance. hardship exemption and subsidy also offered.

Buy through marketplace if not insured through emoyerd

Question 14

Physician is paid for..:

Answer 14

For every service they provide. By insurance and patient

Question 15

What 4 things create the environment for Supplier Induced Demand (and incentive for producer moral hazard)

Answer 15

Asymmetric information (market failure), moral hazard in insurance (market failure), physician fees for service, and health insurance being paid directly by provider

Question 16

Physician reimbursement options

Answer 16

Fee for service, captitation, salary, mixed payment

Question 17

Capitation

Answer 17

Paid amount for each person their treating (not per service)

Question 18

Indemnity Insurance

Answer 18

Insurance will pay all service fees for hospital

Question 19

Diagnostic Related Groups

Answer 19

Medicare provided. Hospital paid set amount for treating particular diagnosis

Question 20

Accountable Care Organizations

Answer 20

Multiple speciality groups, money split between what diagnoses needs it more

Question 21

Physicians role in healthcare inefficiency

Answer 21

Producer moral hazard.

Have incentive to over provide in many contexts

Question 22

Consumer role in healthcare inefficiency

Answer 22

Consumer moral hazard,

Cost-sharing through deductibles, copayments, and coinsurance gives incentive to avoid unnecessary or delay necessary health care