Role Of Goverment

Question 1

What does Laissez faire economics depend on?

Answer 1

Degree of competition, information and spillovers (lots of comp and free flowing information, few spillovers)

Question 2

What are the problems with healthcare being laissez faire?

Answer 2

Competition is restricted, information is asymmetric, and spillovers are ubiquitous

Question 3

What is the Department of Health and Human Services?

Answer 3

A government agency that oversees the FDA, CDC, Center for Medicare and Medicaid Services, and more

Question 4

What are some implementations RFK would like to make?

Answer 4

• stricter food policy (less processed foods and less dyes)
• fewer protections for vaccine manufacturers

Question 5

What is the FDAs job?

Answer 5

Ensure safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices

Question 6

What is the trade-off the FDA is plagued with when it comes to products?

Answer 6

The speed vs the thoroughness of their approval

Question 7

What do the Centers for Medicare & Medicaid Services do?

Answer 7

Manage Medicare, Medicaid, and the children’s health insurance program, and the ACA health insurance marketplace

Question 8

What is the CDCs job?

Answer 8

Identify preventable health problems and maintains active surveillance of diseases

Question 9

What is the job of the NIH?

Answer 9

Lead founder of medical and public health research

Question 10

What is the Federal Trade Commissions job?

Answer 10

Monitor market power and consumer welfare

Hopes to prevent mergers and acquisitions and other anticompetitive practices that will reduce competition and increase prices

Question 11

What do the DOJ, Department of Agriculture, and National Center for Health Statistics do?

Answer 11

• handle criminal prosecutions, survey health care fraud and medical malpractice
• oversees supplemental nutrition assistance program and children’s nutrition programs
• part of the CDC and oversees population surveys and vital records

Question 12

When was Medicare Part D introduced?

Answer 12

2006

Question 13

What is the Employee Retirement Income Security Act (ERISA)?

Answer 13

Provides minimum standards for plans but exempts self-insured plans from state-level legislation

Question 14

What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)?

Answer 14

Allows for continued coverage when an employee leaves a job, which is an attempt to reduce job lock

Question 15

What is the Emergency Medical Treatment and Active Labor Act?

Answer 15

Requires emergency departments that accept Medicare to provide medical screenings to any patient, regardless of ability to pay

Question 16

What is the Health Insurance Portability and Accountability Act (HIPAA)?

Answer 16

Provides guidelines for group health plans and some individual plans, also introduces minimum standards for electronic health records

Question 17

What did the Balanced Budget Act of 1997 create?

Answer 17

Medicare Part C and CHIP

Question 18

What insurance plans are exempt from policies related to insurance because of ERISA?

Answer 18

Self insured plans

Question 19

What are is the major examples of state-level legislation of healthcare?

Answer 19

Medicaid is determined heavily by the states including covered services, payment levels, and expansion

Question 20

What are certificate of need (CON) laws?

Answer 20

CON regulation assumes excess capacity stems from overbuilding of healthcare facilities

CON laws regulate the number of hospital beds (can extent to nursing homes, etc)

Question 21

Do all states follow CON laws?

Answer 21

No

Question 22

Where do federal and state government use price controls?

Answer 22

Medicare, Medicaid, and VA

Question 23

What are price controls?

Answer 23

Cost containment tool

Question 24

What are the tradeoffs of price controls?

Answer 24

Indirect rationing via waitlists, deterioration of quality, and gaming the system to increase revenues

Question 25

What are the main focuses of courts regarding health policy?

Answer 25

• coverage provisions of private insurers
• antitrust
• tax exemption status
• medical malpractice
• antitrust law

Question 26

What are some issues in expanding the courts role in healthcare?

Answer 26

Lack of proper knowledge of healthcare in judges, decentralized judicial system leads to inconsistent rulings, rulings not generalizable

Question 27

What is a monopsony power?

Answer 27

One buyer (insurers)

Question 28

What can antitrust consist of?

Answer 28

Monopoly power and monopsony power

Question 29

What does the FTC and DOJ consider for monopoly power?

Answer 29

Natural monopolies, the need for intellectual property rights, and patient safety

Question 30

What do courts focus on with monopsonies?

Answer 30

They often side with the insurer who can bargain as hard as it wants for lower prices from providers, when its not predatory ofc

Question 31

What is medical malpractice?

Answer 31

When a provider, through negligence or omission, deviates from standard practice and causes injury to a patient

Question 32

What are malpractice premiums?

Answer 32

Premiums doctors must pay for malpractice insurance which is needed because getting sued is so common

Question 33

What are some proposed changes to malpractice?

Answer 33

• damage caps
• limits on attorneys fees
• joint and several liability
• evidence-based guidelines
• special health courts
• no-fault malpractice
• community and resolution programs

Question 34

What is the Chevron Doctrine?

Answer 34

Held that when statutes are unclear and a federal agency regulates based on a “reasonable” reading of them, judges should uphold the regulation