Health Insurance Challenges for Employed and Unemployed Individuals
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Questions and Answers

Which factor contributes the most to premature death according to the text?

  • Medical Care
  • Genetic
  • Social and Environmental Factors
  • Lifestyle And Behaviors (correct)

What was the main change in where healthcare services were provided from the 1950s to the 2000s?

  • Movement towards outpatient centers
  • Movement towards doctors offices
  • Movement towards patient's homes
  • Movement towards hospitals (correct)

Which mode of paying for healthcare is the most prevalent according to the text?

  • Individual Private Insurance
  • Government Financing and Subsidies
  • Out of Pocket
  • Employment-Based Private Insurance (correct)

What was the initial purpose of Employment-Based Private Insurance?

<p>To incentivize workers during WWII wage controls (B)</p> Signup and view all the answers

Which type of insurance is very expensive since there is no group discount?

<p>Individual Private Insurance (B)</p> Signup and view all the answers

What problem did an increase in out of pocket payments aim to control?

<p>Premium costs (A)</p> Signup and view all the answers

Which group is more likely to be employed but uninsured?

<p>People of Color (POCs) (A)</p> Signup and view all the answers

What is one of the reasons why some employed individuals are uninsured?

<p>They work for small firms (B)</p> Signup and view all the answers

Which group is more likely to be unemployed but uninsured?

<p>People with expensive health insurance (A)</p> Signup and view all the answers

Why is financing for healthcare considered regressive?

<p>It takes a falling percentage of income as income increases (A)</p> Signup and view all the answers

What is one of the forms of financing for healthcare mentioned in the text?

<p>IBRA (D)</p> Signup and view all the answers

Why are unemployed individuals with low income ineligible for Medicaid?

<p>They have too much income (D)</p> Signup and view all the answers

Which type of insurance rating sets insurance rates based on a group's actual healthcare expenses in a prior period?

<p>Experience Rating (C)</p> Signup and view all the answers

Which part of Medicare covers hospital insurance?

<p>Medicare Part A (C)</p> Signup and view all the answers

Which program provides healthcare coverage for children from families at or below 200-300% of the Federal Poverty Level?

<p>SCHIP (D)</p> Signup and view all the answers

What are the financial barriers to insurance?

<p>Underinsurance (C)</p> Signup and view all the answers

What are the non-financial barriers to insurance?

<p>Primary Care Physician Shortage (B)</p> Signup and view all the answers

What is one reason why the healthcare market is not a normal market?

<p>Information Asymmetry (B)</p> Signup and view all the answers

What is the most popular type of health insurance coverage in the 1900s?

<p>Indemnity (A)</p> Signup and view all the answers

Which type of health insurance coverage has the most freedom for patients to self-direct care?

<p>PPO (D)</p> Signup and view all the answers

Which type of health insurance coverage requires a PCP responsible for healthcare and making referrals to specialists?

<p>HMO (A)</p> Signup and view all the answers

Which type of health insurance coverage combines fee-for-service and pre-paid insurance?

<p>POS (B)</p> Signup and view all the answers

Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?

<p>HMO (B)</p> Signup and view all the answers

What does COBRA stand for and what is one of its limitations?

<p>Consolidated Omnibus Budget Reconciliation Act of 1985, premiums may be unaffordable with little to no income (B)</p> Signup and view all the answers

Which payment model involves an established rate to cover a person's medical care for a specified time?

<p>Capitation (B)</p> Signup and view all the answers

What is the purpose of the Medicare Resource Based Relative Value Scale?

<p>To estimate the time and effort required for each service (C)</p> Signup and view all the answers

Which payment model involves a fee determined by the doctor and paid by the insurance provider?

<p>Fee for Service (A)</p> Signup and view all the answers

What is one advantage of capitation as a payment model?

<p>Better ability to plan and control costs (C)</p> Signup and view all the answers

What was a focus of cost containment in the 1910s?

<p>Limiting the number and costs of services (D)</p> Signup and view all the answers

What is the current focus of cost containment?

<p>Negotiating blended payments (D)</p> Signup and view all the answers

Which factor contributes the least to premature death according to the text?

<p>Medical Care (D)</p> Signup and view all the answers

Which mode of paying for health care is the least prevalent according to the text?

<p>Individual Private Insurance (B)</p> Signup and view all the answers

Which mode of paying for health care has the most unpredictability according to the text?

<p>Out of Pocket (A)</p> Signup and view all the answers

Which mode of paying for health care was initially introduced as a way to incentivize workers during WWII wage controls?

<p>Employment-Based Private Insurance (A)</p> Signup and view all the answers

Which type of insurance rating sets insurance rates based on a group's average healthcare expenses in a prior period?

<p>Experience Rating (D)</p> Signup and view all the answers

Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?

<p>Health Maintenance Organization (HMO) (B)</p> Signup and view all the answers

Which group is more likely to be uninsured due to working part-time or having multiple part-time jobs?

<p>People of Color (POCs) (A)</p> Signup and view all the answers

What is one reason why unemployed individuals with low income are ineligible for Medicaid?

<p>They have too many assets (C)</p> Signup and view all the answers

Which form of financing for healthcare takes a falling percentage of income as income increases?

<p>Regressive financing (D)</p> Signup and view all the answers

Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?

<p>Medicaid (C)</p> Signup and view all the answers

What is one of the limitations of COBRA?

<p>It is not affordable for low-income individuals (B)</p> Signup and view all the answers

Why is financing for healthcare considered regressive?

<p>It takes a falling percentage of income as income increases (C)</p> Signup and view all the answers

What is the purpose of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>To provide insurance at group rates for people who lose insurance due to certain circumstances (C)</p> Signup and view all the answers

Which model of health care assumes the existence of illness or disease and emphasizes clinical diagnosis and medical interventions?

<p>Medical Model (A)</p> Signup and view all the answers

What is the main limitation of Health Maintenance Organizations (HMOs)?

<p>Limited choice of physicians (B)</p> Signup and view all the answers

What is the main advantage of Preferred Provider Organizations (PPOs)?

<p>Wide choice of providers and hospitals (A)</p> Signup and view all the answers

What is the main feature of Point of Service (POS) plans?

<p>Combining fee-for-service and pre-paid insurance (A)</p> Signup and view all the answers

What is the main benefit of having access to health insurance for employees in large firms?

<p>Access to insurance at group rates (C)</p> Signup and view all the answers

What is one of the risks that providers face in a fee-for-service reimbursement system?

<p>The risk of setting payment unilaterally (B)</p> Signup and view all the answers

What is the main difference between fee-for-service and capitation payment models?

<p>Fee-for-service allows providers to set their own prices, while capitation provides a fixed rate per patient (B)</p> Signup and view all the answers

What is the purpose of the Medicare Resource Based Relative Value Scale (RBRVS)?

<p>To correct for bias in physician payments (A)</p> Signup and view all the answers

What is one advantage of capitation as a payment model?

<p>Better ability to plan, manage, and control costs (A)</p> Signup and view all the answers

What was the focus of cost containment in the 1910s?

<p>Limiting the number and costs of services (D)</p> Signup and view all the answers

What is the current focus of cost containment?

<p>Blended payments (C)</p> Signup and view all the answers

Which type of health insurance coverage provides coverage for hospital care and allows the choice of hospitals?

<p>Blue Cross (A)</p> Signup and view all the answers

Which type of health insurance coverage provides coverage for physician and other outpatient services?

<p>Blue Shield (C)</p> Signup and view all the answers

Which part of Medicare provides hospital insurance?

<p>Medicare Part A (A)</p> Signup and view all the answers

Which part of Medicare provides coverage for physician and outpatient services?

<p>Medicare Part B (B)</p> Signup and view all the answers

Which program provides healthcare coverage for low-income individuals and is financed by state and federal taxes?

<p>Medicaid (C)</p> Signup and view all the answers

What is one of the financial barriers to insurance?

<p>Underinsurance (A)</p> Signup and view all the answers

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