60 Questions
Which factor contributes the most to premature death according to the text?
Lifestyle And Behaviors
What was the main change in where healthcare services were provided from the 1950s to the 2000s?
Movement towards hospitals
Which mode of paying for healthcare is the most prevalent according to the text?
Employment-Based Private Insurance
What was the initial purpose of Employment-Based Private Insurance?
To incentivize workers during WWII wage controls
Which type of insurance is very expensive since there is no group discount?
Individual Private Insurance
What problem did an increase in out of pocket payments aim to control?
Premium costs
Which group is more likely to be employed but uninsured?
People of Color (POCs)
What is one of the reasons why some employed individuals are uninsured?
They work for small firms
Which group is more likely to be unemployed but uninsured?
People with expensive health insurance
Why is financing for healthcare considered regressive?
It takes a falling percentage of income as income increases
What is one of the forms of financing for healthcare mentioned in the text?
IBRA
Why are unemployed individuals with low income ineligible for Medicaid?
They have too much income
Which type of insurance rating sets insurance rates based on a group's actual healthcare expenses in a prior period?
Experience Rating
Which part of Medicare covers hospital insurance?
Medicare Part A
Which program provides healthcare coverage for children from families at or below 200-300% of the Federal Poverty Level?
SCHIP
What are the financial barriers to insurance?
Underinsurance
What are the non-financial barriers to insurance?
Primary Care Physician Shortage
What is one reason why the healthcare market is not a normal market?
Information Asymmetry
What is the most popular type of health insurance coverage in the 1900s?
Indemnity
Which type of health insurance coverage has the most freedom for patients to self-direct care?
PPO
Which type of health insurance coverage requires a PCP responsible for healthcare and making referrals to specialists?
HMO
Which type of health insurance coverage combines fee-for-service and pre-paid insurance?
POS
Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?
HMO
What does COBRA stand for and what is one of its limitations?
Consolidated Omnibus Budget Reconciliation Act of 1985, premiums may be unaffordable with little to no income
Which payment model involves an established rate to cover a person's medical care for a specified time?
Capitation
What is the purpose of the Medicare Resource Based Relative Value Scale?
To estimate the time and effort required for each service
Which payment model involves a fee determined by the doctor and paid by the insurance provider?
Fee for Service
What is one advantage of capitation as a payment model?
Better ability to plan and control costs
What was a focus of cost containment in the 1910s?
Limiting the number and costs of services
What is the current focus of cost containment?
Negotiating blended payments
Which factor contributes the least to premature death according to the text?
Medical Care
Which mode of paying for health care is the least prevalent according to the text?
Individual Private Insurance
Which mode of paying for health care has the most unpredictability according to the text?
Out of Pocket
Which mode of paying for health care was initially introduced as a way to incentivize workers during WWII wage controls?
Employment-Based Private Insurance
Which type of insurance rating sets insurance rates based on a group's average healthcare expenses in a prior period?
Experience Rating
Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?
Health Maintenance Organization (HMO)
Which group is more likely to be uninsured due to working part-time or having multiple part-time jobs?
People of Color (POCs)
What is one reason why unemployed individuals with low income are ineligible for Medicaid?
They have too many assets
Which form of financing for healthcare takes a falling percentage of income as income increases?
Regressive financing
Which type of health insurance coverage is relatively inexpensive and emphasizes preventative care?
Medicaid
What is one of the limitations of COBRA?
It is not affordable for low-income individuals
Why is financing for healthcare considered regressive?
It takes a falling percentage of income as income increases
What is the purpose of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?
To provide insurance at group rates for people who lose insurance due to certain circumstances
Which model of health care assumes the existence of illness or disease and emphasizes clinical diagnosis and medical interventions?
Medical Model
What is the main limitation of Health Maintenance Organizations (HMOs)?
Limited choice of physicians
What is the main advantage of Preferred Provider Organizations (PPOs)?
Wide choice of providers and hospitals
What is the main feature of Point of Service (POS) plans?
Combining fee-for-service and pre-paid insurance
What is the main benefit of having access to health insurance for employees in large firms?
Access to insurance at group rates
What is one of the risks that providers face in a fee-for-service reimbursement system?
The risk of setting payment unilaterally
What is the main difference between fee-for-service and capitation payment models?
Fee-for-service allows providers to set their own prices, while capitation provides a fixed rate per patient
What is the purpose of the Medicare Resource Based Relative Value Scale (RBRVS)?
To correct for bias in physician payments
What is one advantage of capitation as a payment model?
Better ability to plan, manage, and control costs
What was the focus of cost containment in the 1910s?
Limiting the number and costs of services
What is the current focus of cost containment?
Blended payments
Which type of health insurance coverage provides coverage for hospital care and allows the choice of hospitals?
Blue Cross
Which type of health insurance coverage provides coverage for physician and other outpatient services?
Blue Shield
Which part of Medicare provides hospital insurance?
Medicare Part A
Which part of Medicare provides coverage for physician and outpatient services?
Medicare Part B
Which program provides healthcare coverage for low-income individuals and is financed by state and federal taxes?
Medicaid
What is one of the financial barriers to insurance?
Underinsurance
Quiz: Understanding the Challenges of Being Employed or Unemployed Without Health Insurance
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