Healthcare Systems and Financing Matching Quiz

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Questions and Answers

Match the countries with their type of practice:

Australia = Solo practice France = Highly separated systems Finland = Group practice Germany = Separated systems

Match the integration index with the corresponding country:

5 = Portugal 4.5 = New Zealand 3.5 = Israel 2 = Australia

Match the country with their financing type:

Norway = Universalist Austria = Separated Japan = Separated Denmark = Integrated

Match the provided systems with their countries:

Turkey = Highly separated systems Ireland = Moderately integrated systems Poland = Moderately separated systems Greece = Moderately integrated systems Signup and view all the answers

Match the following countries with their health service classification:

UK = National Health Service (NHS) Finland = Highly integrated systems Czech Republic = Separated systems Switzerland = Highly separated systems Signup and view all the answers

Match the following countries with their healthcare insurance coverage percentage:

Australia = 100 Mexico = 77.4 Ukraine = 89.0 Poland = 96.9 Signup and view all the answers

Match the following healthcare programs with their primary beneficiaries:

Medicare = Individuals over age 65 Medicaid = Low-income individuals and families Veteran's Administration Health Care = Veterans Private Insurance = Individuals seeking customizable plans Signup and view all the answers

Match the following healthcare coverage types with their funding sources:

Medicare = Payroll taxes Medicaid = State and federal funding Private Insurance = Premiums paid by individuals Veteran's Administration Health Care = Federal government funding Signup and view all the answers

Match the following health insurance characteristics with their definitions:

Premiums = Regular payments to keep insurance active Deductibles = Amount paid before insurance kicks in Out-of-pocket payments = Costs that are not covered by insurance Copayments = Fixed fees paid for specific services Signup and view all the answers

Match the following countries with their healthcare insurance coverage status:

Greece = 100 Switzerland = 100 Hungary = 96.0 Ireland = 100 Signup and view all the answers

Match the following terms related to healthcare finance with their descriptions:

Part A = Hospital insurance Part B = Outpatient care Part D = Drug coverage Medicaid = Jointly funded health coverage Signup and view all the answers

Match the following healthcare percentages with their corresponding countries:

Canada = 100 Norway = 100 Czech Republic = 100 Finland = 100 Signup and view all the answers

Match the following percentages with the respective Medicare coverage statistics:

62.5 million = Number of Americans covered by Medicare 75% = Percentage of healthcare costs covered by Medicare 14% = Medicare spending as part of federal budget 18.9% = Percentage of US population enrolled in Medicare Signup and view all the answers

Match the following provisions of the PPACA with their descriptions:

Individual mandate = All individuals must purchase insurance or pay a penalty Health insurance exchanges = Marketplace for comparing and purchasing insurance Federal subsidies = Financial assistance for low-income individuals and families Medicaid expansion = Increased coverage for individuals up to 138% of poverty level Signup and view all the answers

Match the following penalties and exemptions under the PPACA:

Penalty for individuals in 2016 = $695 individual / $2,085 family Employer penalty for non-offering = $2,000 per employee Exemption for religious reasons = Individuals not subjected to mandate penalties Penalties abolished = In 2019 for individual mandates Signup and view all the answers

Match the following features of insurance regulations under the PPACA:

Same premiums = Insurers must offer the same premiums to all applicants of the same age Gender and pre-existing conditions = Insurers cannot discriminate based on these factors Spending requirement = Insurers must spend 85% of premiums on healthcare Prohibition on dropping coverage = Insurers cannot drop policyholders when they get sick Signup and view all the answers

Match the following healthcare systems to their characteristics:

German health insurance system = Established by Bismarck in 1883 Funding sources in Germany = 78% from contributions, 8% from general taxation Voluntary private insurance in Germany = Accounts for 3% of total funding Out-of-pocket payments = Constitutes about 11% of total funding in Germany Signup and view all the answers

Match the following years to their significant PPACA events:

2014 = Individual mandate and health insurance exchanges take effect 2019 = Abolishment of individual mandate penalties 2010 = Prohibition on dropping sick policyholders begins 2024 = Medicaid eligibility up to $20,783 poverty level Signup and view all the answers

Match the following aspects of Medicare restructuring:

Fee-for-service (FFS) = Previous payment model before restructuring Bundled payments = New model for Medicare reimbursement High risk pool = Temporary measure established in 2010 Children's coverage = Allowed to stay on parent's insurance until 26 Signup and view all the answers

Match the following statistics regarding Medicaid expansion:

2012 Supreme Court decision = States allowed to opt-out of expansion Population coverage by 2023 = 4% of the population covered Expansion states in 2024 = 40 states opted for Medicaid expansion Non-expansion states = 10 states chose not to expand Medicaid Signup and view all the answers

Match the following terms with their meaning in the context of healthcare:

OOP payments = Out-of-pocket payments for healthcare services Play or pay = Employer mandate regarding health insurance offerings Statutory health insurance = Publicly funded insurance system in Germany Health insurance marketplace = Platform for purchasing and comparing health insurance Signup and view all the answers

Match the type of payment system with the corresponding country:

Extra-billing (EB) = France Private practice (PP) = Australia Salary = Portugal Capitation (Capit) = Italy Signup and view all the answers

Match the country with its payment method for primary care physicians:

UK = Capitation + FFS Spain = Salary + Capitation Japan = FFS Greece = Salary Signup and view all the answers

Match the country with its payment method for hospital doctors:

Norway = Salary + PP Canada = FFS Germany = Salary Sweden = Salary + PP Signup and view all the answers

Match the payment type with its characteristics:

Salary = Fixed amount per time period Fee-for-service (FFS) = Payment per individual service provided Capitation (Capit) = Payment per patient enrolled regardless of services used Pay-for-performance = Incentives based on quality metrics Signup and view all the answers

Match the healthcare programs with their descriptions:

MediShield Life = Mandatory health insurance covering catastrophic costs Medifund = Targeted program for the poor financed by the government Medicare = Covers Americans over age 65 Medicaid = Mean-tested program for low-income persons Signup and view all the answers

Match the country with the type of health service system used:

New Zealand = Salary + PP Italy = Capitation Ireland = Capitation + FFS Denmark = FFS + Capit Signup and view all the answers

Match the healthcare segmentation principles with their definitions:

Segmentation of healthcare services = Dividing services into essential and supplementary procedures Segmentation of the population = Subdividing citizens based on insurance schemes Hybrid health systems = Combining multiple healthcare models National health systems = No system uses only a single model of healthcare Signup and view all the answers

Match the healthcare payment model with its definition:

Private practice (PP) = Additional income from private patients Extra-billing (EB) = Charged difference between insurance reimbursement and provider's charge Salary = Fixed remuneration without productivity incentives Capitation (Capit) = Payment method where providers receive a set fee for each enrolled patient Signup and view all the answers

Match the following countries with their primary care physician payment types:

Netherlands = Capitation + FFS Australia = FFS + EB Canada = FFS Portugal = Salary Signup and view all the answers

Match the U.S. public programs with their target groups:

Chip = Insurance for children of low-income families Medicare = Americans over age 65 or with long-term disabilities Medicaid = Low-income individuals Veteran programs = War veterans and members of the Armed Forces Signup and view all the answers

Match the country with its healthcare remuneration:

France = FFS + EB Spain = Salary + Capitation Ireland = Capitation + FFS Switzerland = FFS Signup and view all the answers

Match the healthcare sectors in the Netherlands with their focus areas:

Exceptional medical expenses = Coverage for unforeseen high-cost medical events Basic package = Essential care services for all citizens Supplementary procedures = Additional services beyond the basic package Hybrid systems = Integration of various healthcare models Signup and view all the answers

Match the healthcare terms with their meanings:

Catastrophic healthcare costs = High costs associated with serious illnesses Targeted health programs = Programs designed for specific groups Segmentation = Breaking down the healthcare system into subsystems Financing health care = Methods of funding various health services Signup and view all the answers

Match the demographic factors influencing segmentation with their descriptions:

Occupation = Divides workers into employees and self-employed Income = Groups individuals based on financial earnings Age = Programs targeted only for the young or elderly Geographic location = Differences in healthcare access based on residence Signup and view all the answers

Match the terms related to health insurance with their explanations:

Essential procedures = Basic medical interventions necessary for health Supplementary procedures = Additional treatments or services optional for patients Public health insurance = Government-funded coverage for specific groups Private health insurance = Insurance purchased by individuals not covered by government programs Signup and view all the answers

Match the characteristics of hybrid healthcare systems with their significance:

Multiple funding sources = Involves both private and public sectors Diverse service offerings = Provides a range of care options to patients Flexibility in payments = Different payment methods for various services Adaptability to population needs = Can cater to different demographic groups efficiently Signup and view all the answers

Match the health care features in Switzerland with their descriptions:

Freedom of choice = Patients can choose their health care physician without referral HMO = Managed care arrangement offering premium reductions Specialists access = Direct access to specialists in ambulatory care Cantonal hospital lists = Limitation of hospital care options for patients Signup and view all the answers

Match the payment methods for physicians with their descriptions:

Fee-for-service (FFS) = Payment based on the quantity and type of services provided Capitation = Set payment for each enrolled individual regardless of service use Salary = Fixed payment regardless of patient volume or services provided Mixed methods = Combination of different payment structures for physicians Signup and view all the answers

Match the advantages and disadvantages of Fee-for-service (FFS) with the relevant statements:

Rewards productivity = Encourages doctors to provide more services Incentivizes unnecessary services = Can lead to over-treatment of patients Higher earnings potential = More productive doctors earn more Encourages thorough care = May promote comprehensive examinations Signup and view all the answers

Match the characteristics of Capitation with their effects:

Stable doctor-patient relationship = Encourages ongoing care over time Reduced financial incentives = Limits unnecessary services being provided Potential patient selection = Doctors may choose less demanding patients Promotes user satisfaction = Encourages quality patient interactions Signup and view all the answers

Match the types of health care coverage with their features:

HMO insurance = Requires members to use a network of providers Fee-for-service = Members pay for each service at the time it is received Capitation = Fixed amount paid per patient enrolled Traditional insurance = Often allows more freedom of choice in providers Signup and view all the answers

Match the impact of physician payment methods with their results:

Fee-for-service (FFS) = Can increase overall healthcare costs Capitation = May lead to fewer visits per patient Salary = Ensures consistent income regardless of workload Mixed methods = Fosters flexible approaches to physician payment Signup and view all the answers

Match the payment method with its main advantage and disadvantage:

Fee-for-service (FFS) = Advantage: productivity increase; Disadvantage: over-treatment risk Capitation = Advantage: cost control; Disadvantage: potential patient selection Salary = Advantage: stability; Disadvantage: lack of incentive for productivity HMO = Advantage: reduced costs; Disadvantage: limited provider choices Signup and view all the answers

Match the terms related to Swiss health care with their definitions:

HMO = Health maintenance organization focusing on managed care Ambulatory care = Medical services given on an outpatient basis Gatekeeping = Formal control over access to specialists (absent in Swiss system) Cantonal = Referring to the regional administration of hospitals in Switzerland Signup and view all the answers

Study Notes

Healthcare Organization Models

Three basic models exist for healthcare organization in industrialized countries: voluntary health insurance, social health insurance, and national health service.
Each model differs in its funding mechanisms and how healthcare services are organized.

Voluntary Health Insurance (VHI)

Citizens choose whether to purchase private health insurance from a private insurance company.
Insurance policies are customizable depending on individual needs, income, or health conditions.
Healthcare providers are usually independent from insurance companies; insurers only reimburse providers.
Policyholders have significant freedom in choosing healthcare providers.

The government mandates health insurance for certain occupational groups.
Multiple sickness funds (not-for-profit organizations) collect contributions from workers based on their employment.
Workers receive total or partial reimbursement for incurred medical expenses.
Contributions are calculated based on earned income, not overall income.
The classic model assigns workers to specific funds according to their profession.
More recently, some countries allow workers to choose their health insurance fund.

National Health Service (NHS)

National health services receive funding through general taxation.
The state manages resources needed to fund healthcare provision.
NHS guarantees healthcare access to the entire population.
Healthcare treatment is considered essential and a fundamental right.
Most hospitals and physicians are publicly owned/employed.

Funding Models

Simple market: Providers directly interact with users, who pay directly for services. No third-party involvement.
Voluntary insurance: Individuals choose whether or not to purchase private insurance.
Targeted programs: Programs funded by general taxes aimed at specific populations experiencing high health risks (e.g., low-income individuals, elderly, and minors).
Social health insurance: The government mandates certain groups to purchase health insurance. Multiple sickness funds collect contributions from each category of workers.
Mandatory residence insurance: The state requires all residents to have private health insurance. Different insurers compete to provide essential health coverage.
Universalist model: Government funds healthcare through general taxation, offering healthcare to everyone.
Medical Savings Accounts (MSAs): Individual deposit accounts where workers set aside funds for healthcare costs. These funds are usually tax-free.

US Public Programs

Medicare: Covers Americans over age 65 and younger people with long-term disabilities. It's a mean-tested program for low-income people.
Medicaid: Covers low-income people.
CHIP: Covers children of low-income families whose earnings exceed Medicaid limitations.
Other public schemes: cover war veterans, military personnel, federal government employees, Native Americans, prisoners, and other vulnerable groups.

Healthcare Systems in Three Countries

Germany: First country to implement SHI in 1883. Funding is mostly through contributions from workers; 8% general taxation.
Canada: Has a single-payer public insurance program (Medicare). About 70% of health spending is funded via taxation.
Switzerland: Each resident is required to have health insurance. Insurance rates are identical within each company for people in the same age and region.

Healthcare Provision

Two rival models: separated and integrated.
- Separated: High autonomy among actors, pluralism, contractual relations, and significant choice;
- Integrated: High coordination within the same organization, stable relations, hierarchy, and limited choice.
Organizational integration: Formal contracts and agreements that bind healthcare providers.
Clinical integration: Coordinating efforts among various healthcare providers treating the same patient.
Primary care: Treats most common health issues.
Secondary care: Specialized treatment delivered by medical experts.
Gatekeeping: System requiring referral from a general practitioner (e.g., family doctor) to access specialists.
Patient freedom of choice: Complete freedom of choice to select any provider (public or private); Limited choice to contracted providers.
Solo practice: General practitioners are independent and work alone.
Group practice: General practitioners work together.

The Importance of Institutional Rules & Political Context

Majoritarian Model: Political power concentrated in the executive branch.
Consensual Model: Political power dispersed among multiple actors.
Veto Players: Actors who can block government initiatives.

The Obama Healthcare Reform

Individual mandate/play or pay: Individuals required to purchase insurance or pay a penalty.
Health insurance exchanges: State-regulated marketplaces allowing individuals to compare policies.
Federal subsidies: Low-income individuals and families receive federal subsidies to help purchase insurance.
Regulations for insurance companies: Prevent discriminatory pricing and policies related to pre-existing conditions.
Medicaid expansion: Increased Medicaid coverage to more low-income and disabled people.
Other public programs: The government maintains existing programs covering military healthcare, children, and/or people with specific diseases.

The Uninsured

Large number of individuals in the USA remain uninsured.
Many factors can lead to this: not meeting eligibility requirements, lacking employment, or high healthcare costs.

Healthcare Payment Methods

Fee-for-service (FFS): Providers are paid for each service rendered.
Capitation: Providers are paid a set amount per person assigned.
Salary: Providers are paid a fixed amount regardless of patients or services.
Extra-billing: Providers charge patients beyond what insurers reimburse.
Private practice (PP): Physicians maintain practices separate from government and group organizations.

Health Insurance in the US

Overall, public health programs are required to address a range of issues such as the insured, the uninsured, costs, and provider and insurance company behavior.

Comparing National Health Services in Northern and Southern Europe

Total health expenditure per capita, and public versus private expenditure
Hospital bed counts (public/private)
Public Health System satisfaction rates

Other Noteworthy Points

Healthcare systems aren't exclusive to one model. A "hybrid" system blends different elements from various models.

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Description

Test your knowledge on global healthcare systems with this matching quiz. Match countries with their healthcare practices, financing types, insurance coverage, and more. Perfect for students of public health or those interested in healthcare policy.