HCD Lesson 1 - History/Insurance Exam Questions With All Correct Answers Verified Answers 2025 Marking Scheme New Update

HCD Lesson 1 - History/Insurance Exam Questions With All Correct Answers Verified Answers 2025 Marking Scheme New Update Three qualities of an acceptable healthcare system (stool analogy) - Answer- - Access - Cost - Quality Some unique attributes of US healthcare - Answer- - Fragmented - High rates of uninsured/underinsured - Inequality of care - No comprehensive, organized system to pay - For-profit - Highest expenditure per capita, spend highest % of GDP - Criticism of socialization 5 Historical Factors that have influenced healthcare system - Answer- - Cultural beliefs/values - Social changes - Technological advances - Economic constraints - Political opportunism Historical Factor: Cultural Beliefs/Values - Answer- - Individualistic - Capitalism - Distrust of big gov - Tax aversion Historical Factor: Social Changes - Answer- - Demographics (lower white pop) - Immigration - Higher urbanization Historical Factors: Technological Advances - Answer- - New treatments, facilities, equipment - Increased training - Higher cost of care Historical Factors: Economic Constraints - Answer- - Higher healthcare cost - Higher health insurance cost - Higher family income, but not enough Historical Factors: Political Opportunism - Answer- - President's agenda - Domestic/foreign policies - Interest groups - Laws/Regulations Three Eras of US Healthcare - Answer- - Pre-Industrial - Post-Industrial - Corporate Pre-Industrial Era - Answer- - Minimally educated physicians - Inexpensive - Poorhouses run by gov, asylums for chronic illnesses - Few hospitals with bad conditions Post-Industrial Era - Answer- - Growth of medical profession - More education - Urbanization - Office-based practice and hospitals - Centralization of facilities and equipment - Health insurance hospital-based - Creation of Medicare/Medicaid - Employer insurance benefits Corporate Era - Answer- - Corporatization: large systems - Growth of non-physician workforce - Information Revolution: EMR, telehealth - Globalization Affordable Care Act Structure (Obamacare) - Answer- - Access Quality Cost - Makes underwriting, individual rating, community rating recission illegal - Creates guaranteed issue, insurance mandates, risk pools, modified community rating Guaranteed Issue - Answer- Gov says insurance companies have to sell policies to those who apply Individual Insurance Mandate - Answer- Gov says everyone in a country is required to obtain insurance Employer Insurance Mandate - Answer- Gov says all employers are required to provide insurance to employees (with caveats) Underwriting - Answer- Person decides if company should sell insurance to an applicant based on low/high risk (illegal under ACA) Preexisting Condition - Answer- Illness/disorder that increases cost of insurance with underwriting Risk Pool - Answer- Number of policy holders in a policy category (large/small, sick/healthy) Favorable Pool - Answer- Large, healthier, safest, lowest premiums Adverse Pool - Answer- Large, sicker, riskiest, highest premiums Stabilizing Risk Pool - Answer- Increasing premiums or choosing not to sell insurance to a geographical area If there was guaranteed issue but no mandate, what happens? - Answer- Healthy people don't get adequate insurance, then get sick. When they get sick, premiums go up.