HCMG LATEST QUESTIONS AND ANSWERS UPDATE: A MASTERING A+ MATERIAL!

HCMG LATEST QUESTIONS AND ANSWERS UPDATE: A MASTERING A+ MATERIAL! Who do taxes affect? Income: all earnings, wages: workers only, sales (VAT)- consumers How options are there for voluntary private payment? Employer/employee premiums: sometimes tax exempt, out of pocket: moral hazard What are component options for insurance? Public system and public plus private systems What is insurance also known as? Risk Pooling What options does the Public system of insurance include? single vs. multiple pools What is a pool? geographic, employer, trade, other Quasi-public institutions What options does a public + private system have? Variations in size of private market (% private), regulations limiting private market entry by type of care, and conditions for opting out- no such things as solely private systems!! What exists between pools within an insurance system? Competition and adverse selection What components are there to the delivery aspect of a health system? Sources of care, ownership, and reimbursement What is included within sources of care within delivery of health systems? MDs (GP and Specialist), Hospitals, other HC Providers (coordination of care) What is included within ownership within delivery of health systems? government owned, private (+regulation), non profit What is included within reimbursement with delivery of health systems? Fixed budgets, FFS, Capitation, Per Diem How does insurance work in Canada? How much coverage is there? What choice do consumers have? Medicare: universal single payer- medically necessary hospital and physician coverage free at point of care and independently managed by each 13 provinces and territories; 100%; provider How much do health care expenses account for of GDP in Canada as of 2012? 11% What kind of insurance can doctors only accept in Canada? public How is does financing in the health system of Canada occur? General tax revenue provides coverage for 70% of total expenditures, other 30% is covered by private supplementary and replacement insurance that is mainly used by large employers to fund vision, dental, and extended drug coverage How does delivery within the Canadian health system work? Public hospitals-- physicians must accept government rates- free to chose primary care doctor, but gatekeepers used to control utilization of health care services Who decides how much is spent on health care in Canada? government How are doctors paid in Canada? service How does insurance work in Germany? Universal insurance coverage provided by government- covers 90% of costs- approximately 200 health plans called sickness funds Who collect money from insurance in Germany? Employers, they are not the sponsors though How much of GDp was spent on health care in 2009 in Germany? 12% How are the sickness funds in Germany run? How do benefits work? Who are the providers? Who can control payment rates and how? Quasi-public and quasi non profit, organized through workplace, occupation, union; benefits vary, but there is a minimum benefit package mandated by government; Private sector providers; government through global budgets When can't Germany deny coverage? Based on preexisting conditions How do sickness funds interact with each other in Germany? Compete between each other for enrollment- goal is to thrive and grow not to profit How does financing in Germany work? How much do workers pay of premiums? Where does the rest come from? How do the different funds set contribution rate? Everyone below a certain income level is expected to join a health insurance fund (sickness fund) and everyone in a sickness fund pays the same percentage of income- it is a flat tax (10-15%)- different sickness funds pay different tax rates; 50-60%; payroll taxes; based on income What is the role of employers in financing of health system in Germany? Only collect money, no power of chice Who can purchase private insurance in Germany? How many do? top 10%; only a 1/3 do How does delivery work in Germany? how does payment differ with doctors? How does Germany's tech use compare to the U.S.? More care in hospitals and more doctors and hospitals; hospital doctors on salary are separate form office-based doctors; use less Describe the breakdown of the universal health insurance system in Japan. Employment based insurance (60%), public national health insurance for uninsured, self-insured, and low income (34%), elderly, welfare support What is the primary insurance program in Japan? Employment based insurance How doe employment based insurance work in Japan? What two kinds of employment based insurance exist? Employers serve as sponsors, health c=plans can customize their benefits packages; small plans and large plans How much of GDP was spent on health care in Japan in 2009?