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GPH Exam 3 Questions with Detailed
Verified Answers
Question: Describe the health system in this country
Answer: It is a pluralistic model. It can be thought of as multiple systems that
operate independently and collaborate with each other at times. Public and
private payers purchase health-care services from providers subjected to
regulations by the federal, state and local governments as well as by private
regulatory organizations. There are government purchasers, private insurers,
and out of pocket payers. Many Americans get their private insurance through
their employers.The private sector stakeholders play a strong role in the
healthcare system. Governmental insurance includes medicaid and medicare.
Medicaid is for the disabled and low income. Medicare is for the elderly and
act like universal coverage. Pharmaceuticals and medical devices are
regulated by the federal government.
Question:How is the health system funded?
Answer: Private insurance pays 35%, Medicare pays 23%, Medicaid pays 16%
and CHIP pays 4%. When combined government funding covers 45% of the
national health care expenditure (2011). Federal funding comes from income
tax ranging from 10% to 35% of taxable earnings. Income tax varies by state.
Sales tax also contributes to funding which varies by state as well. Private
charities and donations also help provide funding for people without
insurance.
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Question:Insurance in US?
Answer: Private health Insurance: 54%
Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
% of country insured: 84%
% insured through employer based plans: 49%
% insured by public plans: 30%
Question:What are the costs to consumers for health care?
Answer: Out of pocket payments are health-care costs paid by the consumer.
These include direct payment for health services, coinsurance, co-payments
and deductibles.
Question:Strengths of the US system
Answer: Large and well trained health workforce
Wide range of high-quality medical specialists
Robust health sector research program
Among the best medical outcomes in the world
Question:Weaknesses of the US system
Answer: Incomplete coverage
Underinsurance
Inadequate care for the uninsured
Health expenditure levels per person that far exceed all other countries
Poor results on many objective and subjective measures of quality and
outcomes
Unequal distribution of resources and outcomes across the country
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Lagging efforts to introduce health information technology
Question:Know the goals of the ACA
Answer: RIE
Reduce expenses
Expand insurance coverage
Improve quality of care
Question:Be able to explain the three private mechanisms and one public
mechanism to increase insurance coverage through the ACA
Answer: Private
Individual mandate
Employer mandate
Dependent coverage provision
Public
Medicaid - Families who fall within 133% of the FPL can get insurance
coverage
Question:Know at least one positive outcome/benefit of the ACA and be able
to explain the data that support it
Answer: As of March 2016, more than 20 million people gained health
insurance for a variety of reasons
-Didn't want to be penalized during tax season
-Employers now provided insurance for their employees
-Medicaid expansion in some locations
-Some staying on their parents' PI until 26 years of age
-Getting individual insurances via ACA marketplace
GPH Exam 3 Questions with Detailed
Verified Answers
Question: Describe the health system in this country
Answer: It is a pluralistic model. It can be thought of as multiple systems that
operate independently and collaborate with each other at times. Public and
private payers purchase health-care services from providers subjected to
regulations by the federal, state and local governments as well as by private
regulatory organizations. There are government purchasers, private insurers,
and out of pocket payers. Many Americans get their private insurance through
their employers.The private sector stakeholders play a strong role in the
healthcare system. Governmental insurance includes medicaid and medicare.
Medicaid is for the disabled and low income. Medicare is for the elderly and
act like universal coverage. Pharmaceuticals and medical devices are
regulated by the federal government.
Question:How is the health system funded?
Answer: Private insurance pays 35%, Medicare pays 23%, Medicaid pays 16%
and CHIP pays 4%. When combined government funding covers 45% of the
national health care expenditure (2011). Federal funding comes from income
tax ranging from 10% to 35% of taxable earnings. Income tax varies by state.
Sales tax also contributes to funding which varies by state as well. Private
charities and donations also help provide funding for people without
insurance.
, Page | 2
Question:Insurance in US?
Answer: Private health Insurance: 54%
Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
% of country insured: 84%
% insured through employer based plans: 49%
% insured by public plans: 30%
Question:What are the costs to consumers for health care?
Answer: Out of pocket payments are health-care costs paid by the consumer.
These include direct payment for health services, coinsurance, co-payments
and deductibles.
Question:Strengths of the US system
Answer: Large and well trained health workforce
Wide range of high-quality medical specialists
Robust health sector research program
Among the best medical outcomes in the world
Question:Weaknesses of the US system
Answer: Incomplete coverage
Underinsurance
Inadequate care for the uninsured
Health expenditure levels per person that far exceed all other countries
Poor results on many objective and subjective measures of quality and
outcomes
Unequal distribution of resources and outcomes across the country
, Page | 3
Lagging efforts to introduce health information technology
Question:Know the goals of the ACA
Answer: RIE
Reduce expenses
Expand insurance coverage
Improve quality of care
Question:Be able to explain the three private mechanisms and one public
mechanism to increase insurance coverage through the ACA
Answer: Private
Individual mandate
Employer mandate
Dependent coverage provision
Public
Medicaid - Families who fall within 133% of the FPL can get insurance
coverage
Question:Know at least one positive outcome/benefit of the ACA and be able
to explain the data that support it
Answer: As of March 2016, more than 20 million people gained health
insurance for a variety of reasons
-Didn't want to be penalized during tax season
-Employers now provided insurance for their employees
-Medicaid expansion in some locations
-Some staying on their parents' PI until 26 years of age
-Getting individual insurances via ACA marketplace
