USP 143 Midterm 1 questions well
answered already passed
How is our HC system rated? (compared to other high-income nations) - correct answer ✔✔-
Rating: 11th (last) in the Health Care System Performance Rankings
--CITE: MIRROR REPORT 2017
--rated last on Access, Administrative efficiency, Equity, and Health Outcomes even though we
spend the most per capita (2.5x more than avg)
---but we are good at health care process
What are some critiques with our HC system? - correct answer ✔✔-Americans don't live longer
than ppl in other countries spending less money
-Poorer outcomes - maternal mortality (Am women = 3x mortality risk than English)
-Market-based system -- creates inequities
The govt (taxpayers) covers what share of US' healthcare bills? - correct answer ✔✔Over 50%
--Medicare, Medicaid, SCHIP, the Veteran's program, govt employees
Broader health context: US health outcomes? Explanations? (3) - correct answer ✔✔-We aren't
living longer
-Higher rates of hospitalizations for chronic conditions
-Emergency/specialty care >> preventative care (more spending)
---highest: infant morality, AIDS, 2nd for HIV, lives lost to alc/drugs, rates of obesity/diabetes,
LOWEST life expectancy!
EXPLANATIONS:
--social determinants are a big contributor (system, institutions, policies)
,--High level of inequality in the US (top 20% holds 90% of wealth)
--We spend more money downstream (instead of preventative care)
Individualistic society (as a cultural/political factor that influences HC provision) - correct answer
✔✔--Disparities among race, income, wealth, and edu
--Belief that health = ind responsibility
----> Leads to less support for national health programs bc they don't think they need it
(Roosevelt, Truman, Nixon HC reforms failed)
Society (as a cultural/political factor that influences HC provision) - correct answer ✔✔--US =
deep/growing economic insecurity (influences ppl's ability to access basic needs -- food,
housing, med care, etc)
STAT: 2016: 41.2 mil lived in food-insecure households
Social determinants (as a cultural/political factor that influences HC provision) - correct answer
✔✔-Conds we live in --> systems, insts, policies; neighborhoods, home life, school, experiences
of social incl/exclusion, levels of social support, occupational status/conds
-we have a repair shop mentality
-Good job vic!
History of the attempts at reform - correct answer ✔✔**Incremental changes, resistance to
major change from pop/hc providers/union groups
*Early 1900s: ROOSEVELT wanted a single national health service --> opposition from
physicians/pharmacists/insurance companies
*1920s: idea to prepay insurance for health care was born
*1930s (Depression): Push for health insurance but initial pushback for govt expansion (Am
Hosp Assoc -- broadened the model and had a system where you could go to any affiliated
hospital if sick (blue cross))
*1940s: TRUMAN'S plan to propose a single national system --> opposed from SOUTHERNERS
(afraid of what it would do to segregation) -- but did get to expand hospitals (sep law)
, *1965: LBJ --> Medicare/Medicaid
*1970s: NIXON proposes national health insurance to all Ams thru employers, Medicare, or govt
assistance --> opposed by unions
*1980s: Reagan: Privitization, regulation, consolidation, corporatization of HC, payment by
diagnosis (DRG) >> treatment
*1990s: CLINTON --> CHIP (low-income children)
*2000s: Medicare is in danger
**opposition also due to "red scare"
Our Current System - correct answer ✔✔-Product of incremental changes meant to solve
problems (solved but also created new problems)
-Public programs = underfunded
---> led to fragmented system w greater emphasis for specialist/hospital care
Medicaid expansion - correct answer ✔✔-ACA expanded to 138% of FPL (23 states opposed)
**ALSO: used to only be applicable to pregnant women, parents w small children --> expanded
to adults that didn't have children
Medicare and dental insurance - correct answer ✔✔50% of elders do not have dental insurance
ACA (main components: 7) - correct answer ✔✔1) Individual mandate
2) Children can stay on parent's plan until age 26
3) Expanded Medicaid to 138% of the FPL (23 STATES OPPOSED THIS)
4) Requires all policies on exchange to cover 10 essential services (mental health, prescrp drugs)
+ requires that preventative healthcare is completely covered!
5) Insurance companies cannot deny people coverage for having pre-existing conds
6) Employers w 50+ employees must provide employees' healthcare
answered already passed
How is our HC system rated? (compared to other high-income nations) - correct answer ✔✔-
Rating: 11th (last) in the Health Care System Performance Rankings
--CITE: MIRROR REPORT 2017
--rated last on Access, Administrative efficiency, Equity, and Health Outcomes even though we
spend the most per capita (2.5x more than avg)
---but we are good at health care process
What are some critiques with our HC system? - correct answer ✔✔-Americans don't live longer
than ppl in other countries spending less money
-Poorer outcomes - maternal mortality (Am women = 3x mortality risk than English)
-Market-based system -- creates inequities
The govt (taxpayers) covers what share of US' healthcare bills? - correct answer ✔✔Over 50%
--Medicare, Medicaid, SCHIP, the Veteran's program, govt employees
Broader health context: US health outcomes? Explanations? (3) - correct answer ✔✔-We aren't
living longer
-Higher rates of hospitalizations for chronic conditions
-Emergency/specialty care >> preventative care (more spending)
---highest: infant morality, AIDS, 2nd for HIV, lives lost to alc/drugs, rates of obesity/diabetes,
LOWEST life expectancy!
EXPLANATIONS:
--social determinants are a big contributor (system, institutions, policies)
,--High level of inequality in the US (top 20% holds 90% of wealth)
--We spend more money downstream (instead of preventative care)
Individualistic society (as a cultural/political factor that influences HC provision) - correct answer
✔✔--Disparities among race, income, wealth, and edu
--Belief that health = ind responsibility
----> Leads to less support for national health programs bc they don't think they need it
(Roosevelt, Truman, Nixon HC reforms failed)
Society (as a cultural/political factor that influences HC provision) - correct answer ✔✔--US =
deep/growing economic insecurity (influences ppl's ability to access basic needs -- food,
housing, med care, etc)
STAT: 2016: 41.2 mil lived in food-insecure households
Social determinants (as a cultural/political factor that influences HC provision) - correct answer
✔✔-Conds we live in --> systems, insts, policies; neighborhoods, home life, school, experiences
of social incl/exclusion, levels of social support, occupational status/conds
-we have a repair shop mentality
-Good job vic!
History of the attempts at reform - correct answer ✔✔**Incremental changes, resistance to
major change from pop/hc providers/union groups
*Early 1900s: ROOSEVELT wanted a single national health service --> opposition from
physicians/pharmacists/insurance companies
*1920s: idea to prepay insurance for health care was born
*1930s (Depression): Push for health insurance but initial pushback for govt expansion (Am
Hosp Assoc -- broadened the model and had a system where you could go to any affiliated
hospital if sick (blue cross))
*1940s: TRUMAN'S plan to propose a single national system --> opposed from SOUTHERNERS
(afraid of what it would do to segregation) -- but did get to expand hospitals (sep law)
, *1965: LBJ --> Medicare/Medicaid
*1970s: NIXON proposes national health insurance to all Ams thru employers, Medicare, or govt
assistance --> opposed by unions
*1980s: Reagan: Privitization, regulation, consolidation, corporatization of HC, payment by
diagnosis (DRG) >> treatment
*1990s: CLINTON --> CHIP (low-income children)
*2000s: Medicare is in danger
**opposition also due to "red scare"
Our Current System - correct answer ✔✔-Product of incremental changes meant to solve
problems (solved but also created new problems)
-Public programs = underfunded
---> led to fragmented system w greater emphasis for specialist/hospital care
Medicaid expansion - correct answer ✔✔-ACA expanded to 138% of FPL (23 states opposed)
**ALSO: used to only be applicable to pregnant women, parents w small children --> expanded
to adults that didn't have children
Medicare and dental insurance - correct answer ✔✔50% of elders do not have dental insurance
ACA (main components: 7) - correct answer ✔✔1) Individual mandate
2) Children can stay on parent's plan until age 26
3) Expanded Medicaid to 138% of the FPL (23 STATES OPPOSED THIS)
4) Requires all policies on exchange to cover 10 essential services (mental health, prescrp drugs)
+ requires that preventative healthcare is completely covered!
5) Insurance companies cannot deny people coverage for having pre-existing conds
6) Employers w 50+ employees must provide employees' healthcare
