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Medical Sociology Final Questions and
Correct Answers/ Latest Update / Already
Graded
Chap 8 - Blue Cross/Blue Shiel
Ans: •Designed to protect doctors and hospitals
•Fee-for-service insurance
Community rating: Each person charged based on average risk
of entire community
Health Maintenance Organizations (HMOs)
Ans: •Designed to provide affordable health care
•Salaried doctors, monitored for unnecessary care
•Emphasis on prevention
Medicare (1960)
Ans: •For persons over 65 and permanently disabled
•Funded and organized by the federal government
•"Entitlement"
Medicaid (1960)
All rights reserved © 2025/ 2026 |
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Ans: •Primarily for poor persons
•Funded jointly by states and the federal government
•"Charity"
Commercial insurance
Ans: •For-profit rather than nonprofit
•Actuarial risk rating: Individual premium based on individual
risk
•Avoid insuring unhealthy persons
Managed Care (revolution)
Ans: •Any system that controls costs by monitoring and
controlling provider decisions
-Price schedules
-Utilization review
-Formularies
•Response to increasing health care costs
•Managed care itself has little impact on health care outcomes
•Backlash against managed care
•President Clinton's 1993 Health Care Security Act
All rights reserved © 2025/ 2026 |
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Ans: •Not passed due to political opposition
•State Children's Health Insurance Program
Ans: •Passed
•Extended coverage for children under 18 via Medicaid
President Obama's ACA
Ans: •passed in 2010
•To gain support from stakeholders, worked within existing
neoliberal system
•Individual mandate
•Employer mandate
•Limits put on insurance deductibles and copayments
•BUT Supreme Court ruled that states did not have to expand
Medicaid
myths of US health care costs
Ans: •Myth 1: It's the malpractice suits.
•Myth 2: It's our aging population.
•Myth 3: It's our advanced technologies.
All rights reserved © 2025/ 2026 |
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•Myth 4: It's because we receive more and better care than do
others.
ACA under attack
Ans: •Numerous attacks against it by Congress and in courts.
•Eligibility restricted, premiums raised, subsidies reduced
•Individual mandated dropped
•More to come...
Impact of ACA
Ans: •20 million gained insurance coverage
•Increases financial security and physical health
•More economic growth and less unemployment in states that
expanded Medical coverage
Health Care Costs
Ans: •Administrative costs of fragmented system
•Health care providers largely set prices
•The for-profit basis of the US health care system
Health care costs and the ACA
All rights reserved © 2025/ 2026 |
Medical Sociology Final Questions and
Correct Answers/ Latest Update / Already
Graded
Chap 8 - Blue Cross/Blue Shiel
Ans: •Designed to protect doctors and hospitals
•Fee-for-service insurance
Community rating: Each person charged based on average risk
of entire community
Health Maintenance Organizations (HMOs)
Ans: •Designed to provide affordable health care
•Salaried doctors, monitored for unnecessary care
•Emphasis on prevention
Medicare (1960)
Ans: •For persons over 65 and permanently disabled
•Funded and organized by the federal government
•"Entitlement"
Medicaid (1960)
All rights reserved © 2025/ 2026 |
, Page |2
Ans: •Primarily for poor persons
•Funded jointly by states and the federal government
•"Charity"
Commercial insurance
Ans: •For-profit rather than nonprofit
•Actuarial risk rating: Individual premium based on individual
risk
•Avoid insuring unhealthy persons
Managed Care (revolution)
Ans: •Any system that controls costs by monitoring and
controlling provider decisions
-Price schedules
-Utilization review
-Formularies
•Response to increasing health care costs
•Managed care itself has little impact on health care outcomes
•Backlash against managed care
•President Clinton's 1993 Health Care Security Act
All rights reserved © 2025/ 2026 |
, Page |3
Ans: •Not passed due to political opposition
•State Children's Health Insurance Program
Ans: •Passed
•Extended coverage for children under 18 via Medicaid
President Obama's ACA
Ans: •passed in 2010
•To gain support from stakeholders, worked within existing
neoliberal system
•Individual mandate
•Employer mandate
•Limits put on insurance deductibles and copayments
•BUT Supreme Court ruled that states did not have to expand
Medicaid
myths of US health care costs
Ans: •Myth 1: It's the malpractice suits.
•Myth 2: It's our aging population.
•Myth 3: It's our advanced technologies.
All rights reserved © 2025/ 2026 |
, Page |4
•Myth 4: It's because we receive more and better care than do
others.
ACA under attack
Ans: •Numerous attacks against it by Congress and in courts.
•Eligibility restricted, premiums raised, subsidies reduced
•Individual mandated dropped
•More to come...
Impact of ACA
Ans: •20 million gained insurance coverage
•Increases financial security and physical health
•More economic growth and less unemployment in states that
expanded Medical coverage
Health Care Costs
Ans: •Administrative costs of fragmented system
•Health care providers largely set prices
•The for-profit basis of the US health care system
Health care costs and the ACA
All rights reserved © 2025/ 2026 |
