US Healthcare System Final Exam –
Questions and Answers
What is a healthcare "system"? - -a regularly interacting or interdependent group of items
forming a unified whole, a group of interacting bodies under the influence of related forces
-What is included in the U.S. healthcare system? - -hospitals, health insurance, long-term
care, health policy, etc. (fragmented, loosely coordinated pieces, constantly changing, no
national health care insurance)
-How does the U.S. healthcare system compare to other countries? - -the US consumes
more health care services as proportion of total economic output than any other country in
the world
-What are the basic functional components of the U.S. healthcare system? - -finance,
insurance, delivery, payment mechanisms
-How does managed care differ from traditional fee for service? - -managed care has cost
control, greater integration of health delivery, emphasize preventative care, maintain
broad provider network
-What is the role of employer-based healthcare insurance? - -employer contracts with the
managed care organization
-What are the requirements of the Affordable Care Act? - -require individuals to have
insurance coverage, businesses to provide coverage or pay fines, cover all applicants with
the same rates regardless of preexisting conditions or sex, provide a minimum set of
standard coverage
-What are the major characteristics of the U.S. healthcare system? - -no central agency,
imperfect market, partial access, third-party insurance and payers, multiple payers -
system cumbersome
-Why isn't healthcare a free market? - -health plans act as intermediaries for patients,
prices are determined by agencies external to the market, lack of unrestrained competition,
inadequacy of buyer information, decisions about utilization are often determined by need
(not price-based demand)
-What is included in the health care continuum? - -health services from birth till end of life
care
-What are the major trends/directions of the U.S healthcare system? - -moving towards
wellness, primary care, outpatient services, community well-being, managed care,
integrated systems, continuum of services
Questions and Answers
What is a healthcare "system"? - -a regularly interacting or interdependent group of items
forming a unified whole, a group of interacting bodies under the influence of related forces
-What is included in the U.S. healthcare system? - -hospitals, health insurance, long-term
care, health policy, etc. (fragmented, loosely coordinated pieces, constantly changing, no
national health care insurance)
-How does the U.S. healthcare system compare to other countries? - -the US consumes
more health care services as proportion of total economic output than any other country in
the world
-What are the basic functional components of the U.S. healthcare system? - -finance,
insurance, delivery, payment mechanisms
-How does managed care differ from traditional fee for service? - -managed care has cost
control, greater integration of health delivery, emphasize preventative care, maintain
broad provider network
-What is the role of employer-based healthcare insurance? - -employer contracts with the
managed care organization
-What are the requirements of the Affordable Care Act? - -require individuals to have
insurance coverage, businesses to provide coverage or pay fines, cover all applicants with
the same rates regardless of preexisting conditions or sex, provide a minimum set of
standard coverage
-What are the major characteristics of the U.S. healthcare system? - -no central agency,
imperfect market, partial access, third-party insurance and payers, multiple payers -
system cumbersome
-Why isn't healthcare a free market? - -health plans act as intermediaries for patients,
prices are determined by agencies external to the market, lack of unrestrained competition,
inadequacy of buyer information, decisions about utilization are often determined by need
(not price-based demand)
-What is included in the health care continuum? - -health services from birth till end of life
care
-What are the major trends/directions of the U.S healthcare system? - -moving towards
wellness, primary care, outpatient services, community well-being, managed care,
integrated systems, continuum of services
