FIPP 2 MIDTERM 1 QUESTIONS & ANSWERS
Beveridge Model - Answer -everything done by government through taxes; single payer
controls; hospitals and clinics are public/ doctors are public and private; example
countries are Great Britain, Spain, Cuba; US similarities are treating veterans (the VA)
Bismarck Model - Answer -uses an insurance system usually financed jointly by
employers and employees through payroll deduction; cost control through tight
regulation; health insurance plans have to cover everybody and don't make a profit
(unlike US); doctors, hospitals, and non-profit sickness funds tend to be private;
example countries are Germany, France, Belgium, Netherlands; US similarities are
working Americans who get insurance on the job
National Health Insurance Model - Answer -uses private sector providers but payment
comes from a government run insurance program that all citizens pay into; healthcare
financed through tax payments; single payer has power to negotiate lower prices;
control costs by limiting medical services that they will pay for or by making patients wait
to be treated; private providers, public run national insurance; example countries are
Canada, Taiwan, South Korea; US similarities are for Americans over the age of 65
The Out-Of-Pocket Model - Answer -individual payments; rich get medical care; most
poor people go their whole lives without seeing a doctor; example countries are
Cambodia, rural India, Africa, China, South America; US similarities are 15% of
Americans who have no health insurance with access to a doctor available if you can
pay the bill out-of-pocket
US healthcare system compared to others - Answer -spend the most; Mostly worse
outcomes ◦ Obesity in adults ◦ Life expectancy at birth ◦ Asthma and COPD hospital
admission ◦ Diabetes hospital admission; Some better outcomes ◦ Daily smoking in
adults ◦ Breast cancer relative survival ◦ Ischemic stroke case fatality ◦ AMI case fatality;
all the other countries have settled on one model, which is simpler, fairer, and cheaper;
One of the most complex healthcare systems in the world, formed by intertwining
relationships between providers, payers, and patients receiving care
Problems in US healthcare system - Answer -many baby boomers currently who need
Medicare; life expectancy lower than other countries; spend way more compared to
other countries; more obesity; hospital admissions for heart failure, diabetes, asthma,
and COPD; about 10% of U.S. citizens lack health insurance and a similar percent is
underinsured; about 16% of Americans say they skipped medication due to cost while
33% of persons without insurance chose not to fill Rx; prescribing antibiotics when not
necessary and not using corticosteroids when necessary for things like COPD
quality - Answer -the degree to which health care services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with
current professional knowledge
, value - Answer -quality/ cost or what do we get for what we pay
National Academy of Medicine aims for healthcare quality - Answer -safe, effective,
patient-centered, timely, efficient, equitable
equitable care - Answer -does not vary in quality due to ethnicity, gender, geographic
location, income
patient centeredness - Answer -97% of patients said that the provider explained things
clearly and 97% said the provider listened carefully; 84% said they usually or always get
an appointment for routine care as soon as needed; results tend to be slightly lower for
Medicaid patients
safety problems - Answer -1 in 4 hospital admissions result in an adverse event, and 1
of 4 of the events are preventable; warfarin prescriptions result in high error rate; many
errors due to adverse drug effects
diabetes - Answer -23% met all goals; NO IMPROVEMENT in goal attainment since
2005
is quality improving in the US - Answer -Quality of healthcare improved overall from
2000 through 2018, but the pace of improvement varied by priority area
drug related morbidity - Answer -the failure of a therapeutic agent to produce the
desired outcome; encompasses the concepts of "therapeutic failure" and the creation of
new problems or harm; leads to billions of dollars in avoidable costs; often preceded by
a Drug-Related Problem
drug related problems - Answer -Untreated indications; Improper drug selection; Sub-
therapeutic dosage; Overdosage; Failure to receive a drug and/or non-adherence;
Adverse drug reaction; Drug interactions; Drug use without indication
non-adherence to medication - Answer -50% of people don't take their medications as
prescribed
Medicare - Answer -federal health insurance program for those age 65 & older; HHS
administers; increases because of baby boomers; life expectancy has increased; now
covers 3x more people; spends 40x more; it will collapse if no reform
Medicaid - Answer -insurance program for the poor to be administered by the states;
use has increased to 25% of US population (28% of Ohio); pandemic led to surge; 5%
drive majority of cost; many are working; HHS administers
Beveridge Model - Answer -everything done by government through taxes; single payer
controls; hospitals and clinics are public/ doctors are public and private; example
countries are Great Britain, Spain, Cuba; US similarities are treating veterans (the VA)
Bismarck Model - Answer -uses an insurance system usually financed jointly by
employers and employees through payroll deduction; cost control through tight
regulation; health insurance plans have to cover everybody and don't make a profit
(unlike US); doctors, hospitals, and non-profit sickness funds tend to be private;
example countries are Germany, France, Belgium, Netherlands; US similarities are
working Americans who get insurance on the job
National Health Insurance Model - Answer -uses private sector providers but payment
comes from a government run insurance program that all citizens pay into; healthcare
financed through tax payments; single payer has power to negotiate lower prices;
control costs by limiting medical services that they will pay for or by making patients wait
to be treated; private providers, public run national insurance; example countries are
Canada, Taiwan, South Korea; US similarities are for Americans over the age of 65
The Out-Of-Pocket Model - Answer -individual payments; rich get medical care; most
poor people go their whole lives without seeing a doctor; example countries are
Cambodia, rural India, Africa, China, South America; US similarities are 15% of
Americans who have no health insurance with access to a doctor available if you can
pay the bill out-of-pocket
US healthcare system compared to others - Answer -spend the most; Mostly worse
outcomes ◦ Obesity in adults ◦ Life expectancy at birth ◦ Asthma and COPD hospital
admission ◦ Diabetes hospital admission; Some better outcomes ◦ Daily smoking in
adults ◦ Breast cancer relative survival ◦ Ischemic stroke case fatality ◦ AMI case fatality;
all the other countries have settled on one model, which is simpler, fairer, and cheaper;
One of the most complex healthcare systems in the world, formed by intertwining
relationships between providers, payers, and patients receiving care
Problems in US healthcare system - Answer -many baby boomers currently who need
Medicare; life expectancy lower than other countries; spend way more compared to
other countries; more obesity; hospital admissions for heart failure, diabetes, asthma,
and COPD; about 10% of U.S. citizens lack health insurance and a similar percent is
underinsured; about 16% of Americans say they skipped medication due to cost while
33% of persons without insurance chose not to fill Rx; prescribing antibiotics when not
necessary and not using corticosteroids when necessary for things like COPD
quality - Answer -the degree to which health care services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with
current professional knowledge
, value - Answer -quality/ cost or what do we get for what we pay
National Academy of Medicine aims for healthcare quality - Answer -safe, effective,
patient-centered, timely, efficient, equitable
equitable care - Answer -does not vary in quality due to ethnicity, gender, geographic
location, income
patient centeredness - Answer -97% of patients said that the provider explained things
clearly and 97% said the provider listened carefully; 84% said they usually or always get
an appointment for routine care as soon as needed; results tend to be slightly lower for
Medicaid patients
safety problems - Answer -1 in 4 hospital admissions result in an adverse event, and 1
of 4 of the events are preventable; warfarin prescriptions result in high error rate; many
errors due to adverse drug effects
diabetes - Answer -23% met all goals; NO IMPROVEMENT in goal attainment since
2005
is quality improving in the US - Answer -Quality of healthcare improved overall from
2000 through 2018, but the pace of improvement varied by priority area
drug related morbidity - Answer -the failure of a therapeutic agent to produce the
desired outcome; encompasses the concepts of "therapeutic failure" and the creation of
new problems or harm; leads to billions of dollars in avoidable costs; often preceded by
a Drug-Related Problem
drug related problems - Answer -Untreated indications; Improper drug selection; Sub-
therapeutic dosage; Overdosage; Failure to receive a drug and/or non-adherence;
Adverse drug reaction; Drug interactions; Drug use without indication
non-adherence to medication - Answer -50% of people don't take their medications as
prescribed
Medicare - Answer -federal health insurance program for those age 65 & older; HHS
administers; increases because of baby boomers; life expectancy has increased; now
covers 3x more people; spends 40x more; it will collapse if no reform
Medicaid - Answer -insurance program for the poor to be administered by the states;
use has increased to 25% of US population (28% of Ohio); pandemic led to surge; 5%
drive majority of cost; many are working; HHS administers
