Test Bank For Health Policy Issues: An Economic Perspective
7th Edition By Paul J. Feldstein, PhD 9781640550100 Chapter
1-38 Complete Guide .
Describe the steps of the Dye analysis model. - ANSWER: Problem identification
Agenda setting
Policy Formulation
Policy Legitimization
Policy Implementation
Policy Evaluation
What is the legislative branch's job in regards to health policy? - ANSWER: Legislative branch
formulates policy
Enacts laws
Veto override president
Appropriations
Senate confirms judges
Congress creates lower courts and may impeach judges
Although, only one Supreme Court justice ever impeached in 1805
Creates and funds health programs
Balances health policy with other policy domains
What is the executive branch's job in regards to health policy? - ANSWER: Executive branch
implements policy
Implements laws
Vetoes
Appoints judges
Proposes legislation
Approves or vetoes legislation
Disseminates rules or regulations
What is the judicial branch's job in regards to health policy? - ANSWER: Judicial branch interprets
policy
Interprets constitution and statutory laws
Develops a body of case law
Preserves rights
Resolves disputes
Health policy: Important event in 1846 - ANSWER: American Medical Association (AMA) was
established. Became strong lobbyists by stopping proposals for universal health insurance during the
Progressive Era and the New Deal
Important Political and social events in the 1860's? - ANSWER: Industrial revolution ended in 1860
US Civil War 1861 - 1865
Important Political and social events in the 1900's? - ANSWER: 1900 - 1920. Progressive Era.
Characterized by support for social reform
Important Political and social events in the 1910's? - ANSWER: WW1: 1914 - 1919
Important Political and social events in the 1930's? - ANSWER: Great Depression and New Deal
Important Political and social events in the 1940's? - ANSWER: WW2: 1939 - 1945
,Important Political and social events in the 1950's? - ANSWER: Korean War: 1950 - 1953
McCarthyism. Early 1950's
Important Political and social events in the 1960's? - ANSWER: Economic Downturn
Important Political and social events in the 1980's? - ANSWER: Regan: New Federalism
1989: Berlin Wall Fell
Important Political and social events in the 1990's? - ANSWER: Gulf War 1990 - 1991
NAFTA
Whitewater Investigation
Oklahoma City Bombing
Important Political and social events in the 2000's? - ANSWER: 9/11/2001: World trade center attacks
2001: US military action in Afghanistan
2003: IRAQ war
Great Recession 2007
Health policy: Important event in 1899 - ANSWER: American Hospital Association (AHA) was created
Health policy: highlights of 1887 - 1923 Progressive Era Politics - ANSWER: European countries
forming government healthcare systems (Germany being the first)
Compulsory health insurance was attempted in US by American Association Labor Legislation Bill in
1915 but failed, partly due to AMA lobbying power and Unions didn't like the bill since it was
concerned government would overtake the union's role in providing social benefits. As a result, third
party health insurance companies gained strength in US
Physicians were gaining more power and authority which gave them better pay and increased health
care costs.
WWI (1914-1918) - Anti-German fever denounced German socialist insurance (a communist idea).
Also the first school of PT was at Walter Reed and recruited women to rehabilitate injured soldiers.
Also during WWI, new programs for veterans started, such as disability compensation, insurance, and
vocational rehab.
Health policy: Important events in 1920's - ANSWER: Hospital expenses were becoming more
burdensome for families. APTA started. PT profession grew as treatment for polio became more
popular
Health policy: Important events in 1929 - 1941
Great Depression - ANSWER: 1930's: Veterans Administration and Veterans Health Care System
started
Healthcare costs continued to rise
Private health insurance growing (covered hospitals and physician visits)
Fee for service was implemented
Hospitals began offering their own insurance plans which started Blue Cross and Blue Shield
Idea of compulsory health insurance resurfaced due to people losing jobs and unable to pay for
medical care.
Social Security Bill of 1935 by FDR as part of New Deal
Initially contained compulsory insurance but out of fear this would sink the New Deal due to lobbying
efforts of AMA, compulsory insurance was taken out. Federal grants to states for public health
programs was included.
National Health Act of 1939
FDR's second attempt at national health insurance
Didn't gain much traction due to conservative majority and eventually WWII
Health Policy: Important events in the 1940's - ANSWER: 1940s, Congress passed legislation that
supported 3rd party insurers. This in conjunction with hospital plans laid foundation for today's
concept of health insurance
,Wage Stabilization Policy (1943)
Pay had to stay the same, unless you went through a war board to get a raise. Fringe benefits weren't
capped so people started bartering health care. Health care benefits were tax exempt.
Wagner - Murray - Dingell (WMD)
Introduced bill in 1943 adding health insurance measures to Social Security Act. Failed.
1944 - Public Health Service Act:
Many other "acts" are amendments under this including HIPAA and PPACA
Under this US Secretary of HHS can take measures to prevent entry and spread communicable
disease, states also have authority within their boundaries based on Police Powers
WMD 2 (1945)(Truman)
Title I focused on public health services & maternal and child health care
Title II established national health insurance
This was debated for 5 years and failed
1946Hospital Survey and Construction Act (Hill-Burton Act)
First federal law intervening in medical delivery system
Provided federal grants and guaranteed loans to states to improve health facilities and build new
hospitals
The Hill-Burton facilities were not allowed to discriminate, had to provide reasonable amount of free
care to those who could not afford it and were to provide uncompensated care initially for 20 years
after funds were received
1947Army-Navy Nurses Act
Established Women's Medical Specialist Corps giving military status to PTs. PT profession grew in 40s
and 50s due to WWII and polio
1910's themes - ANSWER: WW1
1930's themes - ANSWER: Great Depression
1940's themes - ANSWER: WW2
1950's themes - ANSWER: Capitalism vs. Communism
Cold War starts
Space Race starts
Second Red Scare
1950's healthcare breakthroughs - ANSWER: THR, pacemaker, polio vaccine mainstreamed, organ
transplant successful, and JCAHO created
Events of he 1950s - ANSWER: AMA strongly opposed changes in response to Truman's health care
bill, "Fair Deal" since this would decrease reimbursement and large media campaign was launched to
tell patients their choices would be limited and this was a "Socialist agenda".
Commercial insurance aggressively entered. Individual rates based on health risks. This left Blue Cross
with the sickest and highest risks. Middle class could no longer afford health insurance.
PT moved beyond hospital-based practice, including outpatient clinics, public schools, SNFs, and
rehab facilities. The Medical Facilities Survey and Construction Act amended Hill Burton to include
rehab centers, nursing homes, and outpatient facilities to be constructed.
1950 - 1953Korean War. Eisenhower elected in 1952.
1960's themes - ANSWER: AHA recommends statements of human rights in hospitals and healthcare
organizations).
Conservative 1950s turned into young and revolutionary ways of thinking.
Healthcare issues included rising costs (faster than inflation), shortage of nurses (Nurse Training Act),
and access to care for elderly and poor.
Use of a formulary system incorporating generic drugs, one Blue Cross established,
AHA meetings about LTC for elderly though opposed to expanding Social Security. Hill Burton
expanded to fund out-modeled hospitals in urban areas.
Army PTs have practiced under direct access after Vietnam due to physician shortage
, Bills of the 1960s - ANSWER: 1965: Social Security Act
Medicare created from Title XVIII of Social Security Act of 1965. Medicare is the health insurance for
the aged and disabled. Established as a complement to Title II which provided disability, survivor, and
retirement benefits for aged. Implemented in 1966 with insurance coverage for age 65+. Consisted of
two parts, Part A (hospital, SNF, and hospice insurance and was an entitlement program with free
premiums to most eligible) and Part B (physician, outpatient, home health and voluntary. Subject to
deductible and copayments, must pay monthly premium and fee for service plan). CMS (HHS) has
responsibility for administration
1967 Soc Sec Act Amended- Medicare expanded coverage (DME, podiatry, and PT), increased #
inpatient days, and increased pay to some providers
Bills of 1970s - ANSWER: 1970 - Kennedy-Griffiths Health Security program - Single payor. AMA
opposed
1971 - Nixon's plan - employer mandated insurance
1974 - Momentum for both plans collapsed
1973 - Health Maintenance Organization Act
1973 - Rehab Act
1974 - Congressional Budget and Impoundment Control Act (created CBO)
1974 - National Health Planning & Resource Development Act - Consolidated acts to control costs and
improve quality
1974 - Employee Retirement Income Security Act (ERISA)
1975 - Privacy Act
1975 - Individuals with Disabilities Educational Act (IDEA)
1976 & 1978 - HMO Amendments
1977 Medicare -Medicaid Antifraud & Abuse Amendments
1978 Medicare ESRD Amendment
Bills of 1980s - ANSWER: 1980 Omnibus Budget Reconciliation Act (OBRA)changed coverage
provisions to address rising costs (expanded home health care)
1980 - Mental Health System Act ($800 million to mental health over 4 years
1980 - Child welfare Act (adoption assistance; strengthened foster care program)
1981 - Omnibus Budget Reconciliation Act (rescinded MHSA and transferred responsibility back to
states)
1984 - National Organ Transplant Act (created national registry for organ transplants; establishes
standards for organ procurement)
1984 - Deficit Reduction Act (Freezes physician and hospital reimbursement to 1984 levels to promote
efficiency
1986 - Consolidated Omnibus Budget Reconciliation Act (COBRA) - allows individuals to stay on former
employer's health insurance for 18 months
1986 - Emergency Medical Treatment and Active Labor Act (EMTALA) - Anti-patient dumping
1986 - Immigration and Reform Act (amnesty for 3 million immigrants)
1988 - McKinney-Vento Act (provided 15 programs for homeless)
Health care reimbursement in 1980s - ANSWER: 1980 - Fee for Service (FFS)
1983 - Diagnosis related group (DRG)
Health bills in 1990s - ANSWER: 1990 - American with Disabilities Act (1st civil rights law for
individuals with disabilities and prohibits discrimination for employment, public services, public, and
telecommunications)
1990 - Ryan White AIDS Act
1990 - Safe Medical Device Act (must report if any injuries occurred)
1992 - Mammography Quality Standards Act (quality inspection of mammography facilities)
1993 - Family an d Medical Leave Act (FMLA) - Allows 12 weeks in a 12 month period for leave while
maintaining position and benefits accrued
1994 - Health Securities Act (universal coverage; failed due to opposition of Republicans, lobbyists and
insurance industry). As a result, more utilization of HMOs and PPOs
7th Edition By Paul J. Feldstein, PhD 9781640550100 Chapter
1-38 Complete Guide .
Describe the steps of the Dye analysis model. - ANSWER: Problem identification
Agenda setting
Policy Formulation
Policy Legitimization
Policy Implementation
Policy Evaluation
What is the legislative branch's job in regards to health policy? - ANSWER: Legislative branch
formulates policy
Enacts laws
Veto override president
Appropriations
Senate confirms judges
Congress creates lower courts and may impeach judges
Although, only one Supreme Court justice ever impeached in 1805
Creates and funds health programs
Balances health policy with other policy domains
What is the executive branch's job in regards to health policy? - ANSWER: Executive branch
implements policy
Implements laws
Vetoes
Appoints judges
Proposes legislation
Approves or vetoes legislation
Disseminates rules or regulations
What is the judicial branch's job in regards to health policy? - ANSWER: Judicial branch interprets
policy
Interprets constitution and statutory laws
Develops a body of case law
Preserves rights
Resolves disputes
Health policy: Important event in 1846 - ANSWER: American Medical Association (AMA) was
established. Became strong lobbyists by stopping proposals for universal health insurance during the
Progressive Era and the New Deal
Important Political and social events in the 1860's? - ANSWER: Industrial revolution ended in 1860
US Civil War 1861 - 1865
Important Political and social events in the 1900's? - ANSWER: 1900 - 1920. Progressive Era.
Characterized by support for social reform
Important Political and social events in the 1910's? - ANSWER: WW1: 1914 - 1919
Important Political and social events in the 1930's? - ANSWER: Great Depression and New Deal
Important Political and social events in the 1940's? - ANSWER: WW2: 1939 - 1945
,Important Political and social events in the 1950's? - ANSWER: Korean War: 1950 - 1953
McCarthyism. Early 1950's
Important Political and social events in the 1960's? - ANSWER: Economic Downturn
Important Political and social events in the 1980's? - ANSWER: Regan: New Federalism
1989: Berlin Wall Fell
Important Political and social events in the 1990's? - ANSWER: Gulf War 1990 - 1991
NAFTA
Whitewater Investigation
Oklahoma City Bombing
Important Political and social events in the 2000's? - ANSWER: 9/11/2001: World trade center attacks
2001: US military action in Afghanistan
2003: IRAQ war
Great Recession 2007
Health policy: Important event in 1899 - ANSWER: American Hospital Association (AHA) was created
Health policy: highlights of 1887 - 1923 Progressive Era Politics - ANSWER: European countries
forming government healthcare systems (Germany being the first)
Compulsory health insurance was attempted in US by American Association Labor Legislation Bill in
1915 but failed, partly due to AMA lobbying power and Unions didn't like the bill since it was
concerned government would overtake the union's role in providing social benefits. As a result, third
party health insurance companies gained strength in US
Physicians were gaining more power and authority which gave them better pay and increased health
care costs.
WWI (1914-1918) - Anti-German fever denounced German socialist insurance (a communist idea).
Also the first school of PT was at Walter Reed and recruited women to rehabilitate injured soldiers.
Also during WWI, new programs for veterans started, such as disability compensation, insurance, and
vocational rehab.
Health policy: Important events in 1920's - ANSWER: Hospital expenses were becoming more
burdensome for families. APTA started. PT profession grew as treatment for polio became more
popular
Health policy: Important events in 1929 - 1941
Great Depression - ANSWER: 1930's: Veterans Administration and Veterans Health Care System
started
Healthcare costs continued to rise
Private health insurance growing (covered hospitals and physician visits)
Fee for service was implemented
Hospitals began offering their own insurance plans which started Blue Cross and Blue Shield
Idea of compulsory health insurance resurfaced due to people losing jobs and unable to pay for
medical care.
Social Security Bill of 1935 by FDR as part of New Deal
Initially contained compulsory insurance but out of fear this would sink the New Deal due to lobbying
efforts of AMA, compulsory insurance was taken out. Federal grants to states for public health
programs was included.
National Health Act of 1939
FDR's second attempt at national health insurance
Didn't gain much traction due to conservative majority and eventually WWII
Health Policy: Important events in the 1940's - ANSWER: 1940s, Congress passed legislation that
supported 3rd party insurers. This in conjunction with hospital plans laid foundation for today's
concept of health insurance
,Wage Stabilization Policy (1943)
Pay had to stay the same, unless you went through a war board to get a raise. Fringe benefits weren't
capped so people started bartering health care. Health care benefits were tax exempt.
Wagner - Murray - Dingell (WMD)
Introduced bill in 1943 adding health insurance measures to Social Security Act. Failed.
1944 - Public Health Service Act:
Many other "acts" are amendments under this including HIPAA and PPACA
Under this US Secretary of HHS can take measures to prevent entry and spread communicable
disease, states also have authority within their boundaries based on Police Powers
WMD 2 (1945)(Truman)
Title I focused on public health services & maternal and child health care
Title II established national health insurance
This was debated for 5 years and failed
1946Hospital Survey and Construction Act (Hill-Burton Act)
First federal law intervening in medical delivery system
Provided federal grants and guaranteed loans to states to improve health facilities and build new
hospitals
The Hill-Burton facilities were not allowed to discriminate, had to provide reasonable amount of free
care to those who could not afford it and were to provide uncompensated care initially for 20 years
after funds were received
1947Army-Navy Nurses Act
Established Women's Medical Specialist Corps giving military status to PTs. PT profession grew in 40s
and 50s due to WWII and polio
1910's themes - ANSWER: WW1
1930's themes - ANSWER: Great Depression
1940's themes - ANSWER: WW2
1950's themes - ANSWER: Capitalism vs. Communism
Cold War starts
Space Race starts
Second Red Scare
1950's healthcare breakthroughs - ANSWER: THR, pacemaker, polio vaccine mainstreamed, organ
transplant successful, and JCAHO created
Events of he 1950s - ANSWER: AMA strongly opposed changes in response to Truman's health care
bill, "Fair Deal" since this would decrease reimbursement and large media campaign was launched to
tell patients their choices would be limited and this was a "Socialist agenda".
Commercial insurance aggressively entered. Individual rates based on health risks. This left Blue Cross
with the sickest and highest risks. Middle class could no longer afford health insurance.
PT moved beyond hospital-based practice, including outpatient clinics, public schools, SNFs, and
rehab facilities. The Medical Facilities Survey and Construction Act amended Hill Burton to include
rehab centers, nursing homes, and outpatient facilities to be constructed.
1950 - 1953Korean War. Eisenhower elected in 1952.
1960's themes - ANSWER: AHA recommends statements of human rights in hospitals and healthcare
organizations).
Conservative 1950s turned into young and revolutionary ways of thinking.
Healthcare issues included rising costs (faster than inflation), shortage of nurses (Nurse Training Act),
and access to care for elderly and poor.
Use of a formulary system incorporating generic drugs, one Blue Cross established,
AHA meetings about LTC for elderly though opposed to expanding Social Security. Hill Burton
expanded to fund out-modeled hospitals in urban areas.
Army PTs have practiced under direct access after Vietnam due to physician shortage
, Bills of the 1960s - ANSWER: 1965: Social Security Act
Medicare created from Title XVIII of Social Security Act of 1965. Medicare is the health insurance for
the aged and disabled. Established as a complement to Title II which provided disability, survivor, and
retirement benefits for aged. Implemented in 1966 with insurance coverage for age 65+. Consisted of
two parts, Part A (hospital, SNF, and hospice insurance and was an entitlement program with free
premiums to most eligible) and Part B (physician, outpatient, home health and voluntary. Subject to
deductible and copayments, must pay monthly premium and fee for service plan). CMS (HHS) has
responsibility for administration
1967 Soc Sec Act Amended- Medicare expanded coverage (DME, podiatry, and PT), increased #
inpatient days, and increased pay to some providers
Bills of 1970s - ANSWER: 1970 - Kennedy-Griffiths Health Security program - Single payor. AMA
opposed
1971 - Nixon's plan - employer mandated insurance
1974 - Momentum for both plans collapsed
1973 - Health Maintenance Organization Act
1973 - Rehab Act
1974 - Congressional Budget and Impoundment Control Act (created CBO)
1974 - National Health Planning & Resource Development Act - Consolidated acts to control costs and
improve quality
1974 - Employee Retirement Income Security Act (ERISA)
1975 - Privacy Act
1975 - Individuals with Disabilities Educational Act (IDEA)
1976 & 1978 - HMO Amendments
1977 Medicare -Medicaid Antifraud & Abuse Amendments
1978 Medicare ESRD Amendment
Bills of 1980s - ANSWER: 1980 Omnibus Budget Reconciliation Act (OBRA)changed coverage
provisions to address rising costs (expanded home health care)
1980 - Mental Health System Act ($800 million to mental health over 4 years
1980 - Child welfare Act (adoption assistance; strengthened foster care program)
1981 - Omnibus Budget Reconciliation Act (rescinded MHSA and transferred responsibility back to
states)
1984 - National Organ Transplant Act (created national registry for organ transplants; establishes
standards for organ procurement)
1984 - Deficit Reduction Act (Freezes physician and hospital reimbursement to 1984 levels to promote
efficiency
1986 - Consolidated Omnibus Budget Reconciliation Act (COBRA) - allows individuals to stay on former
employer's health insurance for 18 months
1986 - Emergency Medical Treatment and Active Labor Act (EMTALA) - Anti-patient dumping
1986 - Immigration and Reform Act (amnesty for 3 million immigrants)
1988 - McKinney-Vento Act (provided 15 programs for homeless)
Health care reimbursement in 1980s - ANSWER: 1980 - Fee for Service (FFS)
1983 - Diagnosis related group (DRG)
Health bills in 1990s - ANSWER: 1990 - American with Disabilities Act (1st civil rights law for
individuals with disabilities and prohibits discrimination for employment, public services, public, and
telecommunications)
1990 - Ryan White AIDS Act
1990 - Safe Medical Device Act (must report if any injuries occurred)
1992 - Mammography Quality Standards Act (quality inspection of mammography facilities)
1993 - Family an d Medical Leave Act (FMLA) - Allows 12 weeks in a 12 month period for leave while
maintaining position and benefits accrued
1994 - Health Securities Act (universal coverage; failed due to opposition of Republicans, lobbyists and
insurance industry). As a result, more utilization of HMOs and PPOs
