Public Health 150D Final Exam || A+ GRADED.
Comparative Health System: Beveridge correct answers - Socialized medicine
-Government pays and government provides
-Doctors are paid on salary and public hospitals
Funded by income taxes and some cost sharing
- Examples: England and US VA
Comparative Health System: Bismark correct answers - Mandated health insurance
- Private providers
- Payor: employers, employees, government.
- Germany, Switzerland, Japan, Massachusetts
Comparative Health System: Single Payor/ National Insurance correct answers what: Income
tax and cost sharing
Payor: government ONLY
Provider: Private
- Medicare, Taiwan, Canada
Consumer Driven Healthcare correct answers - Patients as consumers
- Individual responsibility to purchase or not
- requires open and transparent information
- The idea is that the patient is responsible for his/her own care and can decide if they want
health insurance
- Payment: Government can provide vouchers; employers can allocate an amount of money
rather than a plan
Health Savings Account (HSA) correct answers - Not an insurance plan
- Savings plan that is tax exempt and used to pay for current and future medical expenses.
- Usually paired with a high deductible health plan.
- Pros: People are responsible for how they spend their money; shift uninsured to "low cost
option"
- Cons: people of higher income will have more money to spend; adverse risk (only healthy
will join); no cost containment
Employer mandate correct answers -Employer must provide health coverage (play) or (pay)
into a healthcare fund
- Leaves many people uninsured (the unemployed)
- Businesses fought this (ERISA)
- Huge expansion costs to start providing coverage.
ERISA: Employee Retirement Income Security Act (1974) correct answers - Protects
employee benefits
- Protects retirement assets of retirees
- Can replace state laws that have to do with employee benefit plans
Three Legged stool correct answers 1. Requires all insurers to cover ALL without
underwriting
2. Requires EVERYONE to be covered (balanced risk pool)
3. Gov provides subsidizes to help cover everyone
, Healthcare purchasing Coops correct answers - allow individuals to create/join purchasing
coops with organizations to get community rating
- Group plan is cheaper
- High risk for adverse selection: group of sick people who want health insurance (not diverse
enough of a risk pool)
Health Purchasing Collaboratives (HIPCs) correct answers -Employer purchasing pools for
increased negotiating power
Expanding Public Coverage correct answers Medicaid and/or SCHIP
- increased services
- removed 5 year wait for immigrants
-Allowed the unemployed "temporary" eligibility
- increase to 133% of FPL
Medicare
-Lower minimum age to 60 and not 65
-Adding persons with specific illnesses
- Allowing retired people to "buy in"
- Eliminate 2 year waiting period for disabled.
Individual mandate correct answers Individuals must sign up for health insurance (no
underwriting) or pay tax penalty
Clinton Healthcare Reform Experience correct answers Put everyone into managed care so
big managed care companies can negotiate to bring the price down
Public Option correct answers -nonprofit, publicly administered plans from the government
to compete with private insurances
PROS
-Create competition, portable across jobs, could control costs while ensuring quality
- CON: failed because insurance companies didn't like it and they have HUGE lobbying
power
Single payor correct answers Government is the only one in control and sets a budget for
healthcare through delivery of providers.
- Failed because it was too extreme: people don't like government only plans.
Reconciliation process correct answers - speeds up passage of budget related legislation (no
filibuster allowed)
- How the ACA was passed
Conference Committee correct answers - committee of US congress appointed by house of
representatives and senate to resolve disagreement over a particular bill.
- Conference committees exist to draft a compromise bill that both houses can accept
Goal of the ACA correct answers Cover the uninsured
ACA Reform: Insurance Industry Regulations correct answers -Premium restriction: gov
regulates how much premium prices can increase and children covered until the age of 26
Comparative Health System: Beveridge correct answers - Socialized medicine
-Government pays and government provides
-Doctors are paid on salary and public hospitals
Funded by income taxes and some cost sharing
- Examples: England and US VA
Comparative Health System: Bismark correct answers - Mandated health insurance
- Private providers
- Payor: employers, employees, government.
- Germany, Switzerland, Japan, Massachusetts
Comparative Health System: Single Payor/ National Insurance correct answers what: Income
tax and cost sharing
Payor: government ONLY
Provider: Private
- Medicare, Taiwan, Canada
Consumer Driven Healthcare correct answers - Patients as consumers
- Individual responsibility to purchase or not
- requires open and transparent information
- The idea is that the patient is responsible for his/her own care and can decide if they want
health insurance
- Payment: Government can provide vouchers; employers can allocate an amount of money
rather than a plan
Health Savings Account (HSA) correct answers - Not an insurance plan
- Savings plan that is tax exempt and used to pay for current and future medical expenses.
- Usually paired with a high deductible health plan.
- Pros: People are responsible for how they spend their money; shift uninsured to "low cost
option"
- Cons: people of higher income will have more money to spend; adverse risk (only healthy
will join); no cost containment
Employer mandate correct answers -Employer must provide health coverage (play) or (pay)
into a healthcare fund
- Leaves many people uninsured (the unemployed)
- Businesses fought this (ERISA)
- Huge expansion costs to start providing coverage.
ERISA: Employee Retirement Income Security Act (1974) correct answers - Protects
employee benefits
- Protects retirement assets of retirees
- Can replace state laws that have to do with employee benefit plans
Three Legged stool correct answers 1. Requires all insurers to cover ALL without
underwriting
2. Requires EVERYONE to be covered (balanced risk pool)
3. Gov provides subsidizes to help cover everyone
, Healthcare purchasing Coops correct answers - allow individuals to create/join purchasing
coops with organizations to get community rating
- Group plan is cheaper
- High risk for adverse selection: group of sick people who want health insurance (not diverse
enough of a risk pool)
Health Purchasing Collaboratives (HIPCs) correct answers -Employer purchasing pools for
increased negotiating power
Expanding Public Coverage correct answers Medicaid and/or SCHIP
- increased services
- removed 5 year wait for immigrants
-Allowed the unemployed "temporary" eligibility
- increase to 133% of FPL
Medicare
-Lower minimum age to 60 and not 65
-Adding persons with specific illnesses
- Allowing retired people to "buy in"
- Eliminate 2 year waiting period for disabled.
Individual mandate correct answers Individuals must sign up for health insurance (no
underwriting) or pay tax penalty
Clinton Healthcare Reform Experience correct answers Put everyone into managed care so
big managed care companies can negotiate to bring the price down
Public Option correct answers -nonprofit, publicly administered plans from the government
to compete with private insurances
PROS
-Create competition, portable across jobs, could control costs while ensuring quality
- CON: failed because insurance companies didn't like it and they have HUGE lobbying
power
Single payor correct answers Government is the only one in control and sets a budget for
healthcare through delivery of providers.
- Failed because it was too extreme: people don't like government only plans.
Reconciliation process correct answers - speeds up passage of budget related legislation (no
filibuster allowed)
- How the ACA was passed
Conference Committee correct answers - committee of US congress appointed by house of
representatives and senate to resolve disagreement over a particular bill.
- Conference committees exist to draft a compromise bill that both houses can accept
Goal of the ACA correct answers Cover the uninsured
ACA Reform: Insurance Industry Regulations correct answers -Premium restriction: gov
regulates how much premium prices can increase and children covered until the age of 26
