Dynamics of Health Care in Society Rutgers
University | Comprehensive Course Examination
2025/2026 Edition | Graded A+
Student Name: __________________________
Date: __________________________
Score: ________ / 50
Domain 1: U.S. Healthcare System Structure & Financing
(10 Questions)
1. Which of the following best describes the primary characteristic that distinguishes the U.S.
healthcare system from other developed nations like the United Kingdom or Canada?
A. It is a single-payer system funded entirely by federal taxation.
B. It is a pluralistic, market-based system with a mix of public and private financing.
C. It provides universal coverage through a national health service.
D. It relies solely on out-of-pocket payments for all services.
2. The U.S. healthcare system is often described as "fragmented." Which of the following
scenarios best illustrates this fragmentation?
A. A patient receives a flu shot at their local pharmacy.
B. A patient sees a specialist but the specialist has no access to the patient’s primary care
records, leading to duplicate testing.
C. A hospital closes due to lack of funding in a rural area.
D. The government sets a fixed price for a surgical procedure.
,3. A 67-year-old retired teacher is admitted to the hospital for a hip replacement. Which part
of Medicare will cover the costs of her inpatient hospital stay, and how is this part primarily
funded?
A. Medicare Part B; funded through beneficiary premiums and general revenues.
B. Medicare Part A; funded through payroll taxes (FICA) during the beneficiary's working
years.
C. Medicare Part D; funded through state and federal block grants.
D. Medicare Part C; funded entirely by private insurance premiums.
4. Which of the following statements accurately distinguishes Medicare from Medicaid?
A. Medicare is a needs-based program for low-income individuals, while Medicaid is an age-
based entitlement for the elderly.
B. Medicare is a federal program for the elderly and disabled, while Medicaid is a joint
federal-state program for low-income populations.
C. Medicaid covers only inpatient hospital care, while Medicare covers only outpatient
physician visits.
D. Medicare eligibility varies significantly by state, while Medicaid eligibility is uniform across
the nation.
5. Under the Medicare Part D prescription drug benefit, beneficiaries often encounter a
coverage gap known as the "donut hole." In the context of the standard benefit design, what
happens once a beneficiary and the plan have spent a certain amount on covered drugs?
A. The beneficiary pays nothing for the rest of the year.
B. The beneficiary enters the catastrophic coverage phase where they pay a significantly
reduced coinsurance or copayment.
C. The beneficiary is automatically disenrolled from the plan.
D. The government pays 100% of all subsequent drug costs.
, 6. A 45-year-old self-employed graphic designer purchases health insurance through the
individual market. Which of the following statements best describes the historical risk profile
of this market prior to the Affordable Care Act?
A. It was characterized by group rating, where premiums were standardized for all individuals
regardless of health status.
B. It was prone to adverse selection, where individuals with higher health needs were more
likely to purchase coverage, driving up premiums.
C. It was heavily subsidized by employer contributions, making it cheaper than group
coverage.
D. It was regulated by the federal government to ensure universal access regardless of pre-
existing conditions.
7. Which feature is characteristic of employer-sponsored health insurance in the United
States?
A. Premiums are paid with post-tax dollars.
B. It operates under the principle of "community rating" where everyone in a geographic area
pays the same rate.
C. Employers typically pay a significant portion of the premium, and employee contributions
are made with pre-tax dollars.
D. Coverage is portable and guaranteed regardless of employment status changes.
8. A patient is enrolled in a Health Maintenance Organization (HMO). To receive coverage for
a visit to a cardiologist, the patient must:
A. Pay a higher deductible than they would in a PPO plan.
B. Obtain a referral from their primary care physician (PCP) and visit a provider within the
HMO network.
C. Select a cardiologist from a national list of providers without restrictions.
D. Pay the full cost of the visit out-of-pocket until an annual deductible is met.
University | Comprehensive Course Examination
2025/2026 Edition | Graded A+
Student Name: __________________________
Date: __________________________
Score: ________ / 50
Domain 1: U.S. Healthcare System Structure & Financing
(10 Questions)
1. Which of the following best describes the primary characteristic that distinguishes the U.S.
healthcare system from other developed nations like the United Kingdom or Canada?
A. It is a single-payer system funded entirely by federal taxation.
B. It is a pluralistic, market-based system with a mix of public and private financing.
C. It provides universal coverage through a national health service.
D. It relies solely on out-of-pocket payments for all services.
2. The U.S. healthcare system is often described as "fragmented." Which of the following
scenarios best illustrates this fragmentation?
A. A patient receives a flu shot at their local pharmacy.
B. A patient sees a specialist but the specialist has no access to the patient’s primary care
records, leading to duplicate testing.
C. A hospital closes due to lack of funding in a rural area.
D. The government sets a fixed price for a surgical procedure.
,3. A 67-year-old retired teacher is admitted to the hospital for a hip replacement. Which part
of Medicare will cover the costs of her inpatient hospital stay, and how is this part primarily
funded?
A. Medicare Part B; funded through beneficiary premiums and general revenues.
B. Medicare Part A; funded through payroll taxes (FICA) during the beneficiary's working
years.
C. Medicare Part D; funded through state and federal block grants.
D. Medicare Part C; funded entirely by private insurance premiums.
4. Which of the following statements accurately distinguishes Medicare from Medicaid?
A. Medicare is a needs-based program for low-income individuals, while Medicaid is an age-
based entitlement for the elderly.
B. Medicare is a federal program for the elderly and disabled, while Medicaid is a joint
federal-state program for low-income populations.
C. Medicaid covers only inpatient hospital care, while Medicare covers only outpatient
physician visits.
D. Medicare eligibility varies significantly by state, while Medicaid eligibility is uniform across
the nation.
5. Under the Medicare Part D prescription drug benefit, beneficiaries often encounter a
coverage gap known as the "donut hole." In the context of the standard benefit design, what
happens once a beneficiary and the plan have spent a certain amount on covered drugs?
A. The beneficiary pays nothing for the rest of the year.
B. The beneficiary enters the catastrophic coverage phase where they pay a significantly
reduced coinsurance or copayment.
C. The beneficiary is automatically disenrolled from the plan.
D. The government pays 100% of all subsequent drug costs.
, 6. A 45-year-old self-employed graphic designer purchases health insurance through the
individual market. Which of the following statements best describes the historical risk profile
of this market prior to the Affordable Care Act?
A. It was characterized by group rating, where premiums were standardized for all individuals
regardless of health status.
B. It was prone to adverse selection, where individuals with higher health needs were more
likely to purchase coverage, driving up premiums.
C. It was heavily subsidized by employer contributions, making it cheaper than group
coverage.
D. It was regulated by the federal government to ensure universal access regardless of pre-
existing conditions.
7. Which feature is characteristic of employer-sponsored health insurance in the United
States?
A. Premiums are paid with post-tax dollars.
B. It operates under the principle of "community rating" where everyone in a geographic area
pays the same rate.
C. Employers typically pay a significant portion of the premium, and employee contributions
are made with pre-tax dollars.
D. Coverage is portable and guaranteed regardless of employment status changes.
8. A patient is enrolled in a Health Maintenance Organization (HMO). To receive coverage for
a visit to a cardiologist, the patient must:
A. Pay a higher deductible than they would in a PPO plan.
B. Obtain a referral from their primary care physician (PCP) and visit a provider within the
HMO network.
C. Select a cardiologist from a national list of providers without restrictions.
D. Pay the full cost of the visit out-of-pocket until an annual deductible is met.
