PUBH 6012 EXAM 2 QUESTIONS AND ANSWERS
SET A+
✔✔What % of local PH funding comes from local sources? - ✔✔~25%
✔✔Where does the majority of U.S. emergency/preparedness funding come from? -
✔✔FEDERAL government (overwhelming majority) - because states can't deficit spend
and the feds have the resources
✔✔How much did 3/4 of states spend per capita on PH? - ✔✔Less than $75 per capita
✔✔ARPA investment in PH workforce/infrastructure - ✔✔$7 billion total; $3 billion over
5 years (2023) for workforce, foundational capabilities, and data systems
✔✔Commonwealth Fund Commission recommended federal PH funding level - ✔✔$4.5
billion per year - reliable, stable funding for state and local PH
✔✔Commonwealth Fund Commission (findings) - ✔✔1. PH efforts not organized for
success
2. PH funding is not sufficient/reliable
3. Minimal expectations for health care agencies
4. HC system missing opportunities
5. PH enterprise facing a crisis in trust
✔✔U.S. health spending as % of GDP (2021) - ✔✔18.3% - roughly 2x the OECD
average
✔✔OECD average health spending as % of GDP - ✔✔~9.6%
✔✔U.S. per capita health spending - ✔✔$12,914
✔✔U.S. total health spending (2021) - ✔✔$4.3 trillion
, ✔✔% of U.S. health spending considered waste - ✔✔~25% ($760-935 billion)
✔✔6 categories of health spending waste - ✔✔Failure of care delivery, failure of care
coordination, overtreatment/low-value care, pricing failure, fraud/abuse, and
administrative complexity
✔✔The U.S. spending-outcomes paradox - ✔✔U.S. spends ~2x OECD average but has
HIGHER avoidable death rates. U.S. allocates less to families/young children and more
to older adults; underinvests in social support relative to other countries
✔✔Roemer's 5 Archetypes of Health Systems - ✔✔1. Entrepreneurial
2. Welfare-oriented
3. Single-payer
4. Comprehensive
5. Socialist
Classified by affluence + government control
✔✔Which Roemer archetype is the U.S.? - ✔✔Entrepreneurial - private insurance +
private delivery; emphasizes individualism
✔✔Which Roemer archetype is Canada? - ✔✔Single payer - national tax-based
insurance with private delivery (providers are private, payer is public)
✔✔Which Roemer archetype is Germany? - ✔✔Welfare-oriented - national
employment-based Social Health Insurance (SHI) via sickness funds; mixed delivery
✔✔Which Roemer archetype is England/UK? - ✔✔Comprehensive - national tax-based
service; government OWNS and runs delivery (NHS); strong public regulation
✔✔Which Roemer archetype is Switzerland? - ✔✔Entrepreneurial - but with individual
MANDATE (emphasizes solidarity, not individualism like the U.S.)
✔✔Which U.S. subsystem is single-payer-like? - ✔✔Medicaid - national tax-based
insurance
✔✔Which U.S. subsystem is welfare-oriented? - ✔✔Medicare - employment-based (tied
to payroll taxes)
✔✔Which U.S. subsystem is comprehensive? - ✔✔VHA (Veterans Health
Administration) - the government owns and runs the delivery
SET A+
✔✔What % of local PH funding comes from local sources? - ✔✔~25%
✔✔Where does the majority of U.S. emergency/preparedness funding come from? -
✔✔FEDERAL government (overwhelming majority) - because states can't deficit spend
and the feds have the resources
✔✔How much did 3/4 of states spend per capita on PH? - ✔✔Less than $75 per capita
✔✔ARPA investment in PH workforce/infrastructure - ✔✔$7 billion total; $3 billion over
5 years (2023) for workforce, foundational capabilities, and data systems
✔✔Commonwealth Fund Commission recommended federal PH funding level - ✔✔$4.5
billion per year - reliable, stable funding for state and local PH
✔✔Commonwealth Fund Commission (findings) - ✔✔1. PH efforts not organized for
success
2. PH funding is not sufficient/reliable
3. Minimal expectations for health care agencies
4. HC system missing opportunities
5. PH enterprise facing a crisis in trust
✔✔U.S. health spending as % of GDP (2021) - ✔✔18.3% - roughly 2x the OECD
average
✔✔OECD average health spending as % of GDP - ✔✔~9.6%
✔✔U.S. per capita health spending - ✔✔$12,914
✔✔U.S. total health spending (2021) - ✔✔$4.3 trillion
, ✔✔% of U.S. health spending considered waste - ✔✔~25% ($760-935 billion)
✔✔6 categories of health spending waste - ✔✔Failure of care delivery, failure of care
coordination, overtreatment/low-value care, pricing failure, fraud/abuse, and
administrative complexity
✔✔The U.S. spending-outcomes paradox - ✔✔U.S. spends ~2x OECD average but has
HIGHER avoidable death rates. U.S. allocates less to families/young children and more
to older adults; underinvests in social support relative to other countries
✔✔Roemer's 5 Archetypes of Health Systems - ✔✔1. Entrepreneurial
2. Welfare-oriented
3. Single-payer
4. Comprehensive
5. Socialist
Classified by affluence + government control
✔✔Which Roemer archetype is the U.S.? - ✔✔Entrepreneurial - private insurance +
private delivery; emphasizes individualism
✔✔Which Roemer archetype is Canada? - ✔✔Single payer - national tax-based
insurance with private delivery (providers are private, payer is public)
✔✔Which Roemer archetype is Germany? - ✔✔Welfare-oriented - national
employment-based Social Health Insurance (SHI) via sickness funds; mixed delivery
✔✔Which Roemer archetype is England/UK? - ✔✔Comprehensive - national tax-based
service; government OWNS and runs delivery (NHS); strong public regulation
✔✔Which Roemer archetype is Switzerland? - ✔✔Entrepreneurial - but with individual
MANDATE (emphasizes solidarity, not individualism like the U.S.)
✔✔Which U.S. subsystem is single-payer-like? - ✔✔Medicaid - national tax-based
insurance
✔✔Which U.S. subsystem is welfare-oriented? - ✔✔Medicare - employment-based (tied
to payroll taxes)
✔✔Which U.S. subsystem is comprehensive? - ✔✔VHA (Veterans Health
Administration) - the government owns and runs the delivery
