Essentials of the US Health Care System
questions and answers 2025/2026
What are the two main objectives of a health delivery system? - answerThe primary objectives of any
health delivery system are to enable all citizens to receive health careservices whenever needed, and to
deliver health services that are cost-effective and meet pre-established standards of quality.
What is the primary reason for employers to purchase insurance plans to provide health benefits to
their employees? - answerThe United States does not have a universal health care system covering all
citizens. Health insurance is primarily employer-based.
What is managed care? - answerManaged care is a system of health care delivery that seeks to achieve
efficiencies by integrating the basic functions of health care delivery, and employs mechanisms to
control utilization of medicalservices and the price at which the services are purchased.
Discuss the intermediary role of insurance in the delivery of health care. - answerthe insurance function
introduces a third party into the transaction between the patient and the provider. Health insurance
insulates the consumer from the cost of health care. Providers are sometimes restricted from delivering
services that are non covered.
Who are the major players in the US health services system? What are the positive and negative effects
of these players? - answerThe key players in the system are the physicians, administrators of health
service institutions, insurance executives, large employers, and the government. One positive effect of
these opposing forces is that they prevent any single entity from dominating the system. On the other
hand, they also make it difficult to achieve system wide reforms.
What main roles does the government play in the US health services system? - answerThe government
is a major financier of health care delivery through the Medicare and Medicaid programs. The
government determines eligibility criteria as to who can receive services under these programs; it also
determines the reimbursement rates that providers will receive for rendering services to Medicaid and
Medicare patients. In order to render services to Medicare and Medicaid, these organizations must
comply with the standards of participation formulated by the government.
What is socialized health insurance (SHI)? - answerIn a socialized health insurance system, health care is
financed through government-mandated contributions by employers and employees.
, What are the two major goals of chapter 2? - answerThe first goal is to propose a holistic approach to
health care delivery that focuses on curative medicine, health promotion, and disease prevention. The
second goal is to further explore the issue of equity in the distribution of health services using the
contrasting theories of market justice and social justice in U.S. Health Care Delivery.
Distinguish between illness and disease. How are these concepts related to the medical model of health
care delivery? - answerIllness reflects what a person feels. Disease may or may not be present. On the
other hand, disease reflects the physician's diagnosis. It requires therapeutic intervention. A person who
is ill seeks health care with the objective of finding relief of symptoms and discomfort. A medical
professional attempts to diagnose the illness and prescribes treatment if disease is present.
What are the 3 classifications of disease? Define them. - answerAcute condition: relatively severe,
episodic and often treatable, Sub acute condition, and Chronic condition: less severe
What are the 4 major determinants of health? Explain each determinant. - answerEnvironment,
Behavior and Lifestyle, Heredity, Medical Care
What are the main objectives of public health? - answerPublic health is concerned with ensuring
conditions that promote optimum health for society as a whole. Its main objectives are to prevent
disease, prolong life, and promote health through organized community effort.
What are the two overarching goals of Healthy People Initiatives? - answerThe first goal is to help
individual of all ages increase life expectancy and improve their quality of life. The second goal is to
eliminate health disparities among different segments of the population.
Describe how health care is rationed in the market justice and social justice systems. - answerIn the
market justice system, health care services are rationed through prices and the ability to pay. The
uninsured and those who lack sufficient income to pay privately cannot obtain the quantity and type of
health care services when they want them. This is referred to as demand-side rationing, or price-
rationing.
What is the role of health risk appraisal in health promotion and disease prevention? - answerHealth risk
appraisal is the process of evaluating risk factors and their health consequences in individuals. Only
when the risk factors and their health consequences are known can avenues be developed for
motivating individuals to alter their behaviors to more healthful patterns.
questions and answers 2025/2026
What are the two main objectives of a health delivery system? - answerThe primary objectives of any
health delivery system are to enable all citizens to receive health careservices whenever needed, and to
deliver health services that are cost-effective and meet pre-established standards of quality.
What is the primary reason for employers to purchase insurance plans to provide health benefits to
their employees? - answerThe United States does not have a universal health care system covering all
citizens. Health insurance is primarily employer-based.
What is managed care? - answerManaged care is a system of health care delivery that seeks to achieve
efficiencies by integrating the basic functions of health care delivery, and employs mechanisms to
control utilization of medicalservices and the price at which the services are purchased.
Discuss the intermediary role of insurance in the delivery of health care. - answerthe insurance function
introduces a third party into the transaction between the patient and the provider. Health insurance
insulates the consumer from the cost of health care. Providers are sometimes restricted from delivering
services that are non covered.
Who are the major players in the US health services system? What are the positive and negative effects
of these players? - answerThe key players in the system are the physicians, administrators of health
service institutions, insurance executives, large employers, and the government. One positive effect of
these opposing forces is that they prevent any single entity from dominating the system. On the other
hand, they also make it difficult to achieve system wide reforms.
What main roles does the government play in the US health services system? - answerThe government
is a major financier of health care delivery through the Medicare and Medicaid programs. The
government determines eligibility criteria as to who can receive services under these programs; it also
determines the reimbursement rates that providers will receive for rendering services to Medicaid and
Medicare patients. In order to render services to Medicare and Medicaid, these organizations must
comply with the standards of participation formulated by the government.
What is socialized health insurance (SHI)? - answerIn a socialized health insurance system, health care is
financed through government-mandated contributions by employers and employees.
, What are the two major goals of chapter 2? - answerThe first goal is to propose a holistic approach to
health care delivery that focuses on curative medicine, health promotion, and disease prevention. The
second goal is to further explore the issue of equity in the distribution of health services using the
contrasting theories of market justice and social justice in U.S. Health Care Delivery.
Distinguish between illness and disease. How are these concepts related to the medical model of health
care delivery? - answerIllness reflects what a person feels. Disease may or may not be present. On the
other hand, disease reflects the physician's diagnosis. It requires therapeutic intervention. A person who
is ill seeks health care with the objective of finding relief of symptoms and discomfort. A medical
professional attempts to diagnose the illness and prescribes treatment if disease is present.
What are the 3 classifications of disease? Define them. - answerAcute condition: relatively severe,
episodic and often treatable, Sub acute condition, and Chronic condition: less severe
What are the 4 major determinants of health? Explain each determinant. - answerEnvironment,
Behavior and Lifestyle, Heredity, Medical Care
What are the main objectives of public health? - answerPublic health is concerned with ensuring
conditions that promote optimum health for society as a whole. Its main objectives are to prevent
disease, prolong life, and promote health through organized community effort.
What are the two overarching goals of Healthy People Initiatives? - answerThe first goal is to help
individual of all ages increase life expectancy and improve their quality of life. The second goal is to
eliminate health disparities among different segments of the population.
Describe how health care is rationed in the market justice and social justice systems. - answerIn the
market justice system, health care services are rationed through prices and the ability to pay. The
uninsured and those who lack sufficient income to pay privately cannot obtain the quantity and type of
health care services when they want them. This is referred to as demand-side rationing, or price-
rationing.
What is the role of health risk appraisal in health promotion and disease prevention? - answerHealth risk
appraisal is the process of evaluating risk factors and their health consequences in individuals. Only
when the risk factors and their health consequences are known can avenues be developed for
motivating individuals to alter their behaviors to more healthful patterns.
