Questions and CORRECT Answers
Payment sources of health care - CORRECT ANSWER - public health insurance(39%)
-medicare (20%)
-Medicaid(15%)
Private health insurance(33%)
-employee health insurance
-marketplace
out of pocket(12%)
-deductibles
-copay
-coinsurance
-direct payment
Where does money come from for insurance - CORRECT ANSWER - taxes
-medicare
-medicaid
-chip
-tricare
-public health insurance
What do taxes also pay for - CORRECT ANSWER - screenings
mitigation of community health hazards
primary payment sources for the US's _________ annual health care bill - CORRECT
ANSWER - $2.9 trillion annual health care bill.
,Investment - CORRECT ANSWER - this category consists of research, structures and
equipment
Other Payers - CORRECT ANSWER - this category comprises worksite health care,
workers' compensation, vocational rehabilitation, Indian Health Services, and maternal and child
health.
Other Public Health Insurance - CORRECT ANSWER - this category includes CHIP
(Children's Health Insurance Program) and Department of Defense and Veterans Affairs health
care.
Out-of-Pocket - CORRECT ANSWER - this category is made up of consumer spending
on deductibles, copays, co-insurance as well as goods and care not covered by insurance. It is
does not include insurance premiums.
is estimated that the US spends roughly __________ on health care - CORRECT
ANSWER - $3.1 trillion a year
Health care spending as a share of the US economy (or GDP) comes in at roughly _________ -
CORRECT ANSWER - 17.5%
US spends roughly 4.5% of GDP on defense
tell me the average person spends _________on health care each year - CORRECT
ANSWER - -$7,097 on average per person
-Females in the US spend more than males ($7,860/year vs. $6,313/year)
-elderly pay the most for health care ($34,783/year for the 85+ cohort
average spending on heath care for variety of ages - CORRECT ANSWER - 0 to 18
$3,628
19 to 44 $4,422
45 to 64 $8,370
,65 to 84 $15,857
85 and older $34,783
All Ages $7,097
top three spending categories in heath care - CORRECT ANSWER - Hospital care,
physician and clinical services
prescription drug
---were the three top spending categories in 1960 and remain so today
how many drugs are purchased out of pocket - CORRECT ANSWER - -1960, 96% of
prescription drugs were purchased via out-of-pocket
-2014 when 16% of prescription drugs were purchased via out-of-pocket.
four primary ways Americans obtain health insurance coverage: - CORRECT ANSWER -
Medicare
Medicaid
Employer-sponsored insurance
Individual plans
Medicare - CORRECT ANSWER - is a federal social insurance program providing
coverage to those 65 years of age and older who have worked and paid into the system.
Medicare for people under the age of 65 - CORRECT ANSWER - Additionally, Medicare
provides coverage for people under 65 year who have permanent disabilities, end-stage renal
(kidney) disease and amyotrophic lateral sclerosis (ALS). According to the US Department of
Health and Human Services, 53.8 million people have Medicare.
Medicare Part A - CORRECT ANSWER - covers hospital care, skilled nursing care, and
home health services. It is paid for by payroll taxes.
, Medicare Part B - CORRECT ANSWER - covers physician services and durable medical
equipment (e.g., wheelchairs, walkers, blood sugar monitors, and oxygen equipment). It is paid
for by general tax revenues (73%) and monthly beneficiary premiums (25%).
Medicare Part C - CORRECT ANSWER - is also known Medicare Advantage Plans or
Medicare managed care programs offered through private insurance companies which are
approved by Medicare. Roughly one-quarter of Medicare beneficiaries are enrolled in such plans.
These plans cover all services provided through Parts A and B and often times offer additional
services and benefits. Medicare pays a fixed amount to the insurance company for each
beneficiary enrolled in its plan. Beneficiaries also may be required to pay a monthly premium
depending on the plan they select.
Medicare Part D - CORRECT ANSWER - covers prescription drugs. It is paid for by
general tax revenues (73%), monthly beneficiary premiums (14%) and state payments (13%).
nearly _________ of Medicare beneficiaries have some form of supplemental insurance -
CORRECT ANSWER - 90%
Supplemental insurance for Medicare - CORRECT ANSWER - -33% of Medicare
beneficiaries are enrolled in Medicare Advantage Plans
-25% of Medicare enrollees receive health insurance coverage through their employer or former
employer via employer sponsored retiree coverage
-17% of Medicare enrollees have Medigap plans designed to help offset deductibles, coinsurance
and copays (in exchange for a monthly premium)
-15% of Medicare enrollees are eligible for Medicaid (known as dual eligible beneficiaries)
Medicaid - CORRECT ANSWER - is a joint federal-state program with the federal
government paying 50 to 83 percent of total costs from general tax revenues
Who controls Medicaid - CORRECT ANSWER - federal government sets broad eligibility
and service guidelines for Medicaid, states exercise considerable control over specific enrollment
thresholds and the generosity of benefits