HSCI 305 Final Exam Updated Actual
Questions and CORRECT Answers
Commonwealth Fund Report 2021 - CORRECT ANSWER - compare the health
systems of 11 high-income countries
- drawn from surveys from public/primary physicians
- used indicators available across five domains:
1. Access to care (affordability and timeliness)
2. Care process (preventive care, safe care, coordinated care, and engagement/patient
preferences)
3. Administrative efficiency (reduce documentation and other bureaucratic tasks, ex. medical
bills)
4. Equity (fair)
5. Health Care Outcomes (responsive to health care, ex. low infant mortality rate, and life
expectancy)
4 Reasons for Better Performance Between Countries' Health Care - CORRECT
ANSWER 1. provide universal coverage and remove cost barriers
2. invest in primary care systems to ensure high-value services available locally
3. reduce administrative burdens on patients and clinicians (can discourage marginalized
groups)
4. invest in social services, increasing equitable access to education, housing, food = healthier
population
Germany's Health Care System (4 Characteristics) - CORRECT ANSWER - uses
Bismarck model (Social Health Insurance Model) based on premise that public ensures those
who cannot afford care will get it, but those who can afford help pay their own costs
1. numerous non-profit insurance plans
2. regulated by government, ensure that all plans provide basic level of coverage 3. funding is
a combination of employer & employee premiums, w/ some government subsidies
4. everyone is covered by some plan, so coverage is effectively universal
Comparison to Canada:
,- not a single payer for core services (government)
United Kingdom's Health Care System (5 Characteristics) - CORRECT ANSWER -
uses National Health Service (NHS) model
- the government pays for care but also delivers it
- have four jurisdictions, NHS has separate units for each
1. universal coverage for range of services
2. funded by national tax system
3. government is the dominant source of funds
4. government owns most hospitals, delivers services with its own employees (although more
contracting now)
5. small private sector for the wealthy, but even private specialists normally work part time in
NHS hospitals as NHS remains the 'gold standard'
Comparison to Canada:
- salary based physicians
- UK has public financing/public delivery, Canada has public financing/private delivery
United States' Health Care System - CORRECT ANSWER - provided through many
systems
- private financing and mostly private delivery
- competing insurance plans, many variations through federal/state governments
- US and Canadian adults more likely visit emergency department = less efficient option than
seeing regular doctor (due to shortage of family physicians)
1. medicare (federal): insured those 65+ or w/ certain chronic diseases
2. medicaid(states): insured the poor
- many not insured/underinsured, whilst employer insurance common for under 65
United States' Health Care System (5 implications) - CORRECT ANSWER 1. privately
owned hospitals can turn people away if situation judged not to be an emergency
2. public hospitals (hospitals owned by a level of government w/ public funding) could not
turn people away if they need care
, 3. this causes large differences in access to care, since public hospitals are not available in all
locations 4. massive financial drain on public hospitals, often left with unpaid bills
5. does not stop providers from still trying to collect bills from patients, including turning
over their files to collection agencies
Obamacare 2010 - CORRECT ANSWER Positives:
1. retained private insurance plans but regulated the market
2. expanded the number of people w/ coverage
Negatives:
1. retained model of competing private insurance plans
2. did not solve the problem of non-coverage completely
Challenges:
1. replace with other plans
2. don't want to extend Obamacare
Canada vs. US Health Care - CORRECT ANSWER - established differently because
Canada started from scratch, not needing to displace big profit insurance corporations like US
- Canada's system has higher levels of satisfaction among it's own population, unlike US
Canada is more appealing because...
1. Seems to do more for less
2. Canada scored better on infant mortality and life expectancy
U.S System Fragmented - CORRECT ANSWER - different insurance companies,
which are all very large, and none of them are connected.
- go from one system to another, one provider to another, meaning health info gets lost in the
transfer process.
Canadian Values Differ - CORRECT ANSWER - differing social values are the core
issue on why the US has not copied the Canadian health care system
- due to mix of public and private in US, so many different values for health care arise
Questions and CORRECT Answers
Commonwealth Fund Report 2021 - CORRECT ANSWER - compare the health
systems of 11 high-income countries
- drawn from surveys from public/primary physicians
- used indicators available across five domains:
1. Access to care (affordability and timeliness)
2. Care process (preventive care, safe care, coordinated care, and engagement/patient
preferences)
3. Administrative efficiency (reduce documentation and other bureaucratic tasks, ex. medical
bills)
4. Equity (fair)
5. Health Care Outcomes (responsive to health care, ex. low infant mortality rate, and life
expectancy)
4 Reasons for Better Performance Between Countries' Health Care - CORRECT
ANSWER 1. provide universal coverage and remove cost barriers
2. invest in primary care systems to ensure high-value services available locally
3. reduce administrative burdens on patients and clinicians (can discourage marginalized
groups)
4. invest in social services, increasing equitable access to education, housing, food = healthier
population
Germany's Health Care System (4 Characteristics) - CORRECT ANSWER - uses
Bismarck model (Social Health Insurance Model) based on premise that public ensures those
who cannot afford care will get it, but those who can afford help pay their own costs
1. numerous non-profit insurance plans
2. regulated by government, ensure that all plans provide basic level of coverage 3. funding is
a combination of employer & employee premiums, w/ some government subsidies
4. everyone is covered by some plan, so coverage is effectively universal
Comparison to Canada:
,- not a single payer for core services (government)
United Kingdom's Health Care System (5 Characteristics) - CORRECT ANSWER -
uses National Health Service (NHS) model
- the government pays for care but also delivers it
- have four jurisdictions, NHS has separate units for each
1. universal coverage for range of services
2. funded by national tax system
3. government is the dominant source of funds
4. government owns most hospitals, delivers services with its own employees (although more
contracting now)
5. small private sector for the wealthy, but even private specialists normally work part time in
NHS hospitals as NHS remains the 'gold standard'
Comparison to Canada:
- salary based physicians
- UK has public financing/public delivery, Canada has public financing/private delivery
United States' Health Care System - CORRECT ANSWER - provided through many
systems
- private financing and mostly private delivery
- competing insurance plans, many variations through federal/state governments
- US and Canadian adults more likely visit emergency department = less efficient option than
seeing regular doctor (due to shortage of family physicians)
1. medicare (federal): insured those 65+ or w/ certain chronic diseases
2. medicaid(states): insured the poor
- many not insured/underinsured, whilst employer insurance common for under 65
United States' Health Care System (5 implications) - CORRECT ANSWER 1. privately
owned hospitals can turn people away if situation judged not to be an emergency
2. public hospitals (hospitals owned by a level of government w/ public funding) could not
turn people away if they need care
, 3. this causes large differences in access to care, since public hospitals are not available in all
locations 4. massive financial drain on public hospitals, often left with unpaid bills
5. does not stop providers from still trying to collect bills from patients, including turning
over their files to collection agencies
Obamacare 2010 - CORRECT ANSWER Positives:
1. retained private insurance plans but regulated the market
2. expanded the number of people w/ coverage
Negatives:
1. retained model of competing private insurance plans
2. did not solve the problem of non-coverage completely
Challenges:
1. replace with other plans
2. don't want to extend Obamacare
Canada vs. US Health Care - CORRECT ANSWER - established differently because
Canada started from scratch, not needing to displace big profit insurance corporations like US
- Canada's system has higher levels of satisfaction among it's own population, unlike US
Canada is more appealing because...
1. Seems to do more for less
2. Canada scored better on infant mortality and life expectancy
U.S System Fragmented - CORRECT ANSWER - different insurance companies,
which are all very large, and none of them are connected.
- go from one system to another, one provider to another, meaning health info gets lost in the
transfer process.
Canadian Values Differ - CORRECT ANSWER - differing social values are the core
issue on why the US has not copied the Canadian health care system
- due to mix of public and private in US, so many different values for health care arise
