US Healthcare Systems Exam 1 (Ch 1-6)
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What are the basic components of a Health Services Delivery System? - CORRECT
ANSWER - 1. Financing - how services are paid for
2. Insurance - protects against catastrophic risks
3. Delivery - provision of health care services by various providers
4. Payment - reimbursement to providers for services delivered
What are 5 key components of the Affordable Care Act (ACA)? - CORRECT ANSWER -
1. Individual mandate
2. Insurance plans must cover "essential health benefits"
3. Insurance available for purchase on a web-based exchange
4. Expansion of Medicaid
5. Employer mandate to provide insurance for employees
What does managed care seek to achieve? - CORRECT ANSWER - 1. Seeks to achieve
efficiencies by integration of the 4 functions of health care.
2. Employs mechanisms to control utilization of medical services.
3. Determines the price at which the services are purchased and how much providers get paid.
What is the iron triangle of healthcare delivery? - CORRECT ANSWER - Access, cost,
quality
Describe health care in the Pre-Industrial Era (Mid-18th to late 19th century) - CORRECT
ANSWER - The consumer was sovereign in the market and healthcare was delivered
under free market conditions.
,Medical practice was in disarray, medical procedures were primitive, the institutional core was
missing, demand was unstable, and medical education was substandard.
What are 5 reasons medical practice was insignificant during the Pre-Industrial Era? -
CORRECT ANSWER - 1. Medical practice was in disarray
2. Medical procedures were primitive
3. Institutional core was missing
4. Demand was unstable
5. Medical education was substandard
Why was demand for medical care unstable in the Pre-Industrial Era? - CORRECT
ANSWER - Opportunity cost of time spent and money spent traveling to the doctor were
too high. Demand was limited by economic conditions and the traditional practice of medicine in
rural eras.
Describe health care during the Post-Industrial Era (late 19th to late 20th century). - CORRECT
ANSWER - 1. Growth of professional sovereignty - as tech/meds advanced, status of
physicians rose.
2. Physicians succeeded in retaining private practice of medicine and resisting national
healthcare.
3. Employers took on a well-defined role in providing health care.
4. Growth of private health insurance.
5. Development of public health
Why did physicians rise to positions of power in the 1920s? - CORRECT ANSWER - 1.
Urbanization
2. Science and technology / cultural authority
3. Institutionalization / pooling of resources
4. Dependency
5. Autonomy and organization (professional cohesiveness)
6. Licensing
, 7. Educational reform
Describe organized medicine. - CORRECT ANSWER - The concerted efforts of
physicians through the AMA which equated to professional cohesiveness.
What 3 factors prompted the general need for health insurance? - CORRECT ANSWER -
1. Technological - advanced treatments that were desirable but expensive.
2. Social - desirability of medical treatments.
3. Economic - risk of catastrophic loss.
What 3 reasons led to the growth of employer-based health insurance? - CORRECT
ANSWER - 1. Wage freeze during WWII - employers offered insurance as a benefit in
lieu of more money.
2. 1948 Supreme Court ruling - employee benefits were legit part of union-management
negotiations.
3. 1954 IRS tax code revision - made employer-paid health insurance tax deductible for
employers, tax-exempt for employees.
Describe the 4 parts of Medicare. - CORRECT ANSWER - Part A - hospital and limited
nursing home coverage (automatic).
Part B - Covers physician bills. Pay separate from part A.
Part C (1997) - Medicare managed care.
Part D (2006) - Prescription drugs.
Describe Medicaid. - CORRECT ANSWER - - Helps indigent populations pay for health
care.
- Eligibility determined via a means test.
- A state run program, funded in part by federal government to match state contributions (Kerr-
Mills Act).
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What are the basic components of a Health Services Delivery System? - CORRECT
ANSWER - 1. Financing - how services are paid for
2. Insurance - protects against catastrophic risks
3. Delivery - provision of health care services by various providers
4. Payment - reimbursement to providers for services delivered
What are 5 key components of the Affordable Care Act (ACA)? - CORRECT ANSWER -
1. Individual mandate
2. Insurance plans must cover "essential health benefits"
3. Insurance available for purchase on a web-based exchange
4. Expansion of Medicaid
5. Employer mandate to provide insurance for employees
What does managed care seek to achieve? - CORRECT ANSWER - 1. Seeks to achieve
efficiencies by integration of the 4 functions of health care.
2. Employs mechanisms to control utilization of medical services.
3. Determines the price at which the services are purchased and how much providers get paid.
What is the iron triangle of healthcare delivery? - CORRECT ANSWER - Access, cost,
quality
Describe health care in the Pre-Industrial Era (Mid-18th to late 19th century) - CORRECT
ANSWER - The consumer was sovereign in the market and healthcare was delivered
under free market conditions.
,Medical practice was in disarray, medical procedures were primitive, the institutional core was
missing, demand was unstable, and medical education was substandard.
What are 5 reasons medical practice was insignificant during the Pre-Industrial Era? -
CORRECT ANSWER - 1. Medical practice was in disarray
2. Medical procedures were primitive
3. Institutional core was missing
4. Demand was unstable
5. Medical education was substandard
Why was demand for medical care unstable in the Pre-Industrial Era? - CORRECT
ANSWER - Opportunity cost of time spent and money spent traveling to the doctor were
too high. Demand was limited by economic conditions and the traditional practice of medicine in
rural eras.
Describe health care during the Post-Industrial Era (late 19th to late 20th century). - CORRECT
ANSWER - 1. Growth of professional sovereignty - as tech/meds advanced, status of
physicians rose.
2. Physicians succeeded in retaining private practice of medicine and resisting national
healthcare.
3. Employers took on a well-defined role in providing health care.
4. Growth of private health insurance.
5. Development of public health
Why did physicians rise to positions of power in the 1920s? - CORRECT ANSWER - 1.
Urbanization
2. Science and technology / cultural authority
3. Institutionalization / pooling of resources
4. Dependency
5. Autonomy and organization (professional cohesiveness)
6. Licensing
, 7. Educational reform
Describe organized medicine. - CORRECT ANSWER - The concerted efforts of
physicians through the AMA which equated to professional cohesiveness.
What 3 factors prompted the general need for health insurance? - CORRECT ANSWER -
1. Technological - advanced treatments that were desirable but expensive.
2. Social - desirability of medical treatments.
3. Economic - risk of catastrophic loss.
What 3 reasons led to the growth of employer-based health insurance? - CORRECT
ANSWER - 1. Wage freeze during WWII - employers offered insurance as a benefit in
lieu of more money.
2. 1948 Supreme Court ruling - employee benefits were legit part of union-management
negotiations.
3. 1954 IRS tax code revision - made employer-paid health insurance tax deductible for
employers, tax-exempt for employees.
Describe the 4 parts of Medicare. - CORRECT ANSWER - Part A - hospital and limited
nursing home coverage (automatic).
Part B - Covers physician bills. Pay separate from part A.
Part C (1997) - Medicare managed care.
Part D (2006) - Prescription drugs.
Describe Medicaid. - CORRECT ANSWER - - Helps indigent populations pay for health
care.
- Eligibility determined via a means test.
- A state run program, funded in part by federal government to match state contributions (Kerr-
Mills Act).
