US Healthcare Systems Chapter 2
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Legislative, organizational, and professional developments changed the U.S. healthcare system
from - CORRECT ANSWER - one-to-one services to a huge, complex, corporation-
dominated industry.
Twentieth-century accomplishments: - CORRECT ANSWER - Prevention of infectious
diseases, psychotropic drugs, imaging and cardiovascular technologies; advancing technology
encouraged medical specialization.
ACA's four aims: - CORRECT ANSWER - Consumer protection; higher quality, lower
costs; access to affordable care; holding insurance companies accountable.
ACA's mandates and results will continue to be challenged - CORRECT ANSWER -
Experimentation with new delivery models with health services research results
Evolving health care provider and insurance marketplaces
Changing political landscape will determine final results of ACA implementation
Overall -
US Health Care Industry Transformation - CORRECT ANSWER - Until 1940s ( a time
referred to as pre-insurance), the healthcare industry was dominated by physicians and hospitals
Patient/Doctor relationships were considered sacred; treatments, payments confidential
Patient mostly made personal payments
"No third party must be permitted to come between patient and physician in any medical matter."
(AMA, 1934)
A statement put forth during testimony for Social Security Amendment
, Shift from Personal Payment to Insurance Payment - CORRECT ANSWER - With the
introduction of health insurance a dramatic alteration occurred in physician/patient relationship
Patients no longer directly paid for services; services were "covered" by insurance.
This distanced patients from awareness of costs and responsibility for making decisions for
services.
Created "business" of medicine
Health Insurance Historical Highlights - CORRECT ANSWER - 1800s: Some employer
sickness insurance, fraternal orders, unions; fixed payments partially replaced lost wages due to
injuries or illnesses.
1915: Drive for compulsory insurance begun with European models but interrupted by WWI
(1914-1918); models to protect workers from lost income due to accidents (insured against
unexpected events).
AMA officially opposed compulsory insurance (1919), believing insurance would decrease
physician incomes based on experience with arbitrary fees paid by accident insurance.
Great Depression:
The Start of Hospital Insurance Plans and the growth of US Healthcare System - CORRECT
ANSWER - Hospitals experimented with insurance as financial woes reduced admissions
Baylor University Plan: birth of the Blue Cross Model; public school teachers paid $.50/month
for guarantee of 21 paid hospital days per year
By 1937, 26 plans with 600,000 enrolled with physician and hospital endorsement
Growth of Private Insurance and its Impact on the Healthcare System - CORRECT
ANSWER - Post WWII (1939-1945): Government exempted health insurance benefits
from wage/price controls and exempted workers' health insurance contributions from taxable
income.
Insurance companies raised premiums without pressure to control costs
Attention focused on avoiding infringement on physicians' and hospitals' freedom to set prices
Social Security Act of 1935—most significant social initiative in U.S. history: - CORRECT
ANSWER - Federal aid to states for public health, welfare, maternal/child health, children
with disabilities, "elderly" - Title I
UPDATED ACTUAL Exam Questions and
CORRECT Answers
Legislative, organizational, and professional developments changed the U.S. healthcare system
from - CORRECT ANSWER - one-to-one services to a huge, complex, corporation-
dominated industry.
Twentieth-century accomplishments: - CORRECT ANSWER - Prevention of infectious
diseases, psychotropic drugs, imaging and cardiovascular technologies; advancing technology
encouraged medical specialization.
ACA's four aims: - CORRECT ANSWER - Consumer protection; higher quality, lower
costs; access to affordable care; holding insurance companies accountable.
ACA's mandates and results will continue to be challenged - CORRECT ANSWER -
Experimentation with new delivery models with health services research results
Evolving health care provider and insurance marketplaces
Changing political landscape will determine final results of ACA implementation
Overall -
US Health Care Industry Transformation - CORRECT ANSWER - Until 1940s ( a time
referred to as pre-insurance), the healthcare industry was dominated by physicians and hospitals
Patient/Doctor relationships were considered sacred; treatments, payments confidential
Patient mostly made personal payments
"No third party must be permitted to come between patient and physician in any medical matter."
(AMA, 1934)
A statement put forth during testimony for Social Security Amendment
, Shift from Personal Payment to Insurance Payment - CORRECT ANSWER - With the
introduction of health insurance a dramatic alteration occurred in physician/patient relationship
Patients no longer directly paid for services; services were "covered" by insurance.
This distanced patients from awareness of costs and responsibility for making decisions for
services.
Created "business" of medicine
Health Insurance Historical Highlights - CORRECT ANSWER - 1800s: Some employer
sickness insurance, fraternal orders, unions; fixed payments partially replaced lost wages due to
injuries or illnesses.
1915: Drive for compulsory insurance begun with European models but interrupted by WWI
(1914-1918); models to protect workers from lost income due to accidents (insured against
unexpected events).
AMA officially opposed compulsory insurance (1919), believing insurance would decrease
physician incomes based on experience with arbitrary fees paid by accident insurance.
Great Depression:
The Start of Hospital Insurance Plans and the growth of US Healthcare System - CORRECT
ANSWER - Hospitals experimented with insurance as financial woes reduced admissions
Baylor University Plan: birth of the Blue Cross Model; public school teachers paid $.50/month
for guarantee of 21 paid hospital days per year
By 1937, 26 plans with 600,000 enrolled with physician and hospital endorsement
Growth of Private Insurance and its Impact on the Healthcare System - CORRECT
ANSWER - Post WWII (1939-1945): Government exempted health insurance benefits
from wage/price controls and exempted workers' health insurance contributions from taxable
income.
Insurance companies raised premiums without pressure to control costs
Attention focused on avoiding infringement on physicians' and hospitals' freedom to set prices
Social Security Act of 1935—most significant social initiative in U.S. history: - CORRECT
ANSWER - Federal aid to states for public health, welfare, maternal/child health, children
with disabilities, "elderly" - Title I
