Health Policy 3: The US Health Care System
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What is "Health"? What is the focus of healthcare in US? - CORRECT ANSWER - 1958
WHO definition:
"A State of complete physical, mental and
social well-being, and not merely the
absence of disease."
▫ What is our focus in the US? Is it this
comprehensive?
No, Absence of disease is the focus in US right now
Natural Histories of Disease and Levels
of Prevention:
The evolutionary stages of disease & the points at
which health services can intervene to: - CORRECT ANSWER - ▫ Prevent disease onset
(Primary Prevention)
▫ Attenuate disease progression (Secondary
Prevention)
▫ Rehabilitate (Tertiary prevention)
An Enormous and Complex Industry
U.S. health care: - CORRECT ANSWER - • $ 2.7 trillion; 16 million+ workers; 11% of
U.S.
,employment; 17% of GDP
▫ larger than total economy of Italy!
• Poorly aligned infrastructure, medical specialization
- a confusing labyrinth for patients & providers
• Public (government) and private payment sources
with differing rules, regulations
Ex: Confusing for patients and providers, Medicaid is different in every state = 50 programs!
Examples US Healthcare Challenges (Enduring Challenges) - CORRECT ANSWER -•
Size and complexity contribute to problems of:
▫ Limited access, inconsistent quality, high costs
• Unwarranted variations in performance
▫ Ineffectiveness (lack of evidence)
▫ Inefficiency (overuse & duplication)
• Inexplicable contradictions in objectives (e.g.
prevention vs. intervention)
▫ How do we transition from a sick-care system to a
system focused on wellness?
How does US health care compare Internationally? - CORRECT ANSWER - • Compared
to U.K., Germany, Sweden, Canada,
France, Australia, & Japan, U.S. health status ranks
8
th
(last!) on important health status indicators:
, ▫ Life expectancy at birth
▫ Infant mortality rate
▫ Probability of dying between ages 15 and 60
• U.S. health expenses are triple those of Japan and
more than double the 7 other nations.
Important dates and events in the Efforts to Reform HC System - CORRECT ANSWER -
▫ 1900s: start of legislative proposals for
comprehensive reform by eight U.S. presidents
▫ 1960s: Increased access for low-income & older Americans
▫ 1970s-1980s: controls to slow cost growth
▫ 1990s: more cost controls + quality improvements;
market influences
▫ 2010 and beyond: cost, quality & access
***Patient Protection & Affordable Care Act ***
Patient Protection and Affordable Care
Act of 2010 (ACA) - CORRECT ANSWER - • Biggest change since Medicare &
Medicaid in
1965; ACA affects virtually all Americans
• Cover 32 M currently uninsured
▫ except illegal immigrants; low-income who do not
enroll in Medicaid; "opt-outs" preferring to pay the
penalty
• Merge public health prevention concepts into
practice of "personal medical care"
▫ realign financial incentives for providers and insurers
UPDATED ACTUAL Exam Questions and
CORRECT Answers
What is "Health"? What is the focus of healthcare in US? - CORRECT ANSWER - 1958
WHO definition:
"A State of complete physical, mental and
social well-being, and not merely the
absence of disease."
▫ What is our focus in the US? Is it this
comprehensive?
No, Absence of disease is the focus in US right now
Natural Histories of Disease and Levels
of Prevention:
The evolutionary stages of disease & the points at
which health services can intervene to: - CORRECT ANSWER - ▫ Prevent disease onset
(Primary Prevention)
▫ Attenuate disease progression (Secondary
Prevention)
▫ Rehabilitate (Tertiary prevention)
An Enormous and Complex Industry
U.S. health care: - CORRECT ANSWER - • $ 2.7 trillion; 16 million+ workers; 11% of
U.S.
,employment; 17% of GDP
▫ larger than total economy of Italy!
• Poorly aligned infrastructure, medical specialization
- a confusing labyrinth for patients & providers
• Public (government) and private payment sources
with differing rules, regulations
Ex: Confusing for patients and providers, Medicaid is different in every state = 50 programs!
Examples US Healthcare Challenges (Enduring Challenges) - CORRECT ANSWER -•
Size and complexity contribute to problems of:
▫ Limited access, inconsistent quality, high costs
• Unwarranted variations in performance
▫ Ineffectiveness (lack of evidence)
▫ Inefficiency (overuse & duplication)
• Inexplicable contradictions in objectives (e.g.
prevention vs. intervention)
▫ How do we transition from a sick-care system to a
system focused on wellness?
How does US health care compare Internationally? - CORRECT ANSWER - • Compared
to U.K., Germany, Sweden, Canada,
France, Australia, & Japan, U.S. health status ranks
8
th
(last!) on important health status indicators:
, ▫ Life expectancy at birth
▫ Infant mortality rate
▫ Probability of dying between ages 15 and 60
• U.S. health expenses are triple those of Japan and
more than double the 7 other nations.
Important dates and events in the Efforts to Reform HC System - CORRECT ANSWER -
▫ 1900s: start of legislative proposals for
comprehensive reform by eight U.S. presidents
▫ 1960s: Increased access for low-income & older Americans
▫ 1970s-1980s: controls to slow cost growth
▫ 1990s: more cost controls + quality improvements;
market influences
▫ 2010 and beyond: cost, quality & access
***Patient Protection & Affordable Care Act ***
Patient Protection and Affordable Care
Act of 2010 (ACA) - CORRECT ANSWER - • Biggest change since Medicare &
Medicaid in
1965; ACA affects virtually all Americans
• Cover 32 M currently uninsured
▫ except illegal immigrants; low-income who do not
enroll in Medicaid; "opt-outs" preferring to pay the
penalty
• Merge public health prevention concepts into
practice of "personal medical care"
▫ realign financial incentives for providers and insurers
