INTRO TO PHP FINAL QUESTIONS AND ANSWERS
FDA Process of Assessing Safety and Effectiveness of Drugs: Preclinical Testing -
Answer -Safety assessment on at least 2 species at high dosages prior to initial use on
humans
Objectives: Access carcinogenic, teratogenic and fertility effects
Limitations: High-dose effects may not correlate with effects on humans, species
differences may result in missing effects that later appear in human testing or
widespread clinical use
How much does the US spend on healthcare? - Answer -Approx. $3 trillion per yr.
-18% of GDP
-$9,000 per person per yr.
Types of Insurance in the US - Answer --Gov't Financed
-Employment-Based
-Health Insurance Exchanges
Medicare - Answer -Federal government program primarily funded by payroll tax that
provides for ages 65 or older, disabled ppl eligible for social security disability benefits,
and those with stage renal disease
-50 mill Americans are eligible
4 Different Parts of Medicare - Answer -Part A: covers hospital care, skilled nursing
care and hospice care
Part B: Voluntary supplemental insurance that covers diagnostic and therapeutic
services
Part C: Program designed to encourage Medicare beneficiaries to enroll in prepaid
health plans
Part D: prescription drug plan open to individuals enrolled in parts A and B
Medicaid - Answer -Federal plus state program designed to pay for health services for
specific categories of poor ppl and other groups
-Disabled, kids, pregnant women, etc.
In the basic program, the gov't pays available amount of the cost, ranging from 50-83%
depending on per capita income of the state (meant to match funds provided by state)
To receive matching funding, states must provide basic services such as inpatient and
outpatient services
,State Child Health Insurance Program (SCHIP) - Answer --Administered thru Medicaid
-Additional funds the states may use to enhance the healthcare of kids
-Participating states may raise the income level for medicaid eligibility, start eligibility
more rapidly and ensure longer periods of eligibility
What types of Employment-Based Health Insurance Programs are available? - Answer
--Fee-for-Service: charges paid for specific services provided. As a payment system, it
encourages the provision of as many services as possible
-Health Maintenance Orgs. (HMOS): charge patients a monthly fee designed to cover a
comprehensive package of services. Clinicians or their orgs are paid based on the # of
individuals enrolled at their practice
-Preferred provide organizations (PPOs): fee for service insurance system decides to
only work with a limited # of clinicians
-Point of Service Plans (POSs): patients in a HMO may choose to receive care outside
the system provided by the health plan, but will pay more out of pocket
What mechanism is available to obtain insurance for those not otherwise eligible for
health insurance? - Answer -Health Insurance Exchanges
-Provide a competitive marketplace to help increase access and control the costs of
health insurance
Consequences of being uninsured or underinsured in the U.S.? - Answer --Less
preventative care, diagnosed at more advanced stages of disease, receive less
treatment after being diagnosed
-Less likely to have usual source of healthcare. More likely to use ER for routine care
and an increased mortality rate
Are there programs for those who are disabled or injured on the job? - Answer -
Complex systems of federal and state programs available, categorized as:
-Workers Compensation and Federal Programs for Workers
-Social Security Disability Insurance & Social Security Income
*Doesn't replace health insurance but does provide some assistance
Conclusions from looking at the US, UK, and Canada Healthcare Systems - Answer -
US: relies heavily on market justice
UK: relies heavily on social justice
Canada: somewhere in between
Describing the US Healthcare Systems - Answer --Has higher percentage of uninsured
-System is more complex for patients and providers and costs more to administer
, -Places greater emphasis on giving patients a wider variety of physicians
-Places more emphasis on specialized physicians with more nurse practitioner and
physician assistances providing primary care
-Has a more complex system for ensuring quality and a unique system of malpractice
law
-Encourages rapid adoption of technology
How Can a Healthcare System be Scored? - Answer -National Scorecard on the US
Healthcare System: standardized measurements to try and objectively measure
performance in 19 developed countries
Criteria: healthy lives, quality, access, efficiency and equity
Highest score possible for each category is 100
Factors That Increase Healthcare Costs - Answer --Aging of the population
-Technological innovations that expand treatment options
-Success of medical care has raised patient expectations
How Can Healthcare Costs be Controlled in the US? - Answer -Variety of efforts have
and are continued to be made through:
-Cost control through reimbursement incentives
-cost sharing
-restrictions on malpractice
-regulation
How Can Population Health Become a Mechanism for Controlling Costs? - Answer -
More efficiently connecting prevention, treatment, and rehabilitation may decrease costs
and increase effectiveness of healthcare treatment
Which of the following represents the status of a right to health care in the United
States?
-The United States, like most countries, has accepted a right to health care.
-The United States Supreme Court has found a right to health care in the United States
Constitution.
-The United States Congress, through legislation, has established a right to health care
under specific circumstances, such as access to emergency care.
-The right to health care is accepted in the United States as a result of participation in
the World Health Organization. - Answer -The United States Congress, through
legislation, has established a right to health care under specific circumstances, such as
access to emergency care.
According to the film "Fix It: Health Care at the Tipping Point", the United States has the
most bureaucratic healthcare system in the world - with _____% of every health care
dollar going to paperwork, overhead and administrative costs. - Answer -30 -35
FDA Process of Assessing Safety and Effectiveness of Drugs: Preclinical Testing -
Answer -Safety assessment on at least 2 species at high dosages prior to initial use on
humans
Objectives: Access carcinogenic, teratogenic and fertility effects
Limitations: High-dose effects may not correlate with effects on humans, species
differences may result in missing effects that later appear in human testing or
widespread clinical use
How much does the US spend on healthcare? - Answer -Approx. $3 trillion per yr.
-18% of GDP
-$9,000 per person per yr.
Types of Insurance in the US - Answer --Gov't Financed
-Employment-Based
-Health Insurance Exchanges
Medicare - Answer -Federal government program primarily funded by payroll tax that
provides for ages 65 or older, disabled ppl eligible for social security disability benefits,
and those with stage renal disease
-50 mill Americans are eligible
4 Different Parts of Medicare - Answer -Part A: covers hospital care, skilled nursing
care and hospice care
Part B: Voluntary supplemental insurance that covers diagnostic and therapeutic
services
Part C: Program designed to encourage Medicare beneficiaries to enroll in prepaid
health plans
Part D: prescription drug plan open to individuals enrolled in parts A and B
Medicaid - Answer -Federal plus state program designed to pay for health services for
specific categories of poor ppl and other groups
-Disabled, kids, pregnant women, etc.
In the basic program, the gov't pays available amount of the cost, ranging from 50-83%
depending on per capita income of the state (meant to match funds provided by state)
To receive matching funding, states must provide basic services such as inpatient and
outpatient services
,State Child Health Insurance Program (SCHIP) - Answer --Administered thru Medicaid
-Additional funds the states may use to enhance the healthcare of kids
-Participating states may raise the income level for medicaid eligibility, start eligibility
more rapidly and ensure longer periods of eligibility
What types of Employment-Based Health Insurance Programs are available? - Answer
--Fee-for-Service: charges paid for specific services provided. As a payment system, it
encourages the provision of as many services as possible
-Health Maintenance Orgs. (HMOS): charge patients a monthly fee designed to cover a
comprehensive package of services. Clinicians or their orgs are paid based on the # of
individuals enrolled at their practice
-Preferred provide organizations (PPOs): fee for service insurance system decides to
only work with a limited # of clinicians
-Point of Service Plans (POSs): patients in a HMO may choose to receive care outside
the system provided by the health plan, but will pay more out of pocket
What mechanism is available to obtain insurance for those not otherwise eligible for
health insurance? - Answer -Health Insurance Exchanges
-Provide a competitive marketplace to help increase access and control the costs of
health insurance
Consequences of being uninsured or underinsured in the U.S.? - Answer --Less
preventative care, diagnosed at more advanced stages of disease, receive less
treatment after being diagnosed
-Less likely to have usual source of healthcare. More likely to use ER for routine care
and an increased mortality rate
Are there programs for those who are disabled or injured on the job? - Answer -
Complex systems of federal and state programs available, categorized as:
-Workers Compensation and Federal Programs for Workers
-Social Security Disability Insurance & Social Security Income
*Doesn't replace health insurance but does provide some assistance
Conclusions from looking at the US, UK, and Canada Healthcare Systems - Answer -
US: relies heavily on market justice
UK: relies heavily on social justice
Canada: somewhere in between
Describing the US Healthcare Systems - Answer --Has higher percentage of uninsured
-System is more complex for patients and providers and costs more to administer
, -Places greater emphasis on giving patients a wider variety of physicians
-Places more emphasis on specialized physicians with more nurse practitioner and
physician assistances providing primary care
-Has a more complex system for ensuring quality and a unique system of malpractice
law
-Encourages rapid adoption of technology
How Can a Healthcare System be Scored? - Answer -National Scorecard on the US
Healthcare System: standardized measurements to try and objectively measure
performance in 19 developed countries
Criteria: healthy lives, quality, access, efficiency and equity
Highest score possible for each category is 100
Factors That Increase Healthcare Costs - Answer --Aging of the population
-Technological innovations that expand treatment options
-Success of medical care has raised patient expectations
How Can Healthcare Costs be Controlled in the US? - Answer -Variety of efforts have
and are continued to be made through:
-Cost control through reimbursement incentives
-cost sharing
-restrictions on malpractice
-regulation
How Can Population Health Become a Mechanism for Controlling Costs? - Answer -
More efficiently connecting prevention, treatment, and rehabilitation may decrease costs
and increase effectiveness of healthcare treatment
Which of the following represents the status of a right to health care in the United
States?
-The United States, like most countries, has accepted a right to health care.
-The United States Supreme Court has found a right to health care in the United States
Constitution.
-The United States Congress, through legislation, has established a right to health care
under specific circumstances, such as access to emergency care.
-The right to health care is accepted in the United States as a result of participation in
the World Health Organization. - Answer -The United States Congress, through
legislation, has established a right to health care under specific circumstances, such as
access to emergency care.
According to the film "Fix It: Health Care at the Tipping Point", the United States has the
most bureaucratic healthcare system in the world - with _____% of every health care
dollar going to paperwork, overhead and administrative costs. - Answer -30 -35
