MHA
707
Exam
D
_____causes
more
preventable
deaths
and
diseases
than
any
other
behavioral
risk
factor
-
CORRECT
ANSWER-tobacco
-
hospitals
built
by
-
public
hospitals
built
by
-
CORRECT
ANSWER--
military
for
members,
vets,
and
fam
-gov
entities
for
the
poor
(usually
local
gov)
-financing
and
organization
of
the
health
care
system
underwent
several
important,
incremental
changes:
-
CORRECT
ANSWER--expansion
of
capitation
and
rise
of
managed
care,
-growth
of
vertical
and
horizontal
integration
of
HC
organizations
and
integrated
delivery
systems
-increase
in
for-profit
healthcare
organizations
-Obama
admin
goal's
-Why
didn't
the
ACA
go
to
a
single-payer
or
an
NHI
format?
-What
was
the
"Public
Option"?
-
CORRECT
ANSWER--bend
the
healthcare
cost
curve
downward
-achieve
greater
equity
in
health
insurance
coverage
-improve
quality
in
health
care
-It
was
apparent
that
a
plan
eliminating
any
of
the
existing
payers
[Single
Payer
or
Public
Option]
in
the
health
care
system
would
not
have
sufficient
support
for
the
passage
-This
fact
precluded
a
popular,
but
not
sufficiently
popular,
option
•A
single-payer
plan
•Also,
a
"PUBLIC
OPINION"
which
would
allow
many
to
purchase
Medicaid
coverage
with
means-tested
premiums.
Theoretically ,
over
time
most
employers,
as
well
as
individuals,
would
migrate
into
Public
Option/Medicaid
and
choke
out
most
private
insurers]
-the
question
is
not
moral
but
functional
--
As
more
doctors
become
employees,
how
will
this
affect
their
behavior?
-
CORRECT
ANSWER-"Can
a
profit-making
system
and
the
free
market
solve
the
myriad
problems
of
the
U.S.
health
care
delivery
system?
--Dr.
Bost=
doctors
are
becoming
employees
having
to
follow
protocols
and
formularies
--
•[As
doctors
become
more
employee
than
entrepreneur ,
then
their
success
will
be
dependent
on
the
success
of
the
enterprise
-
will
lead
to
behavior
change
(e.g.,
following
protocols
and
formularies)]
"repeal
and
replace"
efforts
by
-
CORRECT
ANSWER-republicans
•Employers?
-
CORRECT
ANSWER--May
continue
to
offer
insurance
coverage
•Seek
to
limit
medical
care
$
liabilities
•Encourage
wellness
activities
to
decrease
costs
and
increase
workforce
productivity
•Add
higher
deductibles
and
copays,
passing
cost
increases
to
employees •Bypass
insurance
companies
w/direct
contracting
-May
exert
more
active
roles
in
health
care
•Obesity
-
CORRECT
ANSWER-•About
70%
of
all
American
adults
are
overweight
or
obese.
•Strong
links
between
obesity
and
many
chronic
diseases
•Even
modest
weight
loss
(e.g.,
5%
to
10%
of
body
weight)
can
reduce
risks
•Prevalence
of
overweight
and
obesity
among
children
and
adolescents
(ages
6
to
19),
has
increased
significantly
over
the
past
30
years
•Highest
and
fastest-rising
rates
of
childhood
obesity
are
seen
among
the
following:
•Children
and
adolescents
of
African
American
or
Latino
descent
•Children
from
low-income
backgrounds
and
residing
in
communities
with
limited
access
to
resources
and
opportunities
for
physical
activity
and
healthy
diets
1/3
-
CORRECT
ANSWER-fraction
of
premiums
paid
by
employers
13.3%
HC
expenses
in
-
CORRECT
ANSWER-2000
17.3%
HC
expenses
in
-
CORRECT
ANSWER-2009
1811
-
CORRECT
ANSWER-access
to
health
care
for
members
of
the
military,
vets,
and
fam
had
become
a
public
sector
initiative
1847
-
CORRECT
ANSWER-founding
of
American
Medical
Association
(AMA)
1861
-
CORRECT
ANSWER-founding
U.S.
nursing
corps
1883
-
CORRECT
ANSWER-Bismarck
succeeded
in
passing
a
Sickness
Insurance
Act
1899
-
CORRECT
ANSWER-founding
of
association
of
hospital
superintendents
1900
-
CORRECT
ANSWER-adoption
of
the
Bertillon
or
International
List
of
Causes
of
Death
1900-1930
-
CORRECT
ANSWER-~0.3%
of
GDP
1910
-
CORRECT
ANSWER--early
forerunners
of
health
insurance
plans
appeared
as
"prepaid"
group
practices
-plan
members
paid
a
monthly
premium
and
received
a
wide
range
of
medical
services
through
an
exclusive
group
of
providers
1916
-
CORRECT
ANSWER-AALL
proposed
compulsory
medical
care
and
sickness
benefits
insurance
that
would
have:
-covered
persons
earning
below
a
certain
income
level
(poor),
-used
existing
insurance
carriers -shared
the
costs
among
employers,
employees,
and
the
states
-been
adopted
by
each
state
independently
[some
would
and
wouldn't]
1929
What
are
Blue
Cross
and
Blue
Shield?
-
CORRECT
ANSWER--all
as
Blue
Cross
plans
were
established
to
provide
"prepaid"
hospital
care
to
workers
in
the
public
school
system
-Baylor
university
hospital
forward
with
the
plan
(created
it)
-
Provide
prepaid
hospital
care
to
workers
in
the
Dallas
public
system.
1940s
-
CORRECT
ANSWER-BCBS
unified
1949
-
CORRECT
ANSWER-Harry
Truman
re-elected
with
democratic
majorities
in
both
houses
of
congress
1960
-
CORRECT
ANSWER-1.3%
GDP
=
4x,
four-fold,
400%
1980
-
CORRECT
ANSWER-4.1%
GDP=
3x
since
1960,
13.6x
since
1930
1986
-
CORRECT
ANSWER-two
fed
health
policies
enacted
to
solve
problems
related
to
health
care
coverage
-EMTALA
-HIPAA
1990
-
CORRECT
ANSWER-AMA
dropped
the
non-compulsory
principle
2/3
-
CORRECT
ANSWER-fraction
of
premiums
paid
by
employees
2012:
ACA
passed
supreme
court
because
-
CORRECT
ANSWER-government's
taxing
authority
2015:
ACA
health
insurance
subsidies
were
considered
by
supreme
court:
-
CORRECT
ANSWER-court
ruled
that
fed
gov
can
provide
nationwide
tax
subsidies
to
help
poor
and
middle-class
people
buy
health
insurance
4
of
10
leading
causes
of
death
associated
with
-
CORRECT
ANSWER-unhealthy
diet
70%
-
CORRECT
ANSWER-percent
overweight
or
obese
a
comprehensive
benefit
package
National
Health
Board
-
CORRECT
ANSWER--subject
to
fine-tuning
and
modification
over
time
by
the
National
health
board
[limits
on
care
given--NICE
v.
rationing]
•
Included
all
sites
of
care—inpatient,
outpatient,
short-
and
long-term
facilities
and
home-based
•
Encompassed
all
forms
of
care—preventive,
diagnostic,
treatment,
rehabilitative,
and
follow-up
services
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