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HSML 6202 Midterm Questions With Complete Solutions
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HSML 6202 Midterm Questions With Complete Solutions
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HSML 6202 Midterm Questions With Complete SolutionsBe able to explain why tracing risk factors in people is
important. Correct Answer * Risk factors help us determine
increases the likelihood of developing a particular disease
* To become ill there must be (a) a host; (b) an agent; and (c)
environment external to the host (physical, social, cultural,
economic)
* Mitigate or eliminate the risk factors of one or more of the
three risk factor areas
Can both Medicare and Medicaid cover a person in the U.S.
system at the same time? What would a good example of that
be? Correct Answer * Yes - a person can be covered by
Medicare and Medicaid
* A Medicare Beneficiary either qualifies for Medicaid or
purchases private supplementary insurance to pay for expenses
not covered by Medicare
Did the Affordable Care Act (ACA) do anything about
prevention? If so, what? Correct Answer * Included no cost
coverage for preventative services
* Created a "Prevention and Public Health Fund" for national
and preventive efforts
* CDC establish a National Diabetes Prevention program for
people with pre-diabetes to try and change lifestyles before
diabetes set in
Does "high technology" improve outcomes or cause an increase
in healthcare costs, or both? Explain the balance. Correct
Answer Both; drives costs but can improve success and safety
,Employment-based health insurance is the predominant source
of health insurance in the U.S., but it has a couple of big
problems that leave a lot of people uninsured... what are those
two big problems? Correct Answer Small businesses might not
be able to afford
Lose your job, lose your insurance
Have you ever heard an older family member talk about
"Medigap?" What is that? Correct Answer * No; Private health
insurance that can be purchased only by those enrolled in the
original Medicare program - a program that has high OOP costs;
illegal for companies to sell a Medigap plan to someone who is
covered by Medicaid or Medicare Advantage
* Medigap plans cover all or a portion of Medicare deductibles
and copayments/coinsurance
* Do not cover extended long-term care, vision care, dental care,
hearing aids, or private-duty nursing
* Premiums vary
Health insurance, especially private health insurance, comes in
the form of a "plan," which specifies, among other details,
information pertaining to cost, covered services, and way to
obtain health care when needed. What's the difference between
the "insured" and the "beneficiary?" Correct Answer They are
the same
In Kenneth J. Arrow's seminal 1963 work entitled "Uncertainty
and the Welfare Economics of Medical Care," it was noted that
"hypothetically, insurance requires for its full social benefit a
maximum possible discrimination of risks." In other words,
, those in groups of higher incidences of illness should pay higher
premiums, but in actuality there is a tendency to equalize, rather
than to differentiate premiums, especially in the case of (at that
time) Blue Cross and similar widespread schemes. What does
this kind of structure lead to so far as income is concerned?
Correct Answer Insured vs non-insured
i. Moral hazard
ii. ACA - emergency department
Typically, insurance rates are typically flat (people who use it
and don't use it are usually the same)
Healthy subsidizes the unhealthy
i. Shift in wealth
Tendency to charge people the same
In the articles assigned this week as well as the textbook
readings, it was clear that healthcare does not really behave like
other marketable goods and services. It is important for you to
be able to (a) understand the specific ways in which healthcare
is different from other goods and services, and (b) why? Correct
Answer Is healthcare special?
i. Unique prices aren't transparent (don't know what you are
paying for until after)
ii. For profit vs non-profit
iii. Lack of transparency is one of biggest problems
iv. Does not follow trends of marketed goods
1. Buying a new car vs looking for healthcare
2. Emergency - not enough time for research
v. Difficult for providers of getting in
1. Hard to become a provider
vi. So many buyers and sellers no one can affect it that much;
not the same in healthcare
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