Exam 8: The Market for Health Insurance

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What is the term of the following definintion. -Exists when people with different health-related characteristics than the average person increase the amount of health insurance purchased

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Adverse selection

What is the term of the following definintion. -Rationed using such mechanisms as gatekeepers who are primary care physicians who make all referrals to specialists, thus limiting coverage to service providers with whom the insurance company has a contractual agreement and requiring pre-certification or approval from the insurance company before services are rendered.

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Managed care

Charged insurance premiums generally exceed the fair value of the risk that the insurance company has assumed, where the fair value is the expected payout or actuarially fair premium.

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One problem in modeling the optimal insurance contract is that the degree of moral hazard may vary by type of illness or type of healthcare service.

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What is the term of the following definintion. -Occurs when insurance companies base premiums on past levels of payouts, which is often done in the case of car or homeowner's insurance.

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Because hospital income depends on actual costs incurred or on the volume of services provided, there are many incentives to minimize costs.

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What is the term of the following definintion. -Annual limits on out-of-pocket expenditures that must be borne by the insured.

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Which piece of legislation allows Americans to cut back on work hours or end unsatisfying jobs because health insurance is now portable?

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What is the term of the following definintion. -Applies when each member of an insurance pool pays the same premium per person or per family for the same coverage.

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What is the term of the following definintion. -Helps to reduce the moral hazard factor for the insured who has spent more than his or her deductible because health care is not free to the consumer.

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What is the term of the following definintion. -Refers to the phenomenon of a person's behavior being affected by his or her insurance coverage.

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Which of the following means that hospitals receive payment in full for all healthcare expenditures incurred in some pre-specified period of time?

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Diagnosis-related groups are an example of what type of reimbursement method?

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Due to ___________________, insurance suppliers will be more willing to enter market situations where they can make a reasonable estimate of their payouts or where they can assess the degree of risk they are assuming.

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Which of the following is defined when the insurance companies structure coverage to both avoid adverse selection and to attract lower-than-average risk subscribers?

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What is the term of the following definintion. -A level of expenditure that must be incurred before any benefits are paid out.

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