Question 1

Which of the following statements best describes what was unfortunate about the original private health insurance plans that were developed? (Select all that apply.)

Accepted Answer

A)  Because providers were paid for any service they gave, it was economically advantageous for them to give as much care as possible. 
B)  Health care costs increased very rapidly. 
C)  Health education and health promotion interventions were not included in the idea of health insurance. 
D)  It was immediately seen how much profit could be made by owning or managing an insurance company. 
E)  Patients wanted any and all care that might help, regardless of how expensive it was.
F) There was no limit on what care could be sought and given. 
A)  Because providers were paid for any service they gave, it was economically advantageous for them to give as much care as possible. 
B)  Health care costs increased very rapidly. 
C)  Health education and health promotion interventions were not included in the idea of health insurance. 
D)  It was immediately seen how much profit could be made by owning or managing an insurance company. 
E)  Patients wanted any and all care that might help, regardless of how expensive it was.
F) There was no limit on what care could be sought and given. A, B, C, E, F

Question 2

When was the idea of national health care insurance first debated in the United States?

Accepted Answer

A)  Clinton's 1992 presidential campaign as he attempted to achieve such a plan 
B)  During President Johnson's administration when Medicare and Medicaid were instituted in the 1960s 
C)  President Franklin Roosevelt's attempt to include health insurance in Social Security legislation in the 1930s 
D)  President Theodore Roosevelt advocated such national medical coverage in 1916 
A)  Clinton's 1992 presidential campaign as he attempted to achieve such a plan 
B)  During President Johnson's administration when Medicare and Medicaid were instituted in the 1960s 
C)  President Franklin Roosevelt's attempt to include health insurance in Social Security legislation in the 1930s 
D)  President Theodore Roosevelt advocated such national medical coverage in 1916 D

Question 3

Which of the following best describes what happens when a health care organization receives federal funding for a special health care need?

Accepted Answer

A)  Other groups see the project and write grants wanting similar projects in their geographic area. 
B)  Participants continue to demand the services so local funding has to be readjusted to continue the care. 
C)  Research is done to demonstrate whether or not the intervention was successful and should be replicated. 
D)  When funds cease, so does the health care; therefore, continuity is lacking. 
A)  Other groups see the project and write grants wanting similar projects in their geographic area. 
B)  Participants continue to demand the services so local funding has to be readjusted to continue the care. 
C)  Research is done to demonstrate whether or not the intervention was successful and should be replicated. 
D)  When funds cease, so does the health care; therefore, continuity is lacking. D

Question 4

Which of the following best describes what was done by large industrial giants to stop the constant increase in their costs for health insurance for their employees?

Accepted Answer

A)  Assembled their own health care programs 
B)  Established health promotion programs that employees were required to attend 
C)  Signed only certain providers to give care at a reduced rate in exchange for so many new patients 
D)  Suggested that employees seek only the most necessary services 
A)  Assembled their own health care programs 
B)  Established health promotion programs that employees were required to attend 
C)  Signed only certain providers to give care at a reduced rate in exchange for so many new patients 
D)  Suggested that employees seek only the most necessary services

Question 5

Which of the following best describes the effects of Medicare and Medicaid? (Select all that apply.)

Accepted Answer

A)  All persons who were temporarily disabled now receive free care. 
B)  A previously unseen rise in demand for services occurred. 
C)  Many persons previously without access now receive health care. 
D)  Medicare reimbursement rates became the standard for all insurance carriers. 
E)  Indemnity insurance plans were offered.
F) Public health education was now financed. 
A)  All persons who were temporarily disabled now receive free care. 
B)  A previously unseen rise in demand for services occurred. 
C)  Many persons previously without access now receive health care. 
D)  Medicare reimbursement rates became the standard for all insurance carriers. 
E)  Indemnity insurance plans were offered.
F) Public health education was now financed.

Question 6

Which of the following best describes the first government step in trying to stop constantly rising costs?

Accepted Answer

A)  Insurance companies were told to cease adding new members to their plan. 
B)  Payment reimbursement was based on diagnosis and client characteristics rather than on treatment given. 
C)  Physicians were limited to a maximum amount that would be paid for any particular service. 
D)  Reimbursement was based on prospective payment; that is, in advance of admittance for care. 
A)  Insurance companies were told to cease adding new members to their plan. 
B)  Payment reimbursement was based on diagnosis and client characteristics rather than on treatment given. 
C)  Physicians were limited to a maximum amount that would be paid for any particular service. 
D)  Reimbursement was based on prospective payment; that is, in advance of admittance for care.

Question 7

Which of the following best describes how the federal government determines which projects are awarded special funding for health care?

Accepted Answer

A)  Those that are consistent with societal priorities, such as 2020 Health Objectives 
B)  Those that are supported by legislators 
C)  Those that are written by health care organizations that have special needs 
D)  Those that are consistent with the state's long-term health goals 
A)  Those that are consistent with societal priorities, such as 2020 Health Objectives 
B)  Those that are supported by legislators 
C)  Those that are written by health care organizations that have special needs 
D)  Those that are consistent with the state's long-term health goals

Question 8

Which of the following statements best describes what happened to health care providers during the Great Depression?

Accepted Answer

A)  The amount of charity care greatly increased. 
B)  Both hospitals and physicians went bankrupt. 
C)  Government funding was legislated to assist those in need. 
D)  Public health greatly expanded to care for those in need. 
A)  The amount of charity care greatly increased. 
B)  Both hospitals and physicians went bankrupt. 
C)  Government funding was legislated to assist those in need. 
D)  Public health greatly expanded to care for those in need.

Question 9

Which of the following best describes a current trend related to health care services?

Accepted Answer

A)  Nonprofit organizations are assuming responsibilities for service from for-profit organizations. 
B)  Health care organizations are offering services low in cost and higher in reimbursement. 
C)  Ways to minimize reimbursement using current procedural terminology (CPT) codes have been created. 
D)  Postponing computerized medical record programs increases profitability. 
A)  Nonprofit organizations are assuming responsibilities for service from for-profit organizations. 
B)  Health care organizations are offering services low in cost and higher in reimbursement. 
C)  Ways to minimize reimbursement using current procedural terminology (CPT) codes have been created. 
D)  Postponing computerized medical record programs increases profitability.

Question 10

Which of the following statements best describes why nurses should be knowledgeable about health care funding?

Accepted Answer

A)  To be able to be an effective employee for insurance companies 
B)  To be knowledgeable when media asks for opinions on some new legislation 
C)  To better serve as patient advocates in policy making for funding that provides appropriate care for the greatest good 
D)  To know how to write nursing notes that reflect higher reimbursement possibilities 
A)  To be able to be an effective employee for insurance companies 
B)  To be knowledgeable when media asks for opinions on some new legislation 
C)  To better serve as patient advocates in policy making for funding that provides appropriate care for the greatest good 
D)  To know how to write nursing notes that reflect higher reimbursement possibilities

Question 11

Which of the following statements best summarizes all of the changes resulting from attempts to control costs?

Accepted Answer

A)  Conflict between providers, patients, employer, and insurance plans raged. 
B)  Costs were controlled, at least temporarily. 
C)  Demand for health care drastically dropped. 
D)  Most employers discontinued their insurance plans for employees. 
A)  Conflict between providers, patients, employer, and insurance plans raged. 
B)  Costs were controlled, at least temporarily. 
C)  Demand for health care drastically dropped. 
D)  Most employers discontinued their insurance plans for employees.

Question 12

Which of the following best describes how providers can legally improve their profit under the current reimbursement process?

Accepted Answer

A)  Accept more patients and work more hours so former high income is retained 
B)  Order the cheapest generic medications and treatments possible 
C)  Convince patients that they do not want expensive treatments 
D)  Practice conservatively to earn an incentive payment 
A)  Accept more patients and work more hours so former high income is retained 
B)  Order the cheapest generic medications and treatments possible 
C)  Convince patients that they do not want expensive treatments 
D)  Practice conservatively to earn an incentive payment

Question 13

Which of the following best describes the strengths of the American health care system? (Select all that apply.)

Accepted Answer

A)  Offering the availability and use of technological advances in equipment and procedures 
B)  Having the ability to overcome concerns regarding access and rationing 
C)  Providing the highest quality of life among any industrialized nation 
D)  Having the lowest maternal and infant mortality rate among industrialized nations 
E) Leading the world in laboratory and clinical research
F) Creating the best patient care outcomes 
A)  Offering the availability and use of technological advances in equipment and procedures 
B)  Having the ability to overcome concerns regarding access and rationing 
C)  Providing the highest quality of life among any industrialized nation 
D)  Having the lowest maternal and infant mortality rate among industrialized nations 
E) Leading the world in laboratory and clinical research
F) Creating the best patient care outcomes

Question 14

Which of the following statements best describes the message that public health leaders are trying to emphasize to the public?

Accepted Answer

A)  Assume responsibility for your own health by choosing healthy behaviors 
B)  Have a primary physician and get yearly checkups 
C)  Obtain immunizations and screenings when they are offered 
D)  Support legislative efforts to improve our medical care system 
A)  Assume responsibility for your own health by choosing healthy behaviors 
B)  Have a primary physician and get yearly checkups 
C)  Obtain immunizations and screenings when they are offered 
D)  Support legislative efforts to improve our medical care system

Question 15

Which of the following statements best describes a major event that occurred in the 1960s that affected health care?

Accepted Answer

A)  The amount of charity care by health care providers greatly increased. 
B)  Hospitals began to voluntarily pay taxes to the communities where they were located. 
C)  Legislation greatly expanded funds available to train physicians, nurses, and other health care providers. 
D)  The Social Security Act was amended to create Medicare and Medicaid legislation. 
A)  The amount of charity care by health care providers greatly increased. 
B)  Hospitals began to voluntarily pay taxes to the communities where they were located. 
C)  Legislation greatly expanded funds available to train physicians, nurses, and other health care providers. 
D)  The Social Security Act was amended to create Medicare and Medicaid legislation.

Question 16

Which of the following best describes how the government was successful at containing costs?

Accepted Answer

A)  The original legislation for Medicare and Medicaid had built-in cost controls. 
B)  Certificate-of-need requirements restricted provider overtreatment. 
C)  Utilization review determined appropriateness of care. 
D)  Prospective payments were based on diagnosis-related groups (DRGs). 
E)  Peer standard review organizations were effective watchdogs. 
A)  The original legislation for Medicare and Medicaid had built-in cost controls. 
B)  Certificate-of-need requirements restricted provider overtreatment. 
C)  Utilization review determined appropriateness of care. 
D)  Prospective payments were based on diagnosis-related groups (DRGs). 
E)  Peer standard review organizations were effective watchdogs.

Question 17

Which of the following best describes a carve-out service?

Accepted Answer

A)  A particular service that is offered only by a designated provider or group. 
B)  A particular procedure that receives limited reimbursement. 
C)  A particular treatment is not allowed within a particular diagnosis. 
D)  A particular prescription drug that is only available to those with certain conditions. 
A)  A particular service that is offered only by a designated provider or group. 
B)  A particular procedure that receives limited reimbursement. 
C)  A particular treatment is not allowed within a particular diagnosis. 
D)  A particular prescription drug that is only available to those with certain conditions.

Question 18

Who may receive benefits under Medicare? (Select all that apply.)

Accepted Answer

A)  Federal employees 
B)  Persons aged 55 to 65 years who have bought into the system 
C)  Persons with end-stage renal disease 
D)  Those over 65 years of age, if eligible for Social Security benefits 
E)  Those who are dependents of elderly grandparents, usually because their parents are in prison as a result of drug abuse
F) Those with permanent disabilities 
A)  Federal employees 
B)  Persons aged 55 to 65 years who have bought into the system 
C)  Persons with end-stage renal disease 
D)  Those over 65 years of age, if eligible for Social Security benefits 
E)  Those who are dependents of elderly grandparents, usually because their parents are in prison as a result of drug abuse
F) Those with permanent disabilities

Question 19

Which of the following best describes the health care services that are provided by philanthropic groups?

Accepted Answer

A)  Direct care to patients with problems related to the group's primary interest area 
B)  Legislative lobbying for increased funding for their special interests 
C)  Informational and research activities 
D)  Special services such as housing, transportation, or appearance aids 
A)  Direct care to patients with problems related to the group's primary interest area 
B)  Legislative lobbying for increased funding for their special interests 
C)  Informational and research activities 
D)  Special services such as housing, transportation, or appearance aids

Question 20

Which of the following best describes what insurance companies did to decrease their constantly increasing costs? (Select all that apply.)

Accepted Answer

A)  Did not cover any illnesses that were diagnosed before the person (or his or her employer) purchased insurance 
B)  Limited coverage to only certain services, eliminating any that were experimental, nontraditional, or too costly 
C)  Reimbursed only the care that was requested by the patient's primary physician 
D)  Limited providing insurance to companies who hired mainly young, healthy persons 
E)  Required preapproval before expensive services were used
F) Ceased coverage on any person who used an exorbitant number of services, whenever possible 
A)  Did not cover any illnesses that were diagnosed before the person (or his or her employer) purchased insurance 
B)  Limited coverage to only certain services, eliminating any that were experimental, nontraditional, or too costly 
C)  Reimbursed only the care that was requested by the patient's primary physician 
D)  Limited providing insurance to companies who hired mainly young, healthy persons 
E)  Required preapproval before expensive services were used
F) Ceased coverage on any person who used an exorbitant number of services, whenever possible

Exam 12: Economics of Health Care

Which of the following statements best describes what was unfortunate about the original private health insurance plans that were developed? (Select all that apply.)

When was the idea of national health care insurance first debated in the United States?

Which of the following best describes what happens when a health care organization receives federal funding for a special health care need?

Which of the following best describes what was done by large industrial giants to stop the constant increase in their costs for health insurance for their employees?

Which of the following best describes the effects of Medicare and Medicaid? (Select all that apply.)

Which of the following best describes the first government step in trying to stop constantly rising costs?

Which of the following best describes how the federal government determines which projects are awarded special funding for health care?

Which of the following statements best describes what happened to health care providers during the Great Depression?

Which of the following best describes a current trend related to health care services?

Which of the following statements best describes why nurses should be knowledgeable about health care funding?

Which of the following statements best summarizes all of the changes resulting from attempts to control costs?

Which of the following best describes how providers can legally improve their profit under the current reimbursement process?

Which of the following best describes the strengths of the American health care system? (Select all that apply.)

Which of the following statements best describes the message that public health leaders are trying to emphasize to the public?

Which of the following statements best describes a major event that occurred in the 1960s that affected health care?

Which of the following best describes how the government was successful at containing costs?

Which of the following best describes a carve-out service?

Who may receive benefits under Medicare? (Select all that apply.)

Which of the following best describes the health care services that are provided by philanthropic groups?

Which of the following best describes what insurance companies did to decrease their constantly increasing costs? (Select all that apply.)

Health: A Community View

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