Deck 14: Getting Covered - Health Care Policy and Health Insurance

Question 1

Which of the following statements about the U.S. health system is incorrect?

A) When the Clinton administration tried to create a national health care system in 1994 the health insurance industry provided some of the most forceful opposition to the proposal.
B) Health care organizations, pharmaceutical companies, and for-profit hospitals all joined with business associations to defeat the Clinton Plan in 1995.
C) The enduring legacy of the U.S. Constitution represents an ongoing commitment to limited government and more of a role to be played by private interests.
D) The United States is one of the wealthiest nations in the world and has a strong affordable health care system.

Answer 1

D

Question 2

_______ seeks to ensure that the U.S. health care system provides the highest-quality outcome for patients at the least possible cost.

A) Delivery system reform
B) Fee-for-service
C) Direct-to-consumer advertising
D) Exclusive provider organization

Answer 2

A

Question 3

All European Union member states now have a universal health care system for their populations.

Answer 3

True

Question 4

The American health care system still relies mostly on government subsidy insurance programs to cover its citizens.

Question 5

Briefly describe the Patient Protection and Affordable Care Act.

Question 6

Explain the difference between the Affordable Care Act and health systems in Canada and Europe.

Question 7

Explain why many U.S. citizens advocate for a national health care system that will provide universal coverage.

Question 8

Explain how the emphasis on rugged individualism throughout U.S. history has influenced the health system in the United States.

Question 9

Differentiate between in-patient care and outpatient care.

Question 10

Match each term with the correct definition.
-Patient Protection and Affordable Care Act

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 11

Match each term with the correct definition.
-Medicare

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 12

Match each term with the correct definition.
-Medicaid

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 13

Match each term with the correct definition.
-Health maintenance organization (HMO)

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 14

Match each term with the correct definition.
-Certified Application Counselors (CACs) or Marketplace Navigators

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 15

Match each term with the correct definition.
-Single-payer health care

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 16

Match each term with the correct definition.
-Expensive metals

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 17

Match each term with the correct definition.
-The 1942 Stabilization Act

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 18

Match each term with the correct definition.
-Point-of-service plan

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.

Question 19

Match each term with the correct definition.
-Preferred provider organization

A) Soon after the U.S. entered the World War II, this law was put into place to limit wages employers could providers their workers.
B) The nation's public health insurance program serving people with low incomes and minimal assets. It was passed in 1965 as part of the Federal Social Security Act, and is funded through state and federal governments but managed at the state level.
C) Trained and certified individuals who provide unbiased information about health coverage options. They assist with preparation of electronic and paper applications, establish eligibility, and get people enrolled with the best health insurance option.
D) Insurance plan that provides a limited network of hospitals and clinics and medical professionals. When you are in the network, one important benefit is that your payments at the time of service are often affordable copayments, which typically range from $20 to $50.
E) Program that was established under President Lyndon Johnson, and part of the Social Security Act of 1965. This program covers a portion of health care cost for Americans who are 65 years and older.
F) In these systems, the government, rather than private insurance companies, coordinates all health care payments for its citizens.
G) Insurance plan that provides a network of participating providers and allows members to see physician specialists directly without a referral from a primary care physician, as long as the specialist is within the preferred network.
H) Similar to an HMO plan, where plan members designate an in-network primary care physician to be their care coordinator. However, there is limited coverage available for care that is received outside the provider network.
I) The only comprehensive national health care plan ever passed in the United States.
J) Plans in the Health Insurance Marketplace are presented in four categories. These categories are not based on any type of quality indicators, but rather how you and your plan share the costs of your health care.