Deck 10: Health and Mental Health Policies and Programs

Question 1

Which of the following accurately characterizes the U.S. health care system?

A) unlike countries with socialized medicine, the U.S. does not ration health care
B) the U.S. has historically rationed health care based on ability to pay
C) health care is considered a human right
D) no one in the U.S. has a guarantee of health care coverage

Answer 1

B

Question 2

The biggest difference between the health care system in the U.S., compared to that of other nations, is that:

A) the U.S. spends far less on health care than other countries
B) health outcomes in the U.S. are much better than in countries with socialized medicine
C) we control costs through competition among private health care providers
D) many health outcomes compare poorly to peer nations', despite higher per capita costs

Answer 2

D

Question 3

In the United States, most people who are covered by health insurance receive it through:

A) their employers
B) Medicaid
C) Medicare
D) their state government

Answer 3

A

Question 4

In "prospective payment systems":

A) health insurers reimburse health care providers for any expenditure for a covered individual
B) insurers only reimburse for items that were submitted in advance
C) insurers provide payments to health care providers upfront, that the providers then use to cover costs
D) insurers determine in advance the average cost for a procedure and then set the amount they will reimburse

Question 5

Which of the following is NOT a concern within managed care programs?

A) insurance companies prioritize cost savings over quality of care
B) there is an inherent incentive for overservice
C) patients have difficulty accessing specialists and providers outside of the network under contract with the managed care entity
D) increased bureaucracy limits providers' authority and reduces costs savings

Question 6

The Patient Protection and Affordable Care Act of 2010 ("ACA") does NOT include:

A) requirements that insurance companies immediately stop denying coverage to children based on pre-existing conditions
B) free preventive care for Medicare recipients
C) caps on out-of-pocket spending for health care
D) universal health coverage for all Americans

Question 7

The current status of the Affordable Care Act policy is best characterized as:

A) entirely intact, protected by popular uprising whenever Congress tries to change it
B) overturned by federal court rulings
C) destabilized, weakened, and threatened, through a combination of executive actions and legal attacks
D) irrelevant, since health insurers have voluntarily made all the changes originally mandated

Question 8

Which of the following policy actions have contributed to widening differences in health care access by state, within the U.S.?

A) state actions to expand (or not) Medicaid eligibility
B) state abortion restrictions
C) differences in state health insurance exchanges
D) all the above

Question 9

Medicaid is funded:

A) jointly, by the states and federal government
B) by the Department of Health and Human Services
C) through employer contributions
D) through a payroll tax on workers' earnings

Question 10

The single largest funding source for nursing facility care for older adults is:

A) private long-term care insurance
B) Medicare
C) Medicaid
D) SCHIP

Question 11

Which of the following is NOT a valid critique of the Medicaid program?

A) it fails to cover many people in poverty, despite a goal to provide that coverage
B) it is stigmatizing to those who receive it
C) low reimbursement rates make it difficult for recipients to find health care providers
D) it pays providers more than they make from other sources, creating an incentive to serve only Medicaid recipients

Question 12

Despite being a national program with significant federal funding, states retain considerable control over Medicaid policy, including which of the following?

A) the rate of payment for services
B) whether or not to cover Supplemental Security Income recipients
C) whether or not to cover children under age six with incomes greater than poverty but less than 133% of the federal poverty level
D) whether or not to cover nursing home care for eligible recipients

Question 13

The federal matching rate for Medicaid (non-expansion populations):

A) is 50%
B) varies based on the size of the federal deficit
C) is based on a formula inversely related to the state's per capita income
D) is 83%

Question 14

Which of the following was NOT a change to Medicaid enacted in PRWORA?

A) states given more latitude to expand Medicaid assistance to people in poverty
B) eligibility was separated from eligibility for means-tested income support programs
C) Lawful Permanent Residents (immigrants) who arrived after August 22, 1996 are ineligible for their first five years of Lawful Permanent Residency
D) illegal immigrants were barred from Medicaid for the first time

Question 15

Which of the following best describes eligibility criteria for Medicare?

A) any American older than age 65 is eligible
B) only people older than age 65 are eligible, and only if they have worked at least 40 credits
C) various populations are eligible, including those 65 years and older with 10 years of eligible employment, younger persons on SSDI for at least 2 years, and persons with specific disabling conditions
D) at any age, individuals are only eligible for Medicare after they have developed a disability

Question 16

Medicare covers:

A) only some of recipients' health care expenses, leaving recipients responsible for considerable out-of-pocket expenses
B) inpatient hospital care only
C) doctors' visits and hospitalization, but not any prescription medication
D) all health care costs for eligible beneficiaries

Question 17

Recent changes to Medicare Part D-the prescription drug benefit-include:

A) making coverage a free and universal part of the basic Medicare benefit
B) closing the 'donut hole' that left some beneficiaries without coverage
C) using cost containment strategies that some advocates fear may reduce access to essential medications
D) both B and C

Question 18

Adults over age 18 who have been diagnosed with a major mental illness that results in functional impairment and substantially limits their ability to perform activities of daily living are designated as having:

A) a personality disorder
B) a limitation in Activities of Daily Living (ADLs)
C) a serious mental illness
D) a developmental disability

Question 19

Deinstitutionalization refers to:

A) the policy of providing community-based services for people with disabilities who were formerly served in institutions
B) efforts to make mental health institutions more "home like"
C) strategies to include mental health consumers in agency policymaking
D) organizational development from a strengths perspective

Question 20

The Children's Health Insurance Program (CHIP):

A) provides universal health coverage for all Americans under age 18
B) provides access to health care for immigrant children not eligible for Medicaid
C) is a federal block grant to states, to offer health insurance for children up to age 19 who are not already insured
D) is entirely state-funded, so only children in certain states benefit

Question 21

"Co-occurring conditions" refer to:

A) individuals who are dually eligible for both Medicaid and Medicare
B) individuals with physical and mental illnesses
C) individuals who are elderly and have a mental illness
D) individuals who meet the criteria for mental disorders and substance use disorder

Question 22

Medicaid is a:

A) block grant
B) entitlement program
C) public-private partnership
D) pilot program

Question 23

"Mental health parity" refers to:

A) simultaneously treating physical and mental diseases
B) addressing co-occurring disorders
C) providing equal insurance coverage for mental health care as for physical health
D) standardizing mental health treatment across the country

Question 24

The legislation that provides that workers must be able to continue purchasing their health insurance if they lose their jobs or change jobs is called:

A) Health Insurance Portability and Accountability Act
B) Retrospective payment approach
C) Hill Burton Act
D) Title XIX

Question 25

In the current political environment, which of the following is NOT commonly considered as an option for containing the costs of Medicare:

A) limiting covered services
B) raising the age of eligibility
C) shifting costs to older adults
D) eliminating the involvement of private managed care companies

Question 26

NASW's recommendation for health care reform can best be characterized as:

A) a piecemeal approach that expands Medicaid and encourages medical savings accounts
B) sanctions for companies that fail to offer employer-based health insurance
C) universal health care
D) state-run health care pilot programs, funded with federal block grants

Question 27

Name at least one reason why health care costs in the U.S. are very difficult to control.

Question 28

How did Medicare contribute to the movement for racial justice in the United States?

Question 29

Why would social workers, who generally support asset-based strategies, have concerns about the medical savings accounts?

Question 30

What are some of the concerns related to Medicaid recipients in managed care plans?

Question 31

Name at least two barriers to adequate and appropriate mental health care for people of color and those from particular ethnic groups. How would you reform policy to overcome these barriers?

Question 32

What is an example of an unintended consequence of the policy of deinstitutionalization of those with mental illnesses?

Question 33

How would social policy following the health approach look different than our current medical model policies?