Deck 7: The Health Care System

Question 1

The current health care system best provides help for people with ________ illness.

A) acute
B) mental
C) chronic
D) physical

Answer 1

A

Question 2

The health care system today consists of

A) a comprehensive system of care.
B) a mixture of publicly and privately funded programs.
C) publicly funded programs.
D) privately funded programs.

Answer 2

B

Question 3

Which of the following is not an accepted theoretical model that describes the different approaches to health care in the United States?

A) the health promotion model
B) the social model
C) the transitional model
D) the medical model

Answer 3

C

Question 4

The medical model focuses on the

A) prevention of illness and self-care.
B) diagnosis and cure of illness.
C) behavioral aspects of treatment.
D) psychological effects of injury.

Question 5

Functional capacity refers to

A) how many people the medical system can serve at one time.
B) how well the medical system serves people.
C) an individual's ability to perform activities of daily living.
D) the utility of technology in improving a person's ability to live on their own.

Question 6

Physicians control most of the treatment that takes place within the ________ model of health care.

A) medical
B) social
C) functional
D) health promotion

Question 7

According to the social model of health care, medical care

A) should not just be accessible to the rich.
B) needs replacement by a broad-based social support network.
C) should extend beyond the absence of physical illness to include the patient's ability to function in the social world.
D) should only be used in extreme cases.

Question 8

The social model of health care aims to

A) keep older people in the community.
B) prevent disease.
C) reduce disability.
D) cure illness.

Question 9

In the social model, the best way to deliver health care is through

A) the physician.
B) educating people about disease prevention.
C) counselors and social workers.
D) health care professionals.

Question 10

Health care for older people has begun to shift toward the ________ because of the high cost of institutional care.

A) medical model
B) health promotion model
C) social model
D) medical and health models

Question 11

The health promotion model focuses on

A) prevention and reduced disability.
B) medical diagnosis before illnesses become serious.
C) community involvement in health care.
D) the accessibility of medical treatment.

Question 12

Health care professionals and policy makers have begun to explore the ________ of care, which might save the system money in the long run.

A) health promotion model
B) medical and health promotion model
C) social model
D) social and health promotion models

Question 13

Studies have found that ________ of people aged 65 and over reported good to excellent health.

A) 1/4
B) 1/2
C) 3/4
D) 9/10

Question 14

Current research shows that, even among people with some ADL or IADL limitations, __% live in the community.

A) 14
B) 28
C) 54
D) 81

Question 15

Overuse of the ________ model leads to high costs for care and sometimes over-medicalized services.

A) medical
B) social
C) health promotion
D) structural

Question 16

In the 1960s governmental commitment to Medicare for senior citizens came about because

A) of national regret over past mistreatment of seniors.
B) of the growing prosperity of the nation it could afford to be generous to its senior citizens.
C) of new sympathy for the elderly combined with shrewd campaigning and alliances with labor groups.
D) doctors argued in favor of a national health plan to better service their patients' growing demands.

Question 17

In 2015, nearly the entire population of people aged 65 and over enrolled in

A) Medicare Part
B) Medicare Part
C) private insurance.
D) A and B

Question 18

When measured by distribution of dollars by type of service, which model of health care consumes the most amount of funding?

A) the medical model
B) the health-promotion model
C) the social model
D) the conservative model

Question 19

Medicaid serves low-income Americans of all ages, but those people age 65 and over make up __% of Medicaid recipients.

A) 34
B) 21
C) 16
D) 8

Question 20

Moon (2006) says that the proportion of retirees who have ________ insurance has begun to decrease.

A) Medicare
B) Medicaid
C) employer-sponsored health
D) Medigap

Question 21

In order to make up the difference between Medicare/Medicaid programs and out-of-pocket expenses, seniors often rely on ________ insurance.

A) Medisure
B) Medigap
C) Medirelief
D) Medical

Question 22

Which of the following is a drawback of the Medigap insurance program?

A) The cost of Medigap insurance increases with the insured person's age.
B) It does not cover deductibles and copayments for Medicare services.
C) It excludes healthy people from coverage.
D) It put an upper limit in costs for care.

Question 23

Which of the following is not a reason why long-term care insurance is a poor option for most people?

A) the restrictions and conditions placed on the policy
B) the high cost of policies
C) people's varying life circumstances
D) rising inflation erodes the covering power of the policy

Question 24

The following three phenomena contributed to the dramatic rise of health care costs:

A) higher physicians' fees, more expensive treatments, and increased hospital costs
B) rising number of old people, higher physicians' fees, and increases in research and development costs for pharmaceuticals
C) pension outlays, more expensive treatments, and increased hospital costs
D) Medicare/Medicaid costs, increased hospital costs, and pension outlays

Question 25

While the population age 65 and older has increased almost 130% between 1970 and 2014, Medicare payments have grown more than ________ times.

A) 9
B) 16
C) 25
D) 82

Question 26

Regardless of differing views, all political groups recognize that Medicare

A) does more harm than good.
B) needs long-term reform.
C) should shift health care costs to consumers.
D) benefits will increase in the future.

Question 27

________ threaten the Medicare program.

A) Decreases in government support
B) Rising numbers of older people
C) Rising health care costs
D) Increases in benefits

Question 28

In an attempt to control hospital costs for older people on Medicare, the government instituted

A) a PPS.
B) DRGs.
C) a PPS and DRG system.
D) HMOs.

Question 29

The PPS poses problems for older people on Medicare. The problems include

A) delays in hospital discharges.
B) unrestricted treatment.
C) an increase in hospital readmission.
D) higher costs in home health care.

Question 30

The PPS attempts to cap health costs by changing hospital care reimbursements. However, this leads to

A) a decreased need for home health care.
B) problems in other parts of the system.
C) a decrease in intensity and cost of care.
D) a plan for medical coverage for all Americans and prescription drug and long-term care benefits for senior citizens.

Question 31

Part of Medicaid's increased costs stem from increased and expanded services. These services include

A) respite care, personal care, and day hospitals.
B) personal care, chore services, and child care.
C) chore services, respite care, and personal care.
D) day hospitals, personal care, and chore services.

Question 32

Part of the cost increase in ________ comes from increased doctor and hospital fees along with higher administrative costs.

A) Medicare
B) Medicaid
C) PPS
D) DRAs

Question 33

Today, legislators seeking to reduce Medicare spending advocate greater enrollment of seniors in

A) health maintenance organizations (HMOs).
B) prospective payment systems (PPS).
C) diagnosis-related groupings (DRGs).
D) adult day care (ADC).

Question 34

In 2012, people age 65 and over accounted for __% of the total population's health care spending.

A) 50.2
B) 40.2
C) 34.5
D) 12.2

Question 35

Despite the high cost of health care in the United States, the return in outcomes ________ other developed countries.

A) exceeds that of
B) remains equal to
C) lags behind
D) hasn't been studied as closely as it has in

Question 36

Which of the following findings does not emerge from the study of the U.S. health care system?

A) Health care service for poor older people is adequate and getting better.
B) People pay a lot for health care.
C) People get less for their money than people in other countries.
D) The public is disaffected by the current system.

Question 37

Which of the following is NOT a major cause of increased health care costs?

A) strict spending limits on physicians
B) inflation
C) increase in the older population
D) expanded use of medical technology and services

Question 38

Inflation, rising costs of professional services, and increased costs for medications all

A) reflect the need for more doctors.
B) contribute to increases in health care costs.
C) contribute to decreases in health care.
D) promises better health care for older people.

Question 39

Smith (1992) describes how the U.S. health insurance system resulted from

A) a clear plan regarding the structure of its national health care policy.
B) a consensus between medical professionals and policy makers.
C) the influence of life insurance companies and medical professionals who saw the opportunity to profit off the elderly.
D) discussions dominated by professionals and plagued by institutional weakness.

Question 40

Long-term care does not include

A) in-home service.
B) community-based services.
C) institutional care.
D) municipal hospitals.

Question 41

The ________ the person, the ________ the chance of living in a nursing home.

A) older; less
B) older; greater
C) younger; greater
D) poorer; less

Question 42

Which of the following does not indicate an associated increased risk of entering a nursing home?

A) socioeconomic status
B) gender
C) age
D) homeowner status

Question 43

Leutz and colleagues list four goals of community long-term health care programs. Which of the following is not on their list?

A) to ensure potential patients remain in safe nursing home environments
B) to meet the health needs of seniors not covered by Medicare
C) to link medical care and social support to keep the older person in the community
D) to meet the social and personal care needs of older people

Question 44

Community-based services are composed of

A) adult daycare and hospital services.
B) adult daycare, respite services, and home health care.
C) respite services and nursing homes.
D) home health care, nursing home care, and hospitals.

Question 45

Adult daycare programs may follow the

A) medical model only.
B) social model only.
C) institutional model.
D) a combination of the above

Question 46

People aged 65 and over make up __% of home care patients.

A) 25
B) 33
C) 69
D) 88

Question 47

Home health care may not save the system money, but researchers have found that community care programs

A) provide greater satisfaction to caregivers.
B) provide older people with the kind of help they want and need.
C) are used only by elderly women in their eighties who live alone.
D) follow the medical model.

Question 48

When Medicare, Medicaid, or a private insurer prepays a set amount per person per month for care to a private managed-care facility, this is called a ________ payment.

A) capitulated
B) coronated
C) capitated
D) capsulated

Question 49

SHMOs

A) assume the total cost of health care for a set monthly fee.
B) contract with Medicaid to provide services.
C) do not offer preventative care.
D) have developed programs well suited to older people.

Question 50

As an alternative to Medicare and Medicaid, health maintenance organizations (HMOs) have the advantage of

A) developing local programs suited for older people.
B) friendly face-to-face interaction between the organization and the user.
C) eliminating the need for government-run Medicare and other programs that drain tax dollars.
D) using an interdisciplinary approach to care and coordinating all services for the client.

Question 51

Community care programs such as the On Lok Senior Health Services and the PACE program are

A) a good idea, but won't work at a national level.
B) examples that managed community care can control costs and provide quality care to seniors.
C) becoming popular alternatives to Medicare and HMOs through dozens of sites located in all 50 states.
D) demonstrations that professionals should play a decreased role in the care and treatment of the elderly.

Question 52

Disease prevention and health promotion programs provide

A) institutional care.
B) adult care.
C) other ways to manage illness in an aging society.
D) home care services.

Question 53

Which of the following is not a proven barrier to increasing health promoting behavior?

A) middle-aged and older people today expect less benefit from exercise than do younger people
B) lifelong sedentary habits and a negative attitude toward exercise
C) older people believing in the traditional idea that you shouldn't fight nature, and one must learn to grow old gracefully
D) lack of information about the causes and cures of illness

Question 54

Models of a quality health care system need to include all of the following except

A) improvements in the environment.
B) decreases in social inequality.
C) a supportive social environment.
D) involvement by the tobacco, fast-food, and soft drink industries.

Question 55

The future problems in health care include

A) availability.
B) accessibility.
C) availability, accessibility, and coordination.
D) availability and coordination.

Question 56

The availability of health care services for older people is

A) inadequate but at least evenly distributed throughout most metropolitan areas.
B) greater in rural areas, but the quality of care is lower compared to metro areas.
C) unevenly distributed throughout many parts of the country.
D) inadequate, but the proportion of health care services is similar in both rural and metropolitan areas.

Question 57

Brown (2006) might suggest that the best way to increase the future availability of medical services to rural areas is through

A) incentive programs to encourage health care professionals to move to rural communities.
B) the use of technology to completely replace scarce health care professionals.
C) college programs in medicine and nursing that mandate a minimum term spent in rural communities upon graduation.
D) decreasing the budget of metropolitan areas in order to increase the budget for rural areas.

Question 58

Lack of money, geography, eligibility, and transportation are examples of barriers that reduce people's ________ health services.

A) availability to
B) suitability for
C) usefulness for
D) accessibility to

Question 59

Kane and Kane (2001) say that the U.S. health care system needs a better ________ of its health care services.

A) synthesis
B) coordination
C) combination
D) blending

Question 60

The future of health care should recognize the value of

A) helping people cope with the trauma of aging.
B) better technology and pharmaceuticals to combat disease.
C) disease prevention and health promotion.
D) solving the three major causes of death in old age: heart disease, cancer, and stroke.