PHP 310 EXAM 1 Content

According to the Mirror, Mirror, 2024 report, which two countries had the lowest health care spending as a share of GDP while also being top-ranked overall.

France and Canada

Australia and Netherlands

U.S. and U.K.

Germany and Sweden

Australia and Netherlands

According to Victor Fuch’s article on trends in US health care since 1950, which of the following is a feature of managed care?

• Fees and prices fo physician services are negotiated beforehand by insurance companies

• patients receive personal assistants to manage their health care services

• free medications

• special advertising privileges for pharmaceutical companies

fees and prices for physician services are negotiated beforehand by insurance companies

True or false: according to the mirror, mirror 2024 report, all countries in the study have achieved universal health coverage, including the US

FALSE

According to “Healthcare Costs are not a simple fix,“ eliminating administrative costs overhead and profit from private insurance would result in major healthcare cost savings. True or False?

False

According to Victor Fuch’s article on trends in the US health care since 1950, which is not one of the effects of increased specialization among physicians?

• Greater health expenditures

• increase in the number of years of required training

• better quality of health care

• restructuring of medical education

better quality health care

which of the following is not a trend discussed in Victor Fuch’s article on trends in US healthcare?

• increased number of women physicians

• decreased number of in-patient hospital stays

• decreased role of the federal government in health

• rising health expenditures

decreased role of the federal government in health

According to “How the national debt affects the U.S.— and you — in 10 charts,“ which programs are examples of mandatory spending?

• defense and homeland security

• social security, medicare, and medicaid

• education and transportation

• veterans affairs and student loans only

social security, medicare, and medicaid

True or False: According to the Mirror, Mirror 2024 report, the U.S. spends more than 16% of its GDP on health care, the highest among the 10 countries studied

True

According to “How the national debt affects the U.S. — and you — in 10 charts,“ what is the current size of the U.S. national debt?

• 26.2 trillion

• 30 trillion

• 36.2 trillion

• 40 trillion

36.2 trillion

According to the Mirror, Mirror 2024 report, which three countries ranked highest overall in health system performance?

• australia, netherlands, and United Kingdom

• canada, germany, and france

• sweden, switzerland, and new zealand

• united states, netherlands, and australia

australia, netherlands, and united kingdom

Which of the following is not a trend discussed in Victor Fuch’s article on trends in US healthcare?

• increased number of women physicians

• decreased number of in-patient hospital stays

• decreased role of the federal government in health

• rising health expenditures

Decreased role of the federal government in health

According to the Mirror, Mirror 2024 report, despite its overall poor performance, the US ranks highly in which domain?

• access to care

• administrative efficiency

• care process

• health outcomes

Care process

True or False: According to Victor Fuch’s article on trends in US health care since 1950, In patient hospital care has significantly increased since 1980, causing massive increases in health expenditures.

False

According to “How the national debt affects the U.S. — and you — in 10 charts,“ in fiscal year 2024, the federal government spend more on interest payments for debt service than on the Defense Department. True or False?

True

According to “Healthcare Costs Are not a Simple Fix,“ what portion of U.S. healthcare spending does private insurance account for?

• 20%

• 29%

• 50%

• 75%

29%

According to the Urban Institute article, true or false: death rates for white, middle-aged Americans are rising. True or False?

True

According to the Shit and Singh textbook reading, what is managed care?

• A system of health care delivery that integrates the four basic functional components of health care (financing, delivery, payment, and insurance)

• A type of insurance that seeks to reduce the amount of time physicians spend on patients

• A type of insurance that systematically inspects doctors for high-efficiency care

• A system of health care delivery that emphasizes alternative/holistic treatment options

A system of health care delivery that integrates the four basic functional components of health care (financing, delivery, payment, and insurance)

According to the Shi and Singh textbook reading, which of the following is not among the four basic functional components of the US health care delivery system?

• financing

• screening

• delivery

• payment

screening

According to the Shit and Singh textbook reading, what is the primary reason employers health insurance plans to provide benefits to their employees?

• to ensure their employees have access to the latest medical technology

• to attract and retain talented workers

• to protect their employees from financial catastrophe due to high medical costs

• to reduce the administrative burden of managing employee health benefits

• to protect their employees from financial catastrophe due to high medical costs

According to the Shi and Singh textbook reading, what is not one of the reasons why the US places great emphasis on medical specialization?

• the proliferation of specialty boards certifying physicians to practice certain types of medicine in the 1930s

• specialists are more cost-effective than primary care doctors

• specialists were automatically given a higher rank in the military during WWII

• Medical schools prefer to hire specialists over generalists

• specialists are more cost-effective than primary care doctors

According to the Ted Talk. “The Problem with Race-Based Medicine“, who is Samuel Cartwright, according to Dorothy Roberts?

• cardiologist who developed the first FDA approved race-specific medicine

• physician who developed the race-specific correction for GFR

• head of the human genome project who alluded to the idea that genetic difference between humans are not related to race

• physician who invented the spirometer to show the presumed deficit in lung capacity in african americans

physician who invented the spirometer to show the presumed deficit in lung capacity in african americans

Based on the Ted Talk by Dorothy Roberts, which of the following is FALSE about BiDil?

• it was marketed only to black patients for commercial reasons

• race was used as a proxy to account for an unknown genetic factor

• it did not gain FDA approval due to poor study design

• the clinical trial only included african-american participants

• more than one of the above

it did not gain FDA approval due to poor study design

According to the Shi and Singh textbook reading, which of the following is NOT a characteristic of the U.S. health care system compared to other countries?

• no central agency governs the system

• access to health care services is based on insurance coverage

• it operates under a free market system

• it provides universal health coverage for all citizens

it provides universal health coverage for all citizens

According to the Shi and Singh textbook reading, what is one of the weaknesses of a social justice perspective on health care?

• proponents of social justice are usually uneducated

• social justice encourages freeloading

• the social justice perspective does not address inequities in health care

• health care entitlement programs are extremely expensive

health care entitlement programs are extremely expensive

According to the Wilson & Clearly article, “Linking Clinical Variables with Health-Related Quality of Life”, which of these patient outcomes is easiest to measure according to the Health Related Quality of Life (HRQL) conceptual model?

• Functional status

• symptom status

• biological and physiological variables

• overall quality of life

biological and physiological variables

According to the Shi and Singh textbook reading, how do market justice and social justice differ in their views on health care?

• market justice views health care as an economic reward whereas social justice views health care as a right

• market justice views health care as an economic reward whereas social justice views health as an individual responsibility

• market justice views health care as a social resource whereas social justice views health care as a right

• market justice views health care as a social resource whereas social justice views health care as a way to ensure the common good

• market justice views health care as an economic reward whereas social justice views health care as a right

 According to the Shi and Singh textbook reading, how should health care be rationed from a market justice vs. social justice perspective?

•  According to social justice, everyone should have access to health care; according to market justice, only those who can afford health care should receive health care

•  According to social justice, only those who deserve health care should receive it; according to market justice, only those who can afford health care should receive health care

•  According to social justice, everyone should have access to health care; according to market justice, only those who have achieved a certain level of education should receive health care

•  According to social justice, only those who deserve health care should receive it, according to market justice, only those who have achieved a certain level of education should receive health care

 

According to social justice, everyone should have access to health care; according to market justice, only those who can afford health care should receive health care

According to the Shi and Singh textbook reading, what did the Hill-Burton Act of 1946 do?

• it created universal health care in the U.S.

• it provided federal funds to construct hospitals across the nation

• it outlawed surgery without anesthesia

• it funded the construction of nursing homes

 

It provided federal funds to construct hospitals across the nation

According to the Ted Talk, “The Problem with Race-Based Medicine,” Race-based medicine is:

• When physicians use race as a crude proxy for genetic factors

• Can perpetuate harmful stereotypes about patients of color

• Addresses both the biological and social factors that contribute to racial inequalities

• A and B

• B and C

A and B

According to “How Systemic Racism Works with Tricia Rose,” what key concept describes the powerful effects produced when interconnected policies reinforce one another beyond the impact of any single policy?

• structural racism

• systemic racism

• meta effects (metaracism)

• institutional racism

meta effects (metaracism)

According to the Urban institute, which of the following factors affects health?

• education level

• race

• income

• all of the above

all of the above

According to the Shi and Singh textbook reading, which is not one of the two main objectives of a healthcare delivery system?

• To enable all citizens to obtain health care services when needed

• To have cost-effective health care services that meet established standards of quality

• To compensate all doctors as much as possible for their services

 

To compensate all doctors as much as possible for their services

According to the Wilson & Clearly article, “Linking Clinical Variables with Health-Related Quality of Life”, what is Health-Related Quality of Life (HRQL)?

• Factors which affect one’s functionality in the workplace

• All economic, political, cultural, and spiritual factors that affect quality of life

• The aspects of quality of life that relate specifically to a person’s health

• All factors which affect function

• The aspects of quality of life that relate specifically to a person’s health

According to the Shi and Singh textbook reading, which of the following accurately describes the evolution of hospitals from 1890 to the present?

• Hospitals were used as housing for the poor and chronically ill; currently hospitals are used to house only those with short-term illnesses

• Hospitals were used as housing for the poor and chronically ill; currently hospitals are well-funded and have the latest treatment technology and specialized interventions to treat many different patients

• Only rich people could afford to use hospitals in the 1890s - now hospitals are accessible to everyone

• Hospital physicians were primarily volunteers in the 1890s – now hospitals only hire salaried physicians

Hospitals were used as housing for the poor and chronically ill; currently hospitals are well-funded and have the latest treatment technology and specialized interventions to treat many different patients

According to the Shi and Singh textbook reading, what is one of the weaknesses of the market justice perspective on health care?

• Market justice ensures that there are no free riders in the healthcare system

• Market justice perpetuates disparities by ensuring that poorer individuals have better access to healthcare than wealthier individuals

• Market justice does not ensure that individuals who are ill will have the care that they need if they cannot afford it, thus individual health issues can spread into the general society through the transmission of contagious diseases

• Proponents of market justice are usually uneducated

Market justice does not ensure that individuals who are ill will have the care that they need if they cannot afford it, thus individual health issues can spread into the general society through the transmission of contagious diseases

According to “How Systemic Racism Works with Tricia Rose,” which metaphor does Tricia Rose prefer for illustrating systemic racism because it highlights how institutions (like gears) interconnect and drive one another?

• a birdcage

• a web

• a series of gears

• a locked door

a series of gears

According to the Shi and Singh textbook reading, what are the four key determinants of health according to the Blum model?

• Environment, nutrition, medical care, heredity

• Environment, lifestyle, heredity, medical care

• Environment, social life, mental health, heredity

• Environment, mental health, level of education, income

Environment, lifestyle, heredity, medical care

According to the Shi and Singh textbook reading, why does cost containment remain an elusive goal in US health services delivery?

• Wide availability of cheap medical technology

• it is difficult to get doctors to cooperate with insurance companies

• general inflation

• the us healthcare system is fragmented and each player seeks to price services at a level that is beneficial to themselves rather than the whole system

the us healthcare system is fragmented and each player seeks to price services at a level that is beneficial to themselves rather than the whole system

According to “How Systemic Racism Works with Tricia Rose,” she argues that structural racism refers to isolated discriminatory actions and does not involve interconnected systems. True or false?

False

According to Atul Gawande’s “Is Health Care a Right?”, there are successful examples of free-market health care systems delivering universal coverage. True or false?

False

According to Chapter 2 of Shi & Singh, the Healthy People initiatives have consistently met their targets for reducing health disparities across the U.S. population.

False

According to Chapter 2 of Shi & Singh, which of the following is NOT listed as a reason for the increased prevalence of chronic conditions in the U.S. population?

• New diagnostic methods and medical procedures

• Increased government funding for chronic disease programs

• Lifestyle choices like poor diet and physical inactivity

• Improved survival rates and longevity

Increased government funding for chronic disease programs

According to Chapter 2 of Shi & Singh, which of the following is a major global health challenge discussed?

• malaria

• tuberculosis

• HIV/AIDS

• All of the above

All of the above

According to Chapter 2 of Shi & Singh, the Global Health Security Index found that no country was fully prepared to handle a global pandemic. True or False?

True

In the NYT article by Lipton and Sack, which lucrative drug did Amgen get a special exclusion for in the “fiscal cliff” bill?

• tylenol

• senispar

• enbrel

• nyquil

sensipar

Which is not one of the reforms Mackey suggests in his article The Whole Foods Alternative to Obama Care?

• Increase the salaries of generalists by 20%

• Repeal state laws preventing insurance companies from competing across state lines

• Make costs transparent so consumers understand what health care treatments cost

• Equalize the tax laws so that employer-provided health insurance and individually-owned health insurance have the same tax benefits

increase the salaries of generalists by 20%

In Krugman’s article, what is one major reason private insurance systems have higher administrative costs than single-payer systems?

• They spend resources on denying claims and avoiding sick patients

• They must pay doctors higher salaries

• They invest more in preventive medicine

• They provide broader benefits than public systems

They spend resources denying claims and avoiding sick patients

According to the Brooks article, why doesn’t health care function like other markets?

•  Health care costs are unpredictable

• Providers (health care deliverers) know much more about medicine than patients (consumers) do

• Payment comes after care, not before

• All of the above

All of the above

According to Chapter 2 of Shi & Singh, what is one major difference between Healthy People 2020 and previous Healthy People Initiatives?

• It places more emphasis on the social determinants of health

• It identifies health priorities for the nation

• It has the goal of improving the quality of life for Americans

• It seeks to involve community partners in health improvement initiatives such as businesses, churches, etc.

It places more emphasis on the social determinants of health

According to Paul Krugman’s article “Why markets can’t cure healthcare”, why can’t health care be sold like bread or TVs?

• Because patients can easily compare prices at different hospitals

• Because most health care is inexpensive and routine

• Because doctors do not want competition between hospitals

• Because health care involves unpredictable, extremely costly needs that require insurance

• Because health care involves unpredictable, extremely costly needs that require insurance

According to the Fuchs article on How and Why US Health Care Differs From That in Other OECD Countries, what is the most important reason why US health care is different from other OECD countries?

• Heterogeneity of the US population

• Distrust of the government in the US

• It is relatively easily for “special interests” to hijack the political system

• Medicare and Medicaid exist

• It is relatively easily for “special interests” to hijack the political system

According to Chapter 2 of Shi & Singh, the COVID-19 pandemic highlighted the United States' strong public health infrastructure and preparedness. True or False?

False

According to Atul Gawande’s “Is Health Care a Right?”, what distinction did James Madison make regarding the rights the government must protect?

• Natural rights vs. civil rights

• Political rights vs. economic rights

• Individual rights vs. collective rights

• Negative rights vs. positive rights

Negative rights vs. positive rights

According to Gawande, how do most Americans view the government’s role in health care, despite disagreements about policy?

• They generally expect government to ensure access to essential care

• They believe government should have no role at all

• They are deeply divided, with no shared expectations

• They only support emergency care as a government responsibility

they generally expect government to ensure access to essential care

What argument do opponents of treating health care as a right often make, according to Gawande?

• That health care costs too little to be considered a right

• That health care requires taking resources from some people to give to others

• That health care is unnecessary in modern society

• That health care is already guaranteed under the Constitution

That health care requires taking resources from some people to give to others

Which country is among the top performers for care delivery process?

United States

Americans have BLANK lives and have the most BLANK deaths

shortest, avoidable

OECD stands for?

Organization of Economic Cooperation and Development

What is the association between wealth and mortality in the United States and Europe?

• The gap in survival between the top and bottom wealth quartiles were wider in the United States than in Europe. Survival among the participants in teh top wealth quartiles in northern and western Europe and southern Europe appeared to be higher than that among the wealthiest Americans. Survival in the wealthiest U.S. quartile appeared to be similar to that in the poorest quartile in northern and western Europe.

The Big Beautiful Bill Act would make how many more people uninsured?

16 million people

What is national debt caused by?

the growing debt is caused by a structural mismatch between spending and revenues

Growth in spending on Medicare is projected to account for more than XYZ percent of the increase in spending on the major health care programs over the next 30 years?

90%

Health is something that is? Health care seeking occurs in a societal context and for many in the US that context is complex…it leads us to ask what XYZ had to do with asking for help, leading to delays

• Health is something that is experienced

• Race, gender

What is the WHO definition of health?

A complete state, of physical, mental, and social well-being, and not merely the absence of disease or infirmity

What are some biological and physiological variables?

• molecular and genetic factors

• function of cells, organs, and organ systems

• diagnoses such as HIV/AIDS, diabetes, lung cancer

• laboratory values such as temperature, white blood count, serum glucose level

• exam findings such as weakness on one side of the body, a skin rash, or a heart murmur

• mental diagnosis like panic disorder

Symptoms focus on the whole? What are some examples of physical and emotional symptoms? Biological variables and symptoms have a ? Symptoms drive? Symptoms are dependent and difficult sometimes because…?

• Focus on the whole organism

• Focus on whole organism 

• Physical symptoms such as pain or itching 

• Emotional or psychological symptoms such as frustration, anxiety, fear 

• Stimulation and hypochondriasis 

• Complicated relationship between biological variables and symptoms 

• Subjective; cultural competent; stigma (case)

• Symptoms drive care seeking and care costs

What is functional status?

Dimensions: physical, emotional, role, social

Complexity: motivation, other contexts

Case: hip pain case

Objective measurement possible

FDA now requires measures of functioning

What are general health perceptions?

• Integration of previous factors

• by definition subjective

• strong empirical predictors of

  • general medical and mental health utilization

  • mortality

What is overall quality of life?

• may not be related to health

• may be related to the economy, religious factors, employment factors, etc.

What did researchers find between income inequality and health?

• researchers found that life expectancy was lower in places with more income inequality. this map shows their measure of inequality for every county in the United States