Chapter 12 Quiz: Instructions:

Transcription

1 Chapter 12 Quiz: This is a very dense and informative chapter. It contains much material that every social worker needs to know about Medicare and Medicaid, in order to serve clients well. It also contains much material that we all need to know in order to be effective social work policy advocates and informed citizens. If you have your health, you have everything, my wife s grandmother used to say. Another saying might be, If you don t have accessible health care, you have are at risk of losing everything. I ve posted on the new Health Policy page of my website a clipping which shows that when doctors saw Katrina evacuees, they discovered that many of their new patients had never seen a doctor before for conditions that they had had for years! Instructions: Answer either the ODD or the EVEN questions (including short essay question 32 if you choose even and short essay question 33 if you choose odd), AND either one of the two short essay questions at the end. Print the entire quiz. I ve ed it to you so you can print the . I ve also put it on blackboard under assignments as #1, in Word format. Finally, I ve posted it under SWK 250 quizzes on my website as a PDF File. One way or another, you should be able to get it! Hand the quiz in on Tuesday in class. This quiz should take you about 3 hours to complete including reading the chapter. Please set aside this time between now and class on Tuesday. This quiz took me 6 hours to write, not counting the two hours it took to read the chapter. I learned a lot reading this chapter and writing the quiz, and I m confident you will learn a lot reading the chapter and taking the quiz. Keep in mind this is an entire week s content for this class, not just one class session. So I would contend this is not too much work for one week. Remember, you must answer either one of the two short essay questions at the end. In other words, you can answer either of the two questions regardless whether you choose the odd or even questions on the rest of the quiz. Multiple Choice, short answer, fill-in-the-blank, and true/false are 1 point. Short essays are 5 points. For Multiple Choice questions, please circle the correct answer. For True/False answers, please circle True or False. For fill-in-the-blank questions, please fill in the provided lines. For short answers, please answer on the provided line. There are a total of 26 points possible on the objective questions, and 10 points possible on the two essay questions, for a total of 36 points. If you got 90% of the possible 36 points, or 32.4 points, that would mean you score 90% of the 4 possible points on this quiz, or 3.6 points. With the exception of the final two short essay questions (for which the pages covered is obvious or is mentioned), the order of the questions is in the same order of the pages of the chapter. This should make it easier to follow. You can skip the section on the tobacco policy, although I ll have an update on that from a recent newspaper article in the class session on Tuesday.

2 Extra credit: I will give you a 10% boost in your score on this quiz if you attempt to answer both the odd and the even questions! So if you receive a 3.5 out of the possible 4 points total, you will receive or If your score goes over 4.0, it will be factored into your total for all of your best 10 quizzes counted towards the final grade. 1. Name the two populations whose rate of being uninsured are three times that of European- Americans (11% of whom were uninsured as of earlier in this decade): A. at %. B. at %. 2. True/False: Overall, children are significantly more likely to be uninsured than European- Americans. 3. Which of the five major components of the medical services delivery system in the United States contains the Veteran s Administration s hospital system? A. Physicians in solo practice B. Group outpatient settings C. Hospitals, private, nonprofit, or public D. Public health services. E. Sundry and corollary health services 4. True/False: Medicare is the largest social insurance program in the United States. 5. Which of the following parts of Medicare involves compulsory contributions from all employees and self-employed persons who are required to contribute to the Medicare trust fund: A. Part A Hospital Insurance B. Part B Supplemental Medical Insurance C. Part C Medicare Advantage Program D. Part D Medicare Modernization Program 6. Which of the following parts of Medicare contains provisions for an initial routine physical examination, cardiovascular blood screening tests, and diabetes screening tests and services? A. Part A Hospital Insurance B. Part B Supplemental Medical Insurance C. Part C Medicare Advantage Program D. Part D Medicare Modernization Program 7. Which of the following parts of Medicare contains provisions for an initial routine physical examination, cardiovascular blood screening tests, and diabetes screening tests and services?

3 A. Part A Hospital Insurance B. Part B Supplemental Medical Insurance C. Part C Medicare Advantage Program D. Part D Medicare Modernization Program 8. How are the six million people who are eligible for additional assistance from Part D of Medicare referred to (a two letter term):. 9. True/False: The doughnut hole represents the$3662 that the Medicare Part D participant must pay after meeting the $250 deductible and one quarter of the first $2,250 in drug costs. 10. True/False: The total expenditure of a Medicare Part D recipient in 2006 whose income is higher than 135% of the poverty line is at least $420 a year in premiums for basic drug coverage (although these vary between plans), plus the first $250 deductible, plus 25% of the first $2250 in drug costs, after which the doughnut hole comes into play. 11. True/False: The textbook explains what the annual costs will be for Medicare recipients whose income is below 135% of the poverty tine. 12. True/False: One aspect of the Part D MMA, Health Savings Accounts, offer a tax free shelter for those with high deductible insurance. Conservatives argue that this measure will encourage people to monitor their health spending and bring costs down. The author s argue that this will undermine the concept of shared risk which underlies health insurance systems. 13. True/False: 66.6% of Americans support government-run, universal health care. 14. True/False: Medicare Part A covers spouses of worker s who are not otherwise covered by Part A. 15. True/False: Medicare Part A covers all but which of the following services: A. Inpatient hospital B. Skilled nursing facility C. Home health agency D. Hospice care E. Approved durable medical equipment 16. True/False: Part B or SMI (Supplemental Medicare Insurance) covers certain services provided by clinical social workers who see patients outside a hospital. 17. True/False: Medicare s Part A tax rate is a total of 2.9%, half of which is paid by employees and half of which is paid by employers, with self-employed persons paying all 2.9%. 18. True/False: The Medicare Part B premium is paid by 38 million out of the 40 million people who participate in Medicare Part A. It was $66.60 a month in 2004, and was set at this rate in

4 order to ensure that the premiums collected cover about a quarter of the total cost of the services covered by the SMI program (as listed on page 307). 19. True/False: The remainder of the Medicare Part B expenditures on covered services is funded by a flat rate tax on all employees which is matched by employers. 20. True/False: Medigap plans are forms of private insurance which are used to help pay for charges not covered due to Medicare deductibles and co-pays for Part A and Part B expenses. 21. In 2004, the cost of inpatient hospital care for Medicare Part A participants included all but which one of the following expenses for someone who is hospitalized for 120 days within the same year: A. An $876 one-time deductible at the beginning of each benefit period st th B. $219 dollars each day from the 61 to the 90 days, for a total of $6351. C. The using up of 30 of the 60 days of additional lifetime reserve. st th D. An additional $219 a day of coinsurance payments for the 91 to the 120 days, for a total of an additional $6351. E. The beneficiary s payment share includes an annual deductible of $100. F. A total financial responsibility of $ Unlike Medicare Part B coinsurance payments for other medical services, payments for mental health treatment are: A. 25% B. 50% C. $25 per session D. $50 per session 23. True/False: Doctors who agree to accept the assignment of the Medicare-approved rate of payment are not permitted to request any additional payments from the patient (such as the 20% co insurance payment). 24. True/False: In 2004, Medicaid served more than 42 million people at a cost of $58 billion. This cost is close to the 2002 cost of Medicare expenditures. 25. True/False: Medicare is a federal social insurance program, while Medicaid is a federal/state program, but both Medicare and Medicaid have involved contracts with HMOs. 26. True/False: Foster children, unlike children receiving adoption assistance, are among the mandatory Medicaid eligibility groups. 27. True/False: Medicaid s optional group s of beneficiaries include institutionalized individuals (such as those in nursing homes) regardless of income and resources available to them, but this is

5 up to the states. 28. True/False: Persons whose income or resources would normally be too high for Medicaid or for the Medically Needy programs adopted by 36 states may spend down their income or resources in order to achieve eligibility. 29. Which of the following is not true: A. Medicaid paid for about 1/3 of all live births in the US. B. About half of all Medicaid recipients are children. C. Long-term nursing home care used up 37% of the Medicaid budget. D. 25% of all nursing homes are for-profit facilities. E. Medicaid is a subsidy for the middle class F. In recent years, Medicaid has covered more than half of the population with incomes below the poverty line. 30. True/False: S-CHIP is handled differently in different states, but represents an incremental improvement in the nation s health care system, since it uses block grant funds to extend health insurance coverage (either Medicare or a state CHIP program) to children in families with incomes of 200% of poverty or higher. 31. True/False: Cost shifting means charging one group of patients less in order to make up for underpayment by others. 32. Short essay (five points). Based upon Figure 12.3 that national health care expenditures in 2002 were $1.7 trillion dollars ($1,700,000,000,000). In other words, assume that 100% of the total amount of expenditures in the pie chart in Figure 12.4 was $1.7 trillion, so that for instance the 7% that went to nursing home care represented $119,000,000. Turning to page 316, identify and describe a source of data for another year between which seems to contradicts the data in the pie chart in Figure 12.4.

6 33. Based upon Figure 12.3 that national health care expenditures in 2002 were $1.7 trillion dollars ($1,700,000,000,000). In other words, assume that 100% of the total amount of expenditures in the pie chart in Figure 12.4 was $1.7 trillion, so that for instance the 7% that went to nursing home care represented $119,000,000. Turning to page 316, identify and describe a source of data for another year between which seems to contradicts the data in the pie chart in Figure Which of the elements of the pie chart seems to be a gross? underestimate and why? 34. True/False: In recent years, the U.S. had twice the United Kingdom s level of health care expenditure as a percentage of GDP, and this investment in medical technology has resulted in a lower infant mortality rate than the United Kingdom. 35. Which of the following factors, cited as among the reasons for the increase in health care costs, is NOT considered by the authors to a rather small part of the increase: A. Medical malpractice B. Cost of treating HIV and AIDS C. Increased cost of medical technology D. Increased longevity 36. True/False: Over half of the cost of hospital care is labor costs. 37. True/False: Physician s salaries have increased rapidly. In terms of where the nation s health care dollars went, in 2002 physician s and clinical services 22% of all expenditures. 38. True/False: Health insurers experienced an increase in profits during one recent year which

7 was in double-digits, as was the increase that year in health care insurance premiums. 39. True/False: DRGs (diagnostic related groups) are a form of prospective payment system, or the determination of the amount of payment before the services are actually delivered. This is a payment method for anticipated Medicare-incurred charges that establishes rates, prices or budgets before services are rendered and costs are incurred. 40. Which of the following is not one of the types of organizational acronyms which is part of a managed care system: A. HMO (Health Maintenance Organization) B. NHS (National Health Service) C. POS (Point of Service) D. IPA (Independent Practice Association) E. PPO (Preferred Provider Organization) 41. True/False: A clear majority of American s agree, I m frustrated and angry about the state of the health care system in this country. 42. True/False: The underinsured experience some of the same problems as the uninsured. 43. True/False: A slight majority of all people with AIDS contracted the HIV virus due to maleto-male sexual contact. 44. True/False: AIDS is the second leading cause of death in men and women aged Disparities in access to HIV/AIDS care are frequently associated with all but which one of the following? A. Insurance status B. Gender C. Race D. Ethnicity E. Exposure group (i.e. how one was exposed to HIV) F. Ethnicity G. Income H. Education I. Age J. All of the above 46. True/False: Commodification of health care is associated with a government policy favored by conservatives which takes social needs formerly met in the public sector and places them in the private market sector. 47. True/False: In the Canadian system, the federal government not the provinces is responsible

8 for administering the national health care system. 48. True/False: The Canadian health care system is an example of socialized medicine. 49. True/False: In the Canadian health care system, hospital reimbursements are also made on a global perspective basis similar to the prospective payment system used in the U.S True/False: The majority of Canadian hospitals are in the public sector. 51. True/False: The Canadian Medicare system is more developed than the U.S. model because it became operational just after World War II. 52. True/False: The British National Health Service was originally conceptualized in a White Paper written by the Labor Party during WW II./ 53. True/False: A capitation, according to the textbook, is a method of payment in which the provider (a GP in the British Health Service or an HMO in the US) is paid a fixed amount for each person served regardless of the actual number or nature of services delivered. 54. True/False: The British NHS is funded from general taxes, as are Medicare Part B expenditures in the U.S. that aren t covered by the Part B premium. Answer one of the following two short essay questions: 1. Regarding the plight of the uninsured on pages and the underinsured discussed on page 321, discuss the ways in the textbook indicates that permitting there to be so many people who do not have full access to health care contributes to mortality. In addition, identify one other way in which you feel that these barriers to health care can cause premature deaths. Please come to class prepared to discuss this one additional example of how the lack of health care can kill.

9 (over if you need more space) 2. Current proposals for improving health care fall into there basic categories (see page 324): (1) Removing health care from the marketplace, (2) maintaining the private health care marketplace while providing universal coverage through national health insurance, (3) instituting incremental reforms such as S-CHIP designed to eliminate the more egregious features in the U.S. health care system. There have been a number of proposals for change, consistent with each of these three options, including (1) various forms of socialized medicine, (2) national health insurance, and (3) incremental reform, detailed on pages Based upon your understanding of the U.S., Canadian and British systems, the opinion polls cited in this chapter (two of which are mentioned in this quiz), and the principles of Terri Combs-Orme cited on pages (which you of course are not required to agree with), which of these options seems most desirable and feasible to you and why? Please come to class prepared to discuss which of these proposals you favor.

10