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CHAPTER 2

Multiple Choice

1. In its early origins in colonial America, the patient/physician relationship can be best characterized as:

A. Interactive and supportive of patient involvement in treatment decisions
B. Complicated in terms of the ways that patients paid for treatment
C. Personal, confidential and simple with payments based on patients’ financial capacity
D. Strict “contracted” arrangements between physicians and patients

Ans.: C
Page: 33

2. As early as the 19th century some Americans carried “health insurance” through employers, fraternal orders, guilds, trade associations, unions or commercial insurance companies. However unlike health insurance of today, these insurance policies only provided for:

A. Maternity care
B. Fixed payments to compensate for lost wages due to injury, sickness or disability
C. Job-related injuries
D. Infectious diseases acquired in the workplace

Ans. B
Page: 34

3. Blue Cross Hospital Insurance, the predominant form of health insurance for decades, was modeled after:

A. Baylor University Hospital’s school teachers plan
B. trade union “sickness” insurance
C. the industrial policies of Metropolitan and Prudential
D. the American Hospital Association policies

Ans: A
Page: 35

4. The American Medical Association’s initial reaction to Blue Cross hospital insurance plans suggested that the plans:

A. Would strengthen the quality of hospital care
B. Were unsound and unethical
C. Should be available only to professional workers
D. Would help boost physician income

Ans: B
Page: 35

5. The most significant social legislation passed by any Congress in the history of the United States was the:

A. Health Maintenance Organization Act of 1973
B. Hill-Burton Act of 1946
C. Social Security Act amendments creating Medicaid and Medicare
D. Social Security Act of 1935

Ans: D
Page: 37

6. The major health care advances of the second half of the 20th century were in the area of:

A. imaging technology
B. vaccines and antibiotics to prevent and control infectious diseases, tranquilizers, the birth control pill
C. infertility management
D. joint replacement technology

Ans: B
Page: 42

7. The explosion of science and technology in the 1970s resulted in which of the following?

A. Encouragement for physicians’ specialization
B. Higher costs of health care
C. Medical school efforts to attract more students to primary care
D. All of the above

Ans.: D
Page: 45

8. The Oregon Death with Dignity Act was a response to which of the following?

A. legal challenges to hospice care
B. inadequate Medicaid resources to pay for terminal care
C. public and professional concerns about painful and demeaning terminal medical care
D. overcrowded hospital intensive care units

Ans: C
Page: 53

9. A central provision of the ACA to assure health care coverage for most Americans is:

A. the individual mandate
B. national prevention strategy
C. the independent payment advisory board
D. the small employers’ health insurance option

Ans.: A
Page: 56

10. The Medicaid program has a history of very low reimbursement as compared with Medicare reimbursement; critics site low Medicaid reimbursement as a major reason that primary care doctors have rejected serving the Medicaid population. An ACA provision addresses this issue by:

A. Rewarding primary care physicians with bonuses based on increased of numbers of Medicaid patients they serve in specific time periods
B. Reimbursing states for primary care physician fees for Medicaid patients at no less than100% of Medicare payment rates
C. Requiring Medicaid patients to pay higher co-pays and deductibles for each physician visit
D. Requiring physicians to document their losses from Medicaid payment in relation to their costs in order to receive increased reimbursement for services to Medicaid patients

Ans: B
Page: 62

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