 - 1. What percentage of Americans under age 65 receive health insurance through an employer?
A) 59.3%
B) 28%
C) 35%
D) 9%
- 2. By how much have premiums for family coverage increased since 2001, according to a 2007 Kaiser Family Foundation study?
A) 78%
B) 19%
C) 17%
D) 35%
- 3. What is the average percentage of the premium paid by covered workers for single coverage as of 2007?
A) 9%
B) 59.3%
C) 28%
D) 16%
- 4. What is the average percentage of the premium paid by covered workers for family coverage as of 2007?
A) 16%
B) 59.3%
C) 28%
D) 78%
- 5. What percentage of the U.S. population purchases individual health care insurance?
A) 35%
B) 59.3%
C) 16%
D) Just less than 9%
- 6. Private insurance accounts for what percentage of total health spending in the United States?
A) 59.3%
B) 35%
C) 9%
D) 28%
- 7. Besides the United States, which two other OECD countries have private insurance representing more than 10% of total health spending?
A) Mexico and Spain
B) Germany and Japan
C) Canada and France
D) United Kingdom and Italy
- 8. What type of health plan has gained market share at the expense of HMOs over the past decade?
A) PPOs
B) Individual insurance
C) Staff-model HMOs
D) Public-sector insurance
- 9. What was the model of the first HMOs in the U.S. such as Kaiser Permanente?
A) Public-sector model
B) PPO-model
C) Staff-model
D) Loosely managed network
- 10. What do managed care organizations typically cover to align with the goal of maintaining enrollee health?
A) Only emergency services
B) Preventive health care
C) Non-medical health supplements
D) Out-of-network diagnostic tests
- 11. In a staff-model HMO, what role does the primary care doctor often play?
A) Network negotiator
B) Patient advocate and care coordinator
C) External consultant
D) Insurance biller
- 12. What happens when patients go to out-of-network providers according to a 2009 survey?
A) They are sometimes charged extremely high fees
B) They receive better quality care at lower costs
C) They are prohibited from using those facilities
D) The insurance company automatically covers the difference
- 13. How many people obtained insurance via ACA marketplaces in 2016?
A) 74 million
B) 10 million
C) 12 million
D) 4 million
- 14. What determines the amount of the premium tax credit for individuals?
A) Health status
B) Income level
C) Employment status
D) Age
- 15. What percentage of ACA marketplace users are eligible for subsidies?
A) Approximately 10 million
B) Approximately 12 million
C) Approximately 74 million
D) Approximately 5 million
- 16. What is the primary benchmark plan used in ACA marketplace cost analysis?
A) Second-lowest cost silver plan
B) Lowest-cost bronze plan
C) Standard federal platinum plan
D) Highest-cost gold plan
- 17. What was the projected impact of ending cost sharing reductions on the federal budget deficit over a decade?
A) $200 billion decrease
B) $338 billion decrease
C) $7 billion increase
D) $200 billion increase
- 18. How much would premiums rise if healthier people dropped out of the marketplace after the individual mandate ended?
A) Up to 20%
B) Up to 5%
C) Up to 50%
D) Up to 10%
- 19. What is the expected impact on the number of uninsured by 2027 if the individual mandate is not enforced?
A) Increase by 13 million
B) Increase by 4 million
C) Decrease by 13 million
D) Stay the same
- 20. How many people did Medicaid serve in 2017?
A) 12 million
B) 11 million
C) 74 million
D) 10 million
- 21. What is the range of the Federal Medical Assistance Percentage (FMAP)?
A) 75% to 100%
B) 50% to 75%
C) 10% to 30%
D) 25% to 50%
- 22. Since what year have all states participated in the Medicaid program?
A) 1982
B) 2016
C) 2014
D) 2017
- 23. What is the income eligibility threshold for the ACA Medicaid expansion?
A) 200% of the poverty line
B) 133% of the poverty line
C) 50% of the poverty line
D) 100% of the poverty line
- 24. How many states chose not to adopt the ACA Medicaid expansion?
A) 50
B) 74
C) 12
D) 19
- 25. What was the federal spending on Medicaid in fiscal year 2017?
A) $338 billion
B) $7 billion
C) $200 billion
D) $375 billion
- 26. By what percentage did aggregate U.S. hospital costs increase between 1997 and 2011?
A) 19%
B) 47%
C) 63%
D) 11%
- 27. What was the average employer-based health insurance premium for a family of four in 2017?
A) $5,714
B) $1,500
C) $6,690
D) $18,765
- 28. What was the average premium for single coverage in 2017?
A) $18,765
B) $5,714
C) $1,500
D) $6,690
- 29. How much did the typical worker contribute towards their insurance coverage on average?
A) $1,500
B) $6,690
C) $5,714
D) $18,765
- 30. From 2011 to 2016, by what percentage did worker earnings rise?
A) 11%
B) 19%
C) 47%
D) 63%
- 31. What is the approximate average annual deductible?
A) $1,500
B) $6,690
C) $5,714
D) $2,000
- 32. For employers with fewer than 200 employees, what percentage of employees are in high-deductible plans?
A) 19%
B) 47%
C) 65%
D) 12%
- 33. What percentage of GDP did Warren Buffett state the U.S. spends on health care?
A) 9%
B) 17%
C) 63%
D) 47%
- 34. What is one way to attempt to lower medical bills mentioned in the text?
A) Negotiate the price with the hospital billing department
B) Ask the government for a subsidy
C) Report the hospital to the OECD
D) Change insurance providers mid-year
- 35. Which of the following is cited as a reason for high U.S. healthcare costs?
A) Higher administrative costs
B) Active government intervention to reduce costs
C) Lower per-capita income
D) Less medical care consumed per capita
- 36. What was the percentage of uninsured persons in the U.S. in 2016?
A) 37%
B) 8.8%
C) 13.3%
D) 68%
- 37. What is the largest category of avoidable or wasted health care costs mentioned by the Institute of Medicine?
A) Inflated prices
B) Prevention failures
C) Fraud
D) Unnecessary services
- 38. In which system are doctors directly employed by the government?
A) Medicare
B) Marketplace exchanges
C) Veteran's Administration
D) Medicaid
- 39. What was the per capita healthcare spending in 2007?
A) $7,026
B) $7,439
C) $8,047
D) $9,990
- 40. What percentage of U.S. health care spending was accounted for by the top 1% of persons in 2010?
A) 82%
B) 3%
C) 50%
D) 21%
- 41. The top 20% of the U.S. population accounted for what percentage of health care spending in 2010?
A) 3%
B) 21%
C) 50%
D) 82%
- 42. Which demographic group was more likely to remain in the bottom half of health care spenders?
A) Uninsured
B) Elderly
C) Non-Hispanic whites
D) Those in poor health
- 43. What percentage of spending in 2014 went to hospital care?
A) 32%
B) 20%
C) 10%
D) 7%
- 44. What percentage of Medicare spending for beneficiaries in the last two years of life is accounted for by acute hospital care?
A) 55%
B) 4%
C) 32%
D) 20%
- 45. Did researchers find evidence of 'substitution' where increased hospital care reduces outpatient spending?
A) Yes, but only for seniors
B) Yes, but only for the chronically ill
C) Yes, it significantly reduces it
D) No evidence was found
- 46. How much of the geographic variation in care for the chronically ill is explained by the number of severely ill people in an area?
A) 32%
B) 21%
C) 4%
D) 55%
- 47. Which state had the lowest Medicare average spending per-enrollee in 2014?
A) Montana
B) New Jersey
C) California
D) New York
- 48. Which state had the highest Medicare average spending per-enrollee in 2014?
A) Texas
B) Montana
C) Florida
D) New Jersey
- 49. When was the Defense Health Agency founded?
A) 2016
B) 2010
C) 2013
D) 2020
- 50. Which Tricare option are active duty service members assigned to?
A) TRICARE Reserve
B) TRICARE Military
C) TRICARE Prime
D) TRICARE General
- 51. Approximately what percentage of U.S. healthcare costs are related to administrative expenses?
A) 33%
B) 48%
C) 10-15%
D) 25%
- 52. According to David Cutler, what percentage of healthcare spending is not associated with improved outcomes?
A) 25%
B) 15%
C) 33%
D) 50%
- 53. What percentage of healthcare spending is accounted for by the government in the U.S. versus Europe?
A) 48% in the U.S. versus 76% in Europe
B) 25% in the U.S. versus 50% in Europe
C) 33% in the U.S. versus 66% in Europe
D) 20% in the U.S. versus 40% in Europe
- 54. What factor contributed the most to healthcare cost inflation between 1940 and 1990 according to CBO?
A) Personal income growth
B) Administrative costs
C) Technology changes
D) Aging of the population
- 55. What percentage of the increase in healthcare costs between 1940 and 1990 was attributed to the aging of the population?
A) 2%
B) 5-23%
C) 3-13%
D) 38-65%
- 56. By 2012, what proportion of workers with employer-sponsored insurance were enrolled in a plan requiring a deductible?
A) Almost all
B) About one-quarter
C) About three-quarters
D) About one-half
- 57. What did the Wall Street Journal report in 2008 regarding consumer behavior?
A) Consumers were opting for more expensive insurance
B) Consumers were increasing elective surgeries
C) Consumers were reducing healthcare spending
D) Consumers were switching to private doctors
- 58. Which percentage of personal health expenditures was paid by private insurance in 2004?
A) 36%
B) 11%
C) 34%
D) 15%
- 59. Why do some patients have difficulty finding providers for government-insured medical services?
A) Lack of interest from government officials
B) High competition from private insurance
C) Government regulations forbid certain specialists
D) Low reimbursement rates
- 60. What is the primary legal status of government-funded healthcare programs in the U.S.?
A) Statutory law
B) Constitutional rights
C) Judicial mandates
D) Executive orders
- 61. Which government program is specifically administered by the states?
A) Medicare
B) Medicaid
C) Indian Health Service
D) TRICARE
- 62. What legislation mandates public access to emergency services regardless of ability to pay?
A) EMTALA
B) The Medicare Act
C) SCHIP
D) Title X
- 63. In what year is Medicare enrollment expected to reach 77 million?
A) 2050
B) 2025
C) 2031
D) 2040
- 64. Which program provides health insurance for children who earn too much for Medicaid but cannot afford private insurance?
A) SCHIP
B) The Veterans Administration
C) Title X
D) TRICARE
- 65. What is a primary characteristic of EMTALA passed in 1986?
A) It is administered solely by state governments
B) It only applies to veterans
C) It is fully funded by federal grants
D) It is an unfunded mandate
- 66. In 2016, approximately what percentage of people were covered by private health plans?
A) 37%
B) 50%
C) 85%
D) 68%
- 67. In 2016, approximately what percentage of people were covered by government health plans?
A) 68%
B) 45%
C) 25%
D) 37%
- 68. What percentage of uncompensated care costs are covered by government grants and payments?
A) 80–85%
B) 90–95%
C) 50–60%
D) 30–40%
- 69. Which entity provides the most funding for uncompensated care?
A) State and local tax appropriations alone
B) Physician donations
C) Federal government
D) Private charities
- 70. What factor limits the purchasing power of the U.S. health system?
A) A lack of private insurance providers.
B) Excessive regulation of service prices.
C) A highly fragmented buy side.
D) Too much government centralization.
- 71. What is a suggested target for administrative overhead in a single-payer system?
A) 25-30%
B) 10-15%
C) 20-25%
D) 5-10%
- 72. How do US prescription drug costs compare per-capita to other countries?
A) Four times as much
B) Roughly the same
C) Roughly twice as much
D) Roughly half as much
- 73. What payment strategy is proposed to limit costs while maintaining quality?
A) Bundled payment strategies
B) Capitation-only models
C) Out-of-pocket maximums
D) Fee-for-service models
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