Intro to Health Systems Ch 3

Which of the following forces remains relatively stable, and major shifts in this area would be necessary to bring about any fundamental change in the US health care delivery system?
a. Economic forces
b. Political change
c. Beliefs and values
d. Social forces

c. Beliefs and values

In its historical context, which of the following has played a major role in revolutionizing health care delivery?
a. Beliefs and values
b. Science and technology
c. Medical education
d. Economic growth

b. Science and technology

Medical care in preindustrial America had a strong _____ character.
a. scientific
b. professional
c. applied
d. domestic

d. domestic

The delivery of medical care in preindustrial America was governed mainly by
a. free market conditions
b. collusion among providers
c. supply of medical services
d. high barriers to entry

a. free market conditions

In the preindustrial era, _____ often functioned as surgeons.
a. butchers
b. tailors
c. clergymen
d. barbers

d. barbers

In the preindustrial period, what was the main role of dispensaries?
a. Dispensaries were affiliated with hospitals to provide charity care.
b. Dispensaries functioned as laboratories to conduct diagnostic tests.
c. Dispensaries provided basic medical care to ambulatory patients.
d. Dispensaries provided advanced medical treatments by private physicians.

c. Dispensaries provided basic medical care to ambulatory patients.

Hospitals in the United States evolved from
a. almshouses
b. sickhomes
c. pesthouses
d. inns

a. almshouses

What main purpose was served by an almshouse in the preindustrial period?
a. It was used to quarantine people who had contracted a contagious disease.
b. It provided free medical care and drugs to ambulatory patients.
c. It specialized in performing basic surgeries.
d. It performed general welfare and custodial functions.

d. It performed general welfare and custodial functions.

What was the function of a pesthouse in the preindustrial period?
a. To house people who had a contageous disease.
b. To provide refuge to those who were threatened by pests.
c. To eradicate pests.
d. To treat contageous diseases.

a. To house people who had a contageous disease.

Why in the preindustrial period most people could not afford the services of a qualified physician?
a. Professional fees were too high.
b. The economic cost of travel was too high.
c. Private health insurance was too expensive.
d. Most people relied on home remedies.

b. The economic cost of travel was too high.

In the preindustrial era, asylums were built by ____ to accommodate patients with severe and chronic mental illness.
a. the federal government
b. private entrepreneurs
c. psychiatrists
d. the state governments

d. the state governments

What was the main consequence of early proprietary medical schools, as opposed to state-sponsored schools, in the preindustrial era?
a. Standards were low.
b. The cost of medical education became too high.
c. Medical education became regulated.
d. Science and research became part of medical education.

a. Standards were low.

Which of the following factors was particularly important in promoting the growth of office-based medical practice in the postindustrial period?
a. Urbanization
b. Educational reform
c. Science and technology
d. Dependency

a. Urbanization

When a profession’s services are generally accepted and are legitimized, they impart _____ to the profession
a. specialization
b. organized strength
c. cohesiveness
d. cultural authority

d. cultural authority

Cultural authority was conveyed to the medical profession mainly through
a. the development of the AMA
b. advances in medical science
c. patients’ dependency
d. licensing

b. advances in medical science

Development of the hospital and ______ happened almost hand in hand in a symbiotic relationship between the two.
a. dependency of patients
b. growth of scientific knowledge
c. professionalization of medical practice
d. cohesiveness of the medical profession

c. professionalization of medical practice

Even though hospitals incurred frequent deaths in the early 1900s, their use was on the rise mainly because
a. most people had poor living conditions in their homes
b. people had no other choice but use the hospitals
c. a large number of immigrants were settling in American cities
d. technology was advancing at a rapid pace

c. a large number of immigrants were settling in American cities

Why did physicians remain independent of corporate settings even after the medical profession became well recognized?
a. Hospitals were unable to pay high enough salaries to physicians.
b. Physicians disliked salary arrangements.
c. Licensure laws had not yet been passed.
d. Physicians who took up practice in a corporate setting were castigated by the medical profession.

d. Physicians who took up practice in a corporate setting were castigated by the medical profession.

Organized medicine
a. Concerted activities of physicians through the American Medical Association
b. Affiliation of physicians with medical schools
c. Standardized practice of medicine
d. Unionization of physicians

a. Concerted activities of physicians through the American Medical Association

The Flexner Report, published in 1910, reported on
a. standards for medical licensure in the US and Canada
b. standards of training in medical schools
c. rates of death in US hospitals
d. the state of medical specialization

b. standards of training in medical schools

The US Supreme Court decision in Olmstead v. L.C. directed US states to
a. deinstitutionalize people with mental illness
b. achieve parity in the delivery of physical and mental health services
c. increase funding for mental asylums
d. improve living conditions in mental asylums

a. deinstitutionalize people with mental illness

When the first public health infrastructure was being established in the US, it was recommended that ____ be established.
a. sanitary standards
b. a federal agency to oversee public health functions
c. state and local health departments
d. a presidential commission

c. state and local health departments

In the US, public health and private practice of medicine developed separately because
a. Americans favored private delivery of medical care over public health.
b. physicians were skeptical of the government taking control of medical practice.
c. a public health infrastructure was lacking.
d. the practice of public health was not based on scientific methods.

b. physicians were skeptical of the government taking control of medical practice.

The inception of _____ was used as a trial balloon for the idea of government-sponsored universal health insurance.
a. workers’ compensation
b. trade unions
c. public health
d. health care for the veterans

a. workers’ compensation

Initially, what was the main purpose of private health insurance in the US?
a. Prevent national health insurance from taking hold
b. Provide coverage for major illnesses
c. Provide comprehensive coverage
d. Compensate for loss of income during sickness and temporary disability

d. Compensate for loss of income during sickness and temporary disability

The Baylor Hospital plan, started in 1929, laid the foundation for modern health insurance in the US. This was a _____ plan.
a. managed care
b. contributory
c. comprehensive
d. prepaid

d. prepaid

Why did the first Blue Cross plans cover only hospital care?
a. The AMA objected to the inclusion of physician services.
b. There was little demand for including other types of health care services.
c. Initial hospitalization was required in order to compensate a beneficiary for loss of income.
d. The Blue Cross commission determined that including other types of health care services would be unprofitable.

a. The AMA objected to the inclusion of physician services.

During the World War II period, health insurance became employer-based because of
a. endorsement from Blue Cross and Blue Shield plans
b. wage freezes
c. disputes between labor and management about the cost of health care
d. union demands

b. wage freezes

During the World War II period, the US Supreme Court ruled that
a. health insurance must be employer-based
b. all large employers must provide health insurance to their employees
c. health insurance could be part of the collective bargaining process
d. health insurance must cover major medical expenses

c. health insurance could be part of the collective bargaining process

What was the main reason for initiating national health care in countries such as Germany and England?
a. Improve the health of industrial workers
b. Ward off political instability
c. Provide access to emerging technology
d. Relieve poverty

b. Ward off political instability

The beliefs and values that form American ideology represent the sentiments of
a. the US government.
b. the American middle class.
c. the American upper class.
d. American politicians.

b. the American middle class.

Who was the first American president to make an appeal for national health insurance?
a. Theodore Roosevelt
b. Franklin Roosevelt
c. Harry Truman
d. Bill Clinton

c. Harry Truman

Historically, which interest group was the most powerful in opposing national health insurance?
a. Trade unions
b. Employers
c. The American Medical Association
d. The Republican party

c. The American Medical Association

On what grounds have middle-class Americans generally opposed proposals for a national health insurance program?
a. Higher taxes
b. Government intervention
c. Erosion of personal freedoms
d. Cost of health care

a. Higher taxes

Medicare and Medicaid programs were created for population groups regarded as
a. elderly
b. vulnerable
c. underinsured
d. politically active

b. vulnerable

How has Medicaid created a two-tier system of medical care delivery in the US?
a. Many physicians do not serve Medicaid patients.
b. Only the poor are insured under the Medicaid program.
c. Funding for the program is shared by both federal and state governments.
d. The program is heavily regulated.

a. Many physicians do not serve Medicaid patients.

The private medical sector in the US has been heavily regulated by the government mainly because
a. most health care services are in private hands.
b. most people served by the medical establishment are in a position of dependency.
c. the government has an interest in monitoring quality for all Americans.
d. the government finances Medicare and Medicaid.

d. the government finances Medicare and Medicaid.

Physicians and hospitals in the US began consolidating and integrating mainly in response to
a. increased government regulation
b. pressures to contain costs
c. the growth of managed care
d. the demand for higher quality

c. the growth of managed care

E-health has resulted in
a. patient empowerment and a dilution of their dependent role.
b. loss of control by physicians over health care delivery.
c .increased government regulation.
d. increased corporatization of health care delivery.

a. patient empowerment and a dilution of their dependent role.

Which of the following is not true about the passage of the Patient Protection and Affordable Care Act of 2010?
a. Not a single Republican voted for the legislation
b. Most Americans supported the legislation once they found out what was in it
c. The legislation was opposed by the AMA
d. Most US states have adopted the law’s mandates

b. Most Americans supported the legislation once they found out what was in it

In the preindustrial period, Europe was more advanced than the US in medical science.

True

When hospitals first emerged in the United States, they were used primarily by the wealthy.

False

In the preindustrial era, much of the medical care in the US was provided by nonphysicians.

True

As the health care delivery system developed in the US, it emphasized specialization over primary care.

True

As the health care delivery system developed in the US, right from its inception primary care physicians were assigned a gatekeeping role.

False

When bills for compulsory health insurance were introduced in several states, they were opposed by labor unions.

True

When bills for compulsory health insurance were introduced in several states, they were supported by American employers.

False

Middle-class Americans have historically opposed proposals for a national health insurance program.

True

Wage freezes during World War II helped promote employer-based health insurance in the United States.

True

Corporatization of medicine has resulted in delivering the same quality of health care at a lesser cost.

False

Globalization of health care has produced positive effects in both developed and developing countries.

False

The Patient Protection and Affordable Care Act was vehemently opposed by the AMA.

False