Problem 1. How does health insurance risk differ from other types of insurance risk (e.g., automobile or homeowners insurance)?
Problem 2. Is retiree health insurance likely to become increasingly important as the baby boomer population reaches retirement age? Why or why not?
Problem 3. What is the difference between cost sharing and cost shifting?
Problem 4. Even though the Medicaid program is included in the discussion of social insurance programs, it is not a true insurance program. Explain how Medicaid differs from a health insurance program.
Problem 5. The total expenditure for health services in 2007 was 83 times the total expenditure in 1960, increasing from $26.9 billion to $2.2 trillion. What factors account for this increase? How much did each factor contribute to this increase?
Problem 6: Exhibit shows that the sources of financing for select services vary considerably. What services are supported in large part by private health insurance? By the federal government? By out-of-pocket expenditures? What do these funding sources suggest about the population utilizing these services? About other population or system factors?
Problem 7. Health expenditures in 2007 totaled $2.2 trillion and absorbed 16.2 percent of the gross domestic product. Should we be concerned about the amount of the gross domestic product that is absorbed by the health sector? Why or why not?
Problem 8. Discuss some of the key initiatives to contain or control or reduce health expenditures in recent years. How successful has each initiative been? What factors influenced the success (or failure) of each initiative?
Problem 9. The ability to accurately predict the number of needed healthcare workers, train the required workforce, and ensure appropriate distribution are not hallmarks of the U.S. system. What are some reasons for the difficulty of these tasks? How and to what extent does a market economy influence the supply of healthcare workers?
Problem 10. How would the physician workforce be affected if the Medicare program changed or eliminated its payment of GME expenses? What would be the effect of charging tuition for residency training, as some countries (e.g.,Canada) are doing or proposing to do?
Problem 11. To what extent should the government (federal and state) be involved in the training of the healthcare work force? Are there other professions that receive a comparable amount of training support from the government?
Problem 12. The number of short-stay, nonfederal hospitals in the United States reached a high of more than 6,300 in the early 1970s and has since decreased to slightly more than 5,747 as of 2006. What accounts for this reduction? What are some of the potential effects of this reduction on patient access?
Problem 13. A decade ago, one might have heard reports of the occasional hospital that refused to take Medicare or Medicaid patients because their payments were too much smaller than those of privately insured patients. To what extent do you think hospitals might refuse to accept Medicare and Medicaid patients? What are some reasons hospitals would not refuse such patients?
Problem 14. Discuss some of the differences between not-for-profit and proprietary hospitals, including the types of patients who utilize them, hospital financing, financial viability, and anticipated future direction.
Problem 15. The federal government is a major financier of biomedical research. Congress continues to increase the NIH budget when most other health related federal budgets are declining. Suggestions have been made to target some funds to major initiativesâ?"for example, to renew the War on Cancer, attack Alzheimer's disease, annihilate AIDS, or demolish diabetes. What, in your view, is the appropriate governmental role regarding biomedical research? Why isn't it a private sector responsibility, as was proposed during the Reagan administration? (Reagan proposed the privatization of NIH.)
Problem 16. If the randomized clinical trial (RCT) is the gold standard for assessing new technologies, why isn't it universally required before a new technology is disseminated?
Problem 17. The regular increase in health expenditures has been attributed, in some part, to the development and utilization of new technologies. Compared to other factors that influence expenditure growth, how significant is the technology factor? What efforts have been made to control the use of technologies and limit their effect on expenditure growth?