Which best describes how the federal government determines which projects are awarded special funding for health care?

Correct Answer: A

Rationale: The correct answer is A) Those that are consistent with societal priorities, such as Healthy People 2020. This is because federal funding for health care projects is typically aligned with overarching national health objectives and priorities. Healthy People 2020 is a set of national health goals and objectives established by the federal government to guide health promotion and disease prevention efforts in the United States. Projects that align with these priorities are more likely to receive special funding as they contribute to the larger health improvement goals of the country. Option B) Those that are supported by legislators, may not always reflect the broader societal health priorities and could be influenced by political motivations rather than public health needs. Option C) Those that are written by health care organizations that have special needs, might focus on specific organizational interests rather than addressing the larger population health needs. Option D) Those that are consistent with the state's long-term health goals, while important at the state level, may not always align with the national health priorities set forth by initiatives like Healthy People 2020. Educationally, it is important for students to understand the process by which federal funding for health care projects is allocated and the significance of aligning with national health priorities. This knowledge helps future healthcare professionals and policymakers make informed decisions and advocate for projects that contribute to improving the overall health of the population. Understanding the role of initiatives like Healthy People 2020 in shaping health policy can lead to more effective and impactful interventions in the healthcare system.

Correct Answer: B

Rationale: In an effort to compete with HMOs, physicians and hospitals organized the independent practice model, which provided services to enrollees of one insurance company. This model evolved into the PPO, which offered services at a reduced rate in exchange for a guaranteed increase in consumers. Physicians did not become directly employed by insurance companies, set up private practices with colleagues, or decide to strike in order to compete with the HMOs.

Correct Answer: A

Rationale: Hospitals developed cost shifting to supplement losses caused by Medicare funding. Because private insurance reimbursements were cost based, hospitals included the loss in their total costs; therefore private insurance paid for covering care to both their enrollees and Medicare patients. The implementation of DRGs did not cause hospitals to decrease nursing staff, lobby politicians to increase Medicare reimbursement, or refuse to accept Medicare patients.

Correct Answer: D

Rationale: As a reward for conservative medical practices, health care providers may receive a specified amount of money or a percentage of the agreed reimbursement if services are delivered below the limit set by the third-party payer. Thus, it is the responsibility of the provider to use this conservative practice. Patient care should not be compromised as providers practice conservatively.

Correct Answer: D

Rationale: The correct answer is D) President Theodore Roosevelt advocated such national medical coverage in 1916. This is the right answer because it aligns with the historical context of the early 20th century when the idea of national health care insurance was first debated in the United States. Option A) is incorrect as Clinton's attempt in 1992 came much later and was not the first instance of such debate. Option B) is incorrect because Medicare and Medicaid were instituted in the 1960s, which is also after Theodore Roosevelt's initial advocacy. Option C) is incorrect as President Franklin Roosevelt's attempt in the 1930s was also subsequent to Theodore Roosevelt's proposal in 1916. From an educational perspective, understanding the historical timeline of debates and attempts at national health care insurance in the United States is crucial for students to comprehend the evolution of healthcare policy. Knowing that the idea was first advocated by President Theodore Roosevelt in 1916 provides a foundational understanding of the long-standing discussions and efforts to address the healthcare needs of the country. This knowledge can help students appreciate the complexities of healthcare policy development and the factors that have shaped the current healthcare system in the U.S.