Healthcare Policy and Economics (D223)

Correct Answer

A. Compassionate Care

Explanation

Compassionate care is the principle that emphasizes treating patients with respect, empathy, and understanding. This principle ensures that patients feel valued and cared for, which is essential for their overall well-being and experience at PeaceHealth. It involves more than just providing medical treatment; it focuses on fostering emotional support and addressing the human aspects of patient care.

Why other options are wrong

B. Community Outreach

Community outreach focuses on engaging with the community and providing health education, resources, and services to those in need. While it is an important principle, it is not specifically about treating patients with respect and empathy in the direct care setting, as compassionate care is.

C. Technological Advancement

Technological advancement refers to the use of new technologies to improve healthcare services, but it does not directly address the emotional and respectful treatment of patients. While technology plays a significant role in modern healthcare, compassionate care is focused on the human aspects of patient treatment.

D. Financial Efficiency

Financial efficiency involves managing resources and costs effectively to ensure the hospital operates sustainably. While important for the overall operation, it does not prioritize treating patients with respect and empathy, which is the focus of compassionate care.

Correct Answer

C. She was born there and gave birth to her children there.

Explanation

Isabella Taylor’s significant personal experience at PeaceHealth Southwest was deeply connected to her own life events—she was born there and later gave birth to her children at the same hospital. This connection creates a meaningful bond with the hospital and highlights its role in her family's life. This type of experience is unique and personal compared to other potential connections like volunteering or working there.

Why other options are wrong

A. She had a family member treated there.

While having a family member treated at a hospital can be a significant experience, it does not necessarily create the same level of deep personal connection as being born and giving birth there. This option lacks the direct, lifelong tie that makes the correct answer more meaningful.

B. She volunteered there during her studies.

Volunteering is a valuable experience, but it is not as personally significant as being born in a hospital and later having children there. Volunteering is typically a temporary engagement rather than a lifelong connection.

D. She worked there as a doctor.

Working as a doctor is a professional experience rather than a personal one. While it may be meaningful, it does not compare to the deeply personal nature of birth and childbirth, which establish a generational connection to the hospital.

Correct Answer

A. It incentivized employers to offer more health benefits to attract workers

Explanation

The exclusion of fringe benefits, including health insurance, from taxable income created a tax advantage for employers who offered health benefits to their employees. This tax benefit made it financially advantageous for employers to provide health insurance, which in turn led to an increase in employer-based healthcare offerings. Employers could attract and retain workers by providing health benefits without having to pay additional taxes.

Why other options are wrong

B. It led to a decrease in overall healthcare spending

This is incorrect because employer-based healthcare, in fact, did not decrease overall healthcare spending. It often led to more widespread access to healthcare, but it did not directly reduce the costs of healthcare. In many cases, healthcare spending increased due to higher insurance premiums.

C. It resulted in higher taxes for employees

This is not true. The exclusion of fringe benefits from taxable income actually reduced the taxable income of employees who received employer-provided health benefits, potentially lowering their overall tax burden.

D. It caused a shift towards individual health insurance plans

This is incorrect. The exclusion of fringe benefits led to an increase in employer-based health insurance, not individual health insurance. It made employer-sponsored insurance more attractive and widespread, making individual health insurance plans less common for many workers.

Correct Answer

D. Patients are required to pay all healthcare costs upfront and seek reimbursement later.

Explanation

Indemnity health insurance, also known as traditional or fee-for-service insurance, typically requires patients to pay for healthcare costs out of pocket at the time of service. Afterward, patients submit claims to the insurance company for reimbursement based on the terms of their policy. This system allows for more flexibility in choosing healthcare providers but also places the burden of payment on the patient initially.

Why other options are wrong

A. The insurance company directly pays the patient for all healthcare costs incurred.

This is incorrect because, in indemnity plans, the insurance company reimburses the patient after the patient has paid for the healthcare services, not directly paying the patient upfront.

B. The employer pays the insurance company a fixed premium regardless of claims.

This description aligns more with group health insurance plans where the employer pays a fixed premium, but it is not specific to indemnity plans, which are structured around reimbursement for services rendered rather than a fixed premium arrangement.

C. The insurance company acts as an administrator, processing claims and passing costs onto the employer.

This describes a self-insured employer plan where the employer takes on the financial risk of providing health insurance, not an indemnity plan. In indemnity plans, the insurance company assumes the financial responsibility for claims rather than simply acting as an administrator.

Correct Answer

B. It can cause a delay in medical treatment

Explanation

One potential negative impact of the law on minors is that it can cause a delay in medical treatment. The requirement to obtain parental consent before treatment can sometimes result in delays, particularly if the parent is unavailable or if the consent process takes time to complete. This delay could potentially worsen the minor's health condition or create unnecessary stress for both the child and the healthcare provider.

Why other options are wrong

A. It guarantees immediate treatment for all minors

This is incorrect because the law does not guarantee immediate treatment for minors. In most cases, consent must be obtained before treatment can proceed, which can lead to delays in care, as mentioned in the correct answer.

C. It allows minors to make decisions independently

This is incorrect because, in most jurisdictions, minors do not have the legal capacity to make medical decisions independently. The law requires that a parent or guardian provide consent, not the minor themselves, except in specific situations such as mature minor laws or emergency care.

D. It prevents parents from being involved in care

This is incorrect because the law actually ensures that parents are involved in the care of their minor children. In most cases, parental consent is a requirement, and parents are typically involved in decisions regarding their child's medical treatment.

Correct Answer

B. Written authorization from the patient

Explanation

The California Confidentiality of Medical Information Act (CMIA) requires written authorization from the patient before releasing any patient information. This law ensures that patient privacy is protected, and healthcare providers must obtain explicit, written consent from the patient for the release of their medical information to third parties, unless an exception applies under the law.

Why other options are wrong

A. Authorization from a family member is sufficient

This is incorrect because authorization from a family member alone is not sufficient. The law requires that the patient themselves give written authorization unless there is a legal exception that allows family members to give consent.

C. Verbal authorization from the patient

This is incorrect because verbal authorization is not sufficient under the CMIA. The law mandates written consent for the release of medical information to ensure there is a clear, documented record of the patient’s permission.

D. No authorization is needed

This is incorrect because the CMIA specifically requires authorization before releasing patient information. Exceptions to this rule exist, but in general, patient information cannot be disclosed without written authorization.

Correct Answer

D. Civil and criminal penalties

Explanation

Violating the Confidentiality of Medical Information Act (CMIA) can lead to both civil and criminal penalties. Civil penalties may involve fines, while criminal penalties can result in more severe consequences, including imprisonment, depending on the nature of the violation. These penalties serve to protect patient confidentiality in the healthcare system.

Why other options are wrong

A. Only verbal warnings

Violating CMIA does not result in only verbal warnings. Given the importance of maintaining patient confidentiality, violations can lead to serious legal and financial consequences, including fines and possible jail time, not just warnings.

B. Only civil penalties

While civil penalties are a possible consequence, CMIA violations can also lead to criminal penalties. The law includes provisions for both civil fines and criminal sanctions to ensure strict enforcement of patient confidentiality.

C. No penalties at all

This is incorrect. There are well-defined penalties for violations of CMIA, including both civil and criminal consequences. This ensures that healthcare organizations and providers are held accountable for protecting patient information.

Correct Answer

C. Third party administrators

Explanation

Third-party administrators (TPAs) are commonly hired by self-insured companies to manage the claims process, enrollment, and other administrative functions of self-insured health plans. These firms handle day-to-day operations on behalf of the self-insured entity, ensuring that claims are processed and paid correctly.

Why other options are wrong

A. Secondary administrators

Secondary administrators do not typically refer to firms that manage self-insured health plans. This term is not commonly used in the context of insurance administration.

B. Reinsurers

Reinsurers are companies that provide insurance to insurance companies, allowing them to manage risk. They do not administer self-insured plans, but rather provide financial protection against large losses.

D. Secondary insurers

Secondary insurers are not typically involved in the administration of self-insured plans. Secondary insurance refers to a policy that covers additional costs after the primary insurance has been paid, and they are not responsible for plan administration.

Correct Answer

B. They may face a misdemeanor charge

Explanation

Treating a minor without obtaining proper consent can lead to legal consequences, including potential misdemeanor charges. Healthcare providers are required by law to obtain consent from a parent or legal guardian before treating a minor. Failure to do so could result in legal action, including criminal charges depending on the jurisdiction and the circumstances.

Why other options are wrong

A. They will receive a warning only

A warning is not sufficient for treating a minor without consent, as this is a violation of legal requirements. Providers can face more severe consequences, such as legal charges, rather than just a warning.

C. They can continue treating without consequences

Treating a minor without consent carries legal risks, and providers cannot continue treatment without consequences. Failure to obtain proper consent may result in serious legal issues, including criminal charges.

D. They will be fined but not charged

While fines could be part of the penalty, the potential legal consequence for treating a minor without consent often includes criminal charges such as a misdemeanor. A fine alone does not address the seriousness of this violation.