CHAPTER 19: POLICYMAKING FOR HEALTH CARE, THE …



CHAPTER 19: POLICYMAKING FOR HEALTH CARE, THE ENVIRONMENT, AND ENERGY

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1. Which of the following statements is TRUE about health care in the United States?

a. The cost of medical care in the U.S. is the highest in the world.

b. Americans spend more money on health care than people in any other nation.

c. The average life expectancy in the U.S. is 78, slightly lower than that in Canada and most other developed nations.

d. The chances of a baby born in the U.S. dying in the first five years of its life are more than 50 percent higher than those of a baby born in Japan.

e. All of these are true.

2. Health care costs account for what portion of America’s gross domestic product?

a. One-seventh

b. One-fifth

c. One-third

d. One-sixth

e. One-fourth

3. American health care costs are projected to be ____ percent of GDP by the year 2019.

a. 5

b. 10

c. 19

d. 25

e. 40

4. Americans spend _____ per year on health care.

a. 1 million

b. 1 billion

c. 1 trillion

d. 2.5 trillion

e. 5 trillion

5. Compared to Western European nations, the United States has a ________ infant mortality rate.

a. higher

b. nearly identical

c. slightly lower

d. significantly lower

e. faster growing

6. Which of the following countries has the highest life expectancy?

a. United States

b. Canada

c. France

d. Germany

e. Japan

7. Which of the following countries provides universal health care for its citizens?

a. Canada

b. France

c. Germany

d. All of the above provide universal health care.

e. None of the above provides universal health care.

8. Which of the following is a reason that American health care expenses are so high when compared to other countries?

a. Americans visit the doctor more often.

b. Americans have longer hospital stays.

c. Doctors practice “offensive medicine” to avoid medical liability.

d. High-tech care is available for previously untreatable conditions.

e. All of the above are contributing reasons.

9. Doctors have no reason to compete with each other to offer cheaper health care expenses because

a. insurance companies and government pay for most health care expenses.

b. the government mandates that everyone receives equal access to health care.

c. technology has made medical care more efficient and less costly.

d. specialization has made competition unnecessary.

e. All of the above are true.

10. Organizations contracted by individuals or insurance companies to provide care for a yearly fee, and that limit the choice of doctors and treatments, are called

a. health maintenance organizations.

b. Medicaid programs.

c. Medicare programs.

d. government insurance providers.

e. Either b or c is correct.

11. Which of the following statements about Americans’ access to health care is FALSE?

a. The most common reason for losing health insurance is losing or changing a job.

b. Older adults are the least insured Americans.

c. Nearly everyone age 65 and older participates in Medicare.

d. The most common reason for lacking health insurance is poverty.

e. Most Americans have some kind of health insurance.

12. Which of the following statements is TRUE of Americans’ access to health care?

a. Twenty-five percent of households with incomes less than $25,000 per year lack health insurance.

b. Family income is not related to health insurance coverage or access to health care.

c. A greater percentage of whites are uninsured, compared to percentages of African Americans and Hispanics.

d. Despite a lack of health care insurance, uninsured Americans are no more likely to be sick, to be at risk for death, or to die in a hospital than are insured Americans.

e. Average life expectancy is lower for whites than it is for African Americans.

13. The U.S. government subsidizes employer-provided health insurance through approximately ____ worth of tax breaks each year.

a. 10 million

b. 100 million

c. 1 billion

d. 171 billion

e. 1 trillion

14. Medicare was adopted in 1965 to provide government health insurance to

a. veterans.

b. government employees.

c. the poor.

d. the elderly.

e. children living in poverty.

15. Medicare is

a. part of the Social Security system.

b. entirely voluntary.

c. compulsory.

d. the name of America’s national health insurance program.

e. provided by the states.

16. Which of the following statements about Medicare is FALSE?

a. Medicare costs are outnumbering contributions to the Medicare Trust Fund.

b. Medicare comprises about 13 percent of the federal budget.

c. Medicare payments cover all costs for Medicare patients.

d. Fewer and fewer doctors are willing to treat Medicare patients.

e. Physicians that treat Medicare patients frequently lose money.

17. What is the difference between Medicare Part A and Medicare Part B?

a. Part A provides hospitalization and short-term nursing care; Part B is voluntary and allows older Americans to purchase inexpensive coverage for doctors’ fees and nonhospital medical expenses.

b. Part A allows older Americans to purchase inexpensive coverage for doctors’ fees and nonhospital medical expenses; Part B provides hospitalization and short-term nursing care.

c. Part A provides health insurance to the elderly; Part B provides health insurance to the poor.

d. Part A provides health insurance to the poor; Part B provides health insurance to the elderly.

e. Part A covers prescription drugs; there is no prescription drug coverage in Part B.

18. Which of the following is the most rapidly increasing component of the federal budget?

a. Social Security

b. Medicare

c. Medicaid

d. Food Stamps

e. CHIP

19. The public assistance program designed to provide health care for poor Americans, funded by both the states and federal government, is called

a. Medicare.

b. Medicaid.

c. Social Security.

d. CHIP.

e. TANF.

20. The program that provides hospitalization insurance for elderly Americans is ___________; the program that provides public assistance for health care for poor Americans is _________.

a. Medicare; Medicaid

b. Medicaid Part A; Medicaid Part B

c. Medicare Part A; Medicare Part B

d. Social Security; Medicaid

e. CHIP; Medicare

21. Who was the first president to articulate a need for a national health insurance plan?

a. Harry S. Truman

b. Richard Nixon

c. John F. Kennedy

d. Bill Clinton

e. Barack Obama

22. Under the Clean Air Act of 1970, who is responsible for reducing auto emissions?

a. The Department of Transportation

b. The Environmental Protection Agency

c. State governments

d. The National Highway Traffic Safety Administration

e. The secretary of Health and Human Services

23. The National Environmental Policy Act, the Clean Air Act, and the Water Pollution Control Act are implemented by the

a. Department of the Interior (DOI).

b. Department of Transportation (DOT).

c. Environmental Protection Agency (EPA).

d. Department of Energy (DOE).

e. President’s National Environmental Council.

24. An environmental impact statement

a. provides consumers with an assessment of the environmental harm caused by corporate goods and services.

b. details a proposed policy’s environmental impact, required of agencies every time they undertake a policy that might be disruptive to the natural environment.

c. sets guidelines about permissible emissions and other environmental impacts for corporations seeking to operate in the U.S.

d. provides a summary of the costs and benefits of protecting endangered species.

e. is a strategy pursued by interest groups, such as the Sierra Club, seeking to influence environmental policy.

25. Which agency is charged with administering much of U.S. environmental policy?

a. The Sierra Club

b. The World Wildlife Fund

c. The Environmental Protection Agency

d. The Superfund

e. The Department of Transportation

26. Responsibility for implementing the Water Pollution Control Act of 1972 rests mostly with

a. the Environmental Protection Agency.

b. the Department of Transportation.

c. Congress.

d. the president.

e. local legislatures.

27. Which of the following is NOT true about the Superfund?

a. Taxes on chemical products are used to pay for it.

b. It has successfully located and isolated the country’s toxic waste dump sites and has completely cleaned more than half of those sites.

c. It was created by Congress in part to respond to the Love Canal disaster in New York State.

d. Its costs represent the fastest-growing segment of the nation’s environmental budget.

e. It is administered by the EPA.

28. Which of the following laws requires agencies to file environmental impact statements?

a. The National Environmental Policy Act

b. The Clean Air Act

c. The Water Pollution Control Act

d. The Endangered Species Act

e. The Superfund

29. The 1970 Clean Air Act

a. charges the Department of Transportation with the responsibility of reducing automobile emissions.

b. charges the Environmental Protection Agency with cleaning up lakes and rivers.

c. commits the Environmental Protection Agency to reducing air pollution.

d. limits the release of CFCs into the atmosphere.

e. prohibits the use of certain pesticides.

30. The Comprehensive Environmental Response, Compensation, and Liability Act is the formal name of the

a. Clean Air Act of 1970.

b. Superfund.

c. 1990 amendments to the Clean Air Act.

d. the endangered species list.

e. the list of animal species that have become extinct.

31. President Bush approved and President Obama later revised a decision to store nuclear waste as which site?

a. Rocky Mountain National Park

b. Yucca Mountain

c. Yellowstone National Park

d. The Grand Teton Mountains

e. Mt. Washington

32. Today, about 98 percent of the nation’s energy comes from

a. coal, oil, and natural gas.

b. coal, oil, and sunlight.

c. coal, sunlight, and wind.

d. oil, sunlight, and wind.

e. oil, natural gas, and sunlight.

33. How much of the nation’s energy sources are renewable?

a. 7 percent

b. 15 percent

c. 25 percent

d. 40 percent

e. 60 percent

34. Approximately _____ of the entire world’s carbon dioxide is produced in the United States.

a. 5 percent

b. 20 percent

c. 40 percent

d. 50 percent

e. 60 percent

35. Which of the following is NOT true of coal?

a. It is the nation’s most abundant fuel.

b. It is responsible for the “black lung” health hazard to coal miners.

c. It accounts for half the energy Americans use.

d. Its use to produce electricity is linked to acid rain.

e. About 90 percent of all of America’s energy resources are in coal deposits.

36. What is the Strategic Petroleum Reserve?

a. A stockpile of oil in underground salt caverns along the Gulf of Mexico, maintained by the Department of Energy, established to provide oil during an emergency

b. The proposed location for storing nuclear waste in the United States

c. A key territory in the oil-rich nation of Iraq that supplies at least 10 percent of the world’s oil supply

d. The name of the international treaty, signed by industrialized countries, promising to reduce greenhouse emissions to 1990 levels by about 2010

e. The fund set up by Congress in 1980 to clean up hazardous waste sites, paid for with money from taxes on chemical products

True/False Questions

1. Americans do not live as long as the average Canadian.

2. The average life expectancy for Americans is 78 years.

3. The changes of a baby born in the United States dying in the first five years of life are more than 50 percent higher than those of a baby born in Japan.

4. The United States spends about 5 percent of its gross domestic product on health care.

5. The United States is the healthiest among all industrialized nations.

6. One reason U.S. health care costs are so high is that Americans make more trips to doctors’ offices than do individuals in other nations.

7. Physicians are mostly insulated from competing with one another to offer less expensive care.

8. More than one-half of Americans participate in health maintenance organizations.

9. More than one-half of Americans get their health insurance through their employers.

10. Age is one of the biggest predictors of being uninsured; the uninsured are disproportionately young.

11. Most individuals over the age of 65 have health insurance.

12. The higher a family’s income, the more likely it is that its members will be insured.

13. The United States has the most thoroughly privatized medical system in the developed world.

14. Despite the fact that insurance is linked to employment in the U.S., the majority of America’s uninsured are full-time workers.

15. Small companies with fewer employees have to pay more for health insurance than do larger companies with many employees.

16. A greater percentage of African Americans lack health insurance when compared to Hispanics; a greater percentage of both African Americans and Hispanics lack health insurance when compared to whites.

17. Lack of health insurance has been estimated to cause tens of thousands of preventable deaths each year.

18. Private industry pays a greater share of the costs of health care than does the federal government in the United States.

19. Medicaid is a program connected to Social Security that provides hospitalization insurance for the elderly and allows them to purchase coverage for other health benefits and fees.

20. Unlike Social Security, in which costs are outrunning contributions, the Medicare Trust Fund has benefitted from several years of greater contributions than expenditures.

21. The AARP is the single largest voluntary association in the world.

22. Medicaid is a public assistance program designed to provide health care for the poor.

23. Only about one-half of those living below the poverty line are eligible for Medicaid.

24. Bill Clinton was the first U.S. president to propose a national health care plan.

25. The health insurance industry opposed Clinton’s health reform plan.

26. A key provision of President Barack Obama’s comprehensive health care reform was a public option that would have provided health insurance to uninsured Americans who could not find affordable coverage; the public option ultimately was not included in the bill passed by Congress.

27. The Department of the Interior is responsible for administering the Clean Air Act.

28. The Environmental Protection Agency is the largest federal independent regulatory agency.

29. Only about 4 percent of the United States is now designated as wilderness.

30. One-half of protected wilderness in the U.S. is in the state of Alaska.

31. The law requiring the federal government to protect endangered species is the Endangered Species Act of 1973.

32. The Superfund was created to clean up the Great Lakes in the 1970s, an effort that has been fairly successful.

33. The Superfund requires that those who pollute are responsible for paying to clean it up.

34. Yucca Mountain in Nevada has been proposed as a potential storage site for nuclear waste.

35. Most scientists agree that, due to global warming, the Earth’s temperature will rise between 2 and 6 percent by the year 2100.

36. There is no technology to control carbon emissions.

37. Oil is America’s most abundant fuel.

38. An estimated 90 percent of the country’s energy resources are in coal deposits.

39. The U.S. imports more than 58 percent of the oil it uses.

40. Renewable energy sources include wind, water, the sun, geothermal sources, hydrogen, and biomass.

41. Environmental groups grew dramatically in the 1960s and 1970s.

42. High-tech issues tend to limit public participation in democracy.

43. Individual citizens are unlikely to have the information or resources to participate meaningfully in high-tech issues.

44. Calls for added environmental protection increase demands on the federal government.

45. Environmental regulation has enlarged the scope of government.

Short Answer Questions

1. What are the primary obstacles to access to health care in the United States?

2. What is Medicare and what are its purposes? What are the differences between Medicare Part A and Medicare Part B?

3. What were President Obama’s health care reform goals? Which did he ultimately achieve with 2010 health care reform?

4. What are the primary challenges in reducing American dependency on oil and other nonrenewable sources of energy?

5. What are the main sources of renewable energy in the U.S.? How much energy do renewable sources provide?

6. What role does the government play in providing health care in the United States? What are Medicare and Medicaid, and why are they significant? To what extent is health care rationed in the United States?

7. Should health care be considered a fundamental right or entitlement of citizenship, as is the case in other democratized and industrialized nations? Why or why not?

8. What are the pros and cons of instituting a national health insurance plan versus using market forces to reform our existing health care system? In what ways did Obama’s health care reform and the legislation eventually passed by Congress address this question?

9. Describe some of the key laws passed by Congress in the past three decades to protect the environment. How effective have these laws been? What is the significance of the environmental impact statement requirement? Explain.

10. Explain the role of interest groups in shaping environmental policy in the United States. Do environmental groups exercise too much power over policymaking?

11. What are the potential benefits and the environmental challenges at stake when it comes to nuclear energy? Is nuclear energy a solution to U.S. energy needs?

12. If environmental, energy, and health care policy involve increasingly complex and technological issues, can ordinary American citizens be expected to have the requisite knowledge for reasonable and meaningful participation in policy debates? How ought Americans be included in the policymaking process in these areas?

13. According to your text, health care is the single most important policy difference between the United States and other industrialized democracies. In what ways does this difference matter to public participation, citizenship, and the scope of government in the U.S. vis a vis other industrialized democracies?

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