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Chapter 15 – Economic Issues

Multiple Choice

1. There are a number of different models of health care. Which model does the Russian health care system
follow?
a. national health systems model
b. public insurance model
c. entrepreneurial model
d. financing systems model
ANSWER: a

2. In Canada, almost all people are insured against the cost of hospital and physician expenses through a
government health insurance program. What is this type of health care financing commonly called?
a. fee for service
b. out-of-pocket expenses
c. universal health insurance
d. voluntary or private insurance
ANSWER: c

3. What is one of the ethical problems associated with the traditional fee-for-service system that medicine is
predominantly driven by?
a. overutilization
b. privatization
c. privileges
d. opportunities
ANSWER: a

4. Which of the following health care financing systems has a strong focus on the principle of autonomy?
a. fee for service
b. managed care
c. universal health insurance
d. single payer systems
ANSWER: a

5. Three patients arrive at a health care facility in a remote northern area of Canada. All have serious injuries,
but there is only enough room on a small plane for one patient. The nurse in charge of the facility asks, “Who
needs access to specialties the most?” What does this scenario suggest?
a. The nurse is using a material rule of distributive justice to make the decision.
b. Decisions about how to distribute scarce medical resources are unpredictable.
c. The nurse should collaborate with the physician when this type of decision is made.
d. There are no rules regulating distribution of scarce medical resources in this facility.
ANSWER: a

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Chapter 15 – Economic Issues

6. What is the term for an out-of-pocket payment that some provinces still require?
a. fee for service
b. premium
c. allied service fee
d. voluntary health fee
ANSWER: b

7. How does the Canada Health Act describe Canadian health care?
a. as a constitutional right
b. as facilitating reasonable access to health services
c. as the protection of basic needs, including a right to the protection of health
d. as treating health care as a commodity, not a right
ANSWER: b

8. From a Constitutional perspective, what complicates the discussion of a Canadian’s entitlement to health
care?
a. The provinces and territories have very different perspectives based on different populations.
b. It is difficult to support from a financial perspective justice for all.
c. There is nothing in the Charter of Rights and Freedoms that describes health care as a right.
d. Health care is designated as a privilege in the Charter of Rights and Freedoms.
ANSWER: c

9. An elderly patient who suffered a knee injury following a fall and who has severe degenerative disease in her
knee is denied an arthroscopy. The orthopedic surgeon does not feel, given her age and severity of disease, that
the procedure will help. What is this an example of?
a. a judgement based on age
b. a judgement based on severity of injury
c. a judgement based the availability of services
d. a judgement based on usefulness of therapy
ANSWER: d

10. Which ethical theories of justice are based on the concept that it is good to maximize the greatest good for
the greatest number of people?
a. libertarian theories
b. utilitarian theories
c. deontological theories
d. communitarian theories
ANSWER: b

11. John Rawls suggested that in making decisions of distributive justice, one should examine the situation
behind a “veil of ignorance” so that no one would be able to design principles to favour his or her own
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Chapter 15 – Economic Issues

particular condition. This idea supports a political philosophy of which Rawls was a proponent. What is that
political philosophy called?
a. utilitarianism
b. communitarianism
c. egalitarianism
d. libertarianism
ANSWER: c

12. The economics of Country A support the rights of property and liberty for each person and allow each
citizen to improve life circumstances by his or her own effort. Health care can be purchased or given freely in
Country A, but there is no entitlement program to ensure basic health care for vulnerable people. Which of the
following best describes this type of economic structure?
a. Marxism
b. communitarianism
c. democracy
d. libertarianism
ANSWER: d

13. What is a natural consequence of utilitarian forms of health care financing?

a. Resources and services will be distributed equally.
b. Some people will not receive resources and services.
c. The people with the greatest need will receive the bulk of resources and services.
d. People who have greater personal resources will receive greater benefit.
ANSWER: b

14. Which of the following can recent trends in Canadian health policy in areas concerning reform be related to?
a. changing values and stronger trade relationships with the United States
b. increased efficiency based on private market entrepreneurialism
c. not enough accountability on the part of the government
d. reduced transfer payments to the provinces and territories
ANSWER: a

15. Which of the following health care financing systems would be described this way: “A health care system
willing to be held accountable both clinically and financially for the health outcomes of an enrolled population
for a capitated (fixed) payment.”
a. fee for service
b. universal health care
c. categorical financing
d. managed care
ANSWER: d

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Chapter 15 – Economic Issues

16. According to the Romanow Commission Report, which of the following is a challenge to the health care
system?
a. guaranteed reasonable access to care
b. resources not being used optimally
c. decisions being made by physicians
d. considerations of how rationing should occur
ANSWER: b

17. Which of the following is an example of the element of privatization in Canadian health care?
a. a national “drug agency” to oversee and monitor pharmaceutical activity
b. laundry services outsourced to private companies
c. integration between “pharmacare” and Medicare
d. national platform for home care
ANSWER: b

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