Final_2021
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PAM 2350 Final Exam
December 12, 2021
There are 100 points on the exam.
The point value for each question is in [brackets].
If you need
more space to answer a question, please ask for a white book and label your question carefully in
the white book.
You have 2.5 hours to complete the exam.
I. True/False: CIRCLE the correct answer [3 points each, for a total of 9]
1)
True
False
In her book, Vivian Lee argues that the number of people who die each
year in a hospital due to a medical error is higher than what is estimated by the
Institute of Medicine.
II. Multiple Choice: CIRCLE the correct answer [3 points each, for a total of 9]
2) Why hasn’t the Independent Payment Advisory Board (IPAB) met yet?
a.
The Supreme Court ruled it unconstitutional in 2012
b.
Congress repealed it
c.
Medicare expenses are projected to grow sufficiently slowly such that the IPAB has not
yet been required to meet
3) Which of the following could be a reason(s) why the Food and Drug Administration (FDA)
might reject a new prescription drug application?
a.
The company plans to charge a price that would result in an incremental cost
effectiveness ratio of over $100,000 per quality adjusted life year (QALY).
b.
The company still has a full 20 years left before its patent will expire, which will delay
generic entry for a substantial amount of time.
c.
Although the drug does improve health, it also has substantial side effects or safety
concerns.
d.
All of the above
4)
Canada, Germany, and Japan provide health insurance to all citizens and spend much less on
medical care than the United States. What can you conclude from this association?
a.
Countries that provide health insurance to all citizens tend to institute other policies that
substantially reduce medical spending
b.
Providing health insurance to people causes their medical spending to decrease
c.
Both of the above
5) 90% of the dispensed prescriptions in the US are generic drugs for the following reason(s):
d.
Health insurers provide financial incentives for enrollees/patients to use generic drugs
e.
In most states pharmacists are required to dispense a generic drug if it is available
f.
For both of the reasons presented in this question
6) Consider a state that passes a malpractice policy that caps damages for the patient’s pain and
suffering at $250,000. This policy would be expected to have the following effect:
a.
Reduce medical malpractice lawsuits filed and increase medical spending in the state
b.
Reduce the number of malpractice lawsuits filed and reduce medical spending in the
state.
c.
Cause malpractice premiums to be experience-rated
III. Short Answer [12 points each except for Questions #8 and #10, which are worth 11
points each]
Feel free to use bullet points and/or incomplete sentences in this section.
7) Consider a situation where Congress allows the U.S. to import prescription drugs from Canada.
Describe 1 way that this could help the U.S. health care system; 1 way this could harm the U.S.
health care system; and 1 way this could harm the Canadian health care system.
8) The U.S. government allows nonprofit hospitals to avoid paying taxes because they expect
those hospitals to provide substantial benefits to their local communities.
Provide one bit of
evidence to indicate that nonprofit hospitals are fulfilling
this obligation, and one bit of evidence
that nonprofit hospitals are failing to fulfill
this obligation.
9) The Institute of Medicine identified 4 reasons why the quality of medical care in the U.S. is not
as good as it should be, given how much we spend on medical care.
Describe 2
policies that have
been effective at addressing these problems, and why
they have been effective.
And describe how
1 of these policies has had an unintended negative effect on the health care system.
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10) Describe 2 ways that the Affordable Care Act is reducing or could reduce health disparities by
improving the health of black people and Hispanic people more than white people.
Make sure to
explain the mechanism
for how the ACA is (or could) improving health, and why
black and
Hispanic people are, or are likely to, benefit more
than white people via that mechanism.
11) Provide evidence to support or refute the 3 underlined
parts of the following statement: “The
malpractice crisis in the United States has been concentrated to certain physician specialties
, to
certain geographic locations
, and to certain time periods
.”
12) Evaluate the following statement: “The new policies/taxes/fines that pay for or finance the
Affordable Care Act (or used to) borrow heavily from policies/programs that Canada, the United
Kingdom, Germany, and/or Japan use.
The three new policies/programs that were or are in the
ACA to reduce the long-term
growth rate of medical spending, on the other hand, are different
from what these four countries use.”
Do you agree or disagree with this statement?
Support your
argument by referring to 1
specific policy/tax/fine that pays for or used to pay for the ACA; and
all 3
specific long-term cost-control policies/programs in the ACA.
You can refer to a different
country or the same country in each of your responses (one country per ACA
policy/tax/fine/program is fine).
13) Consider the health care reform policy proposed by David Goldhill (published in
The
Atlantic
) that we discussed on the final day of class.
How does Goldhill’s proposed policy
attempt to improve access
to medical care; improve the quality
of care; and slow down the
growth rate of medical spending
?
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