Chapter 1: Health Care of the Past, Present, and Future
Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

MULTIPLE CHOICE

Read the following questions carefully and choose the best answer for each question.

	1.	All of the following are true of health care of the past except:
a.	Health needs were met by a specific group.	
b.	Some remedies are still used today.	
c.	Herbs were used for medication.	
d.	All treatments were harmful in some way.	
e.	Plants were used for medication.	

ANS:	C
Ancient treatments were harmful in some cases and helpful in others.

DIF:	Knowledge	REF:	page 3

	2.	Agencies of accreditation:
a.	Train health care providers	
b.	Test nurses for competency	
c.	Determine whether a training program meets acceptable standards	
d.	Offer advanced skills courses to keep medical workers abreast of current research	
e.	Set standards to ensure quality services	

ANS:	C
Agencies of accreditation have been established to determine whether a training program meets acceptable standards.

DIF:	Knowledge	REF:	page 12

	3.	All of the following are true of diagnosis-related groupings (DRGs) except:
a.	They greatly affect the health care industry.	
b.	They lengthen the time allowed for treatment.	
c.	They provide a diagnosis to Medicare.	
d.	They were established in 1984.	
e.	They allow Medicare to reimburse for services based on the diagnosis versus the actual cost.	

ANS:	B
DRGs shorten the time allowed for treatment.

DIF:	Knowledge	REF:	page 6

	4.	Those who choose a career in the health field seek:
a.	Economic security	
b.	Good working conditions	
c.	Opportunities for advancement	
d.	Set working hours	
e.	a, b, and c	

ANS:	E
Individuals who choose a career in the health care field seek economic security, good working conditions, and opportunities for advancement, but not set working hours.

DIF:	Comprehension		REF:	page 9

	5.	Advancement in health care careers is usually based on all of the following except:
a.	Training	
b.	Experience	
c.	Education	
d.	Accreditation	

ANS:	D
Advancement in health careers usually is based on additional experience, education, and training. Accreditation is the official authorization or approval of a training program, not a person.

DIF:	Knowledge	REF:	page 9

	6.	All of the following may practice independently without supervision except:
a.	A midwife	
b.	A doctor	
c.	A physician assistant	
d.	A nurse practitioner	

ANS:	C
A physician assistant must work under the supervision of a physician.

DIF:	Knowledge	REF:	page 9

	7.	Health care in the United States is influenced by all of the following except:
a.	The state of the economy	
b.	The values of society	
c.	The law of supply and demand	
d.	Health career ladders	
e.	Technological developments	

ANS:	D
Health care in the United States is influenced by the state of the economy, the values of society, the law of supply and demand, and technological developments. Health career advancement is achieved by completing courses or programs for a specific health care field or health career ladder.

DIF:	Knowledge	REF:	page 9

	8.	To reduce health care costs, larger hospitals have been known to do all of the following except:
a.	Become large corporate facilities	
b.	Form partnerships with physicians for services	
c.	Buy out smaller hospitals	
d.	Discharge patients earlier	
e.	Refuse care for clients with conditions or diagnoses for which treatment is not financially profitable	

ANS:	E
Hospitals are meeting the challenge of increased cost by becoming large corporate facilities and forming partnerships with physicians for services such as extended care. Many smaller hospitals have been forced to close or sell to larger corporations.

DIF:	Knowledge	REF:	page 12

	9.	Care of the elderly is an area of focus for all the following reasons except:
a.	The population of the United States continues to age and live longer.	
b.	Fewer children are born each year.	
c.	Of the U.S. population, 20% will be older than 65 years of age by 2030.	
d.	The elderly require 10 times the amount of health care as younger groups.	
e.	Many older people have at least one chronic disease.	

ANS:	D
The elderly require three times the amount of health care as younger groups.

DIF:	Knowledge	REF:	page 12

	10.	All of the following reflect correct information on medical milestones except:
a.	1893—Aspirin is developed.	
b.	1928—Sir Alexander Fleming discovers penicillin.	
c.	1986—AIDS is identified as a disease.	
d.	1967—The first hospice is founded in England.	
e.	1994—Scientists in Boston devise an eye examination to detect Alzheimer’s disease.	

ANS:	C
AIDS was identified as a disease in 1981.

DIF:	Knowledge	REF:	page 3

	11.	The correct term for HIPAA is which of the following:
a.	Health Insurance Practice Association of America	
b.	Health Insurance Program and Accountability Action	
c.	Health Insurance Programs of Alabama and Arkansas	
d.	Health Insurance Portability and Accountability Act	

ANS:	D
HIPAA is the acronym for the Health Insurance Portability and Accountability Act, which was passed in 1996 to allow employed individuals to maintain insurance coverage if they lose or change jobs.

DIF:	Knowledge	REF:	page 9

	12.	All of the following are true of Medicare except:
a.	It is a health program for individuals 65 or older.	
b.	It is a state health program.	
c.	It is a health program for certain younger people with disabilities.	
d.	It is a health program for people with ESRD.	

ANS:	B
Medicare is a federal health program.

DIF:	Knowledge	REF:	page 6

COMPLETION

	1.	____________________ is considered the father of modern medicine.

ANS:	Hippocrates

REF:	page 3

	2.	The development of alternative therapies in some cases may lead to an increase in the incidence of ____________________.

ANS:	Quackery

REF:	page 13

	3.	A health professional who acquires ____________________ has attained the legal authority to perform an activity.

ANS:	Licensure

REF:	page 12

	4.	Malpractice suits often involve lengthy ____________________.

ANS:	Litigation

REF:	page 6

	5.	Agencies of ____________________ determine whether a training program meets acceptable standards.

ANS:	Accreditation

REF:	page 12

	6.	The ____________________ currently provides research money for unconventional therapies through the Office of Alternative Medicine.

ANS:	NIH

REF:	page 13

	7.	The ____________________ allows the FDA to release some drugs early to meet the needs of the ill when other medications have not been developed for the disease.

ANS:	Orphan Drug Act

REF:	page 9

	8.	Upon successful completion of a particular course, individuals may attain ____________________ in a particular area.

ANS:	Certification

REF:	page 12

	9.	____________________ may be earned through the state or an agency.

ANS:	Registration

REF:	page 12

	10.	A third-party payer or ____________________ company assumes most health care costs.

ANS:	Insurance

REF:	page 6

MATCHING

Match the numbered word below with the best definition.

a.	An epidemic that spreads over a wide geographical area, affecting a large part of the population	
b.	Payment in advance for services that may or may not be needed	
c.	Provides surgical, diagnostic, and ambulatory care	
d.	Provides care through federal, state, and local agencies for those who cannot pay; provides preventive health care for the entire population	
e.	Places a strong emphasis on individual dignity and self-determination	
f.	Provides personal care for the elderly and extended convalescent care	
g.	An occupation that requires special training	
h.	A disease that causes a high rate of death or mortality	
i.	Assists the professional	
j.	An official record of individuals qualified to perform certain services	
k.	Provides research, education, and support for special concerns; funded by donations and grants	
l.	Provides health services at group rates	

	1.	Profession

	2.	Plague

	3.	Insurance

	4.	Voluntary organization

	5.	Long-term care center

	6.	Health maintenance

	7.	Registration

	8.	Paraprofessional

	9.	Outpatient care facility

	10.	Public health care

	11.	Pandemic

	12.	Nursing Home Reform Law

	1.	ANS:	G	REF:	page 5

	2.	ANS:	H	REF:	page 5

	3.	ANS:	B	REF:	page 8

	4.	ANS:	K	REF:	page 5

	5.	ANS:	F	REF:	page 6

	6.	ANS:	L	REF:	page 6

	7.	ANS:	J	REF:	page 12

	8.	ANS:	I	REF:	page 9

	9.	ANS:	C	REF:	page 6

	10.	ANS:	D	REF:	page 6

	11.	ANS:	A	REF:	page 5

	12.	ANS:	E	REF:	page 12

SHORT ANSWER

Using two or three sentences, answer the following questions as concisely as possible.

	1.	Explain the education requirements for the following careers in health care:
a. Aide
b. Assistant
c. Technician
d. Technologist
e. Professional

ANS:	
An aide must have on-the-job training; an assistant may have up to 1 year of classroom and clinical preparation; a technician must complete a 2-year community college or vocational training program; a technologist must complete a 3- to 4-year college program; and a professional must complete a 4-year degree, advanced degree, and clinical training program.

	2.	When was the Public Health Services division established, what is its purpose, and how has this purpose evolved since the agency’s inception?

ANS:	
The Public Health Services division was established in 1798 to provide care for American merchant seamen. The division has expanded to cover many other facets of health care. It is part of the Department of Labor, which also regulates health concerns through the Occupational Safety and Health Administration.

	3.	What are the two main reasons for rising health care costs?

ANS:	
Rising health care costs may be attributed to advanced technological developments and an increase in malpractice litigation.

	4.	Explain how wellness services relate to the health care of the future.

ANS:	
Health care of the future will continue to emphasize wellness and prevention instead of cure. Wellness services include nutritional advice, stress reduction counseling, habit cessation management, and exercise instruction.

	5.	How might technology affect health care?

ANS:	
The impact of technology can only be imagined for the future. Inventions in nanotechnology and telemedicine currently have an impact on medical practice. Recombinant DNA techniques will allow new types of gene therapy and fetal stem cell research. Although technology will enable health care to move forward, it will also stimulate controversy in areas such as stem cell research and cloning.

	6.	What are the four factors that influence the health care industry?

ANS:	
The four factors that influence health care are (1) the state of the economy, (2) the values of society, (3) the law of supply and demand, and (4) technological developments.

	7.	How does the Hippocratic oath conflict with the idea of euthanasia?

ANS:	
The Hippocratic oath states, “I will give no deadly medicine to anyone who asks, nor suggest any counsel.” However, the idea of euthanasia is to administer medicine to end a life when quality diminishes and pain persists.

	8.	Explain the purpose of the Food and Drug Administration.

ANS:	
The Food and Drug Administration regulates the safety of food, cosmetics, pharmaceutical and biological products, and medical devices.

	9.	Compare a general hospital’s services with those of a specialty hospital.

ANS:	
A general hospital provides short-term care, acute care, and diagnostic and rehabilitation services as either a profit or nonprofit facility and may or may not be a teaching institution. A specialty hospital provides treatment for a specific condition such as tuberculosis, mental health disorders, or rehabilitation services.

	10.	Delineate the differences between home health care and hospice care.

ANS:	
Home health care provides care in the home of the patient and may be publicly or privately owned, whereas hospice care provides medical and psychological care for the terminally ill, either in the home or at a hospice facility; it may be private or part of another facility.

	11.	Describe the main differences between Medicare and Medicaid.

ANS:	
Medicare is a federal health program for individuals age 65 or older, certain younger people with disabilities, and individuals with end-stage renal disease (ESRD). Medicaid is a joint program supported by both the federal and state governments. It helps provide coverage for individuals with low and limited resources.

ESSAY

Write a well-developed essay in response to the following statements.

	1.	Compare and contrast the role of the patient in the health care industry in the past and in the present.

ANS:	
Answers may vary.

	2.	Explain the primary influences on health care in the United States and the effects these influences have on the health of American citizens.

ANS:	
Answers may vary.

	3.	What effects do the Centers for Disease Control and Prevention and the National Institutes of Health have on the health industry?

ANS:	
Answers may vary.

	4.	A health care facility’s structure includes four areas: therapeutic, diagnostic, informational, and environmental. Explain the elements of each area and how each might influence patient care.

ANS:	
Answers may vary.

	5.	Explain how malpractice insurance costs affect the way some physicians and pharmaceutical companies operate and analyze the effects of these changes on health care.

ANS:	
Answers may vary.

Choose a project below and complete an investigation in response to each premise you discover.

	6.	What is the purpose of the Patients’ Bill of Rights and how might it affect the hospital in positive and negative ways?

ANS:	
Answers may vary.

	7.	Why is quackery a booming business in America today? Research and cite documented cases of quackery in today’s society.

ANS:	
Answers may vary.

	8.	How might cloning affect the future of our society in both the health care and political arenas? Research progress made with cloning and laws created to govern this area.

ANS:	
Answers may vary.

	9.	Investigate health care services in Canada and compare the findings to health care services in America to determine which country provides the best services to its citizens.

ANS:	
Answers may vary.

	10.	Stem cell research affords medical professionals a promising road to developing cures for various diseases. However, the morality of stem cell research is questioned by some politicians, who often put up roadblocks to this type of research. Develop a proposal to present to Congress in favor of promoting and furthering stem cell research.

ANS:	
Answers may vary.