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Some Answers and Comments on the Text Discussion Questions

1. U.S. health expenditures are highest in the world in both absolute dollars and as a percent of GDP.

2. U.S. infant and maternal death rates are higher (worse) than many other industrial countries. They are approximately equal to others, but we spend significantly more on health care than do these other countries.

3. Physician sovereignty is the doctors’ control of their own demand. It will increase demand. Third-party payment is payment by anyone other than the patient or the patient’s family. If the government or the insurance company pays for it, patients are less conscious of costs and demand tends to increase. Defensive medicine is the prescribing of unnecessary tests or treatments by doctors solely in order to avoid malpractice suits. This increases demand. If patients feel they deserve the most technologically advanced care available, if they do not take care of themselves and expect the medical system to cure them of any resulting condition, it increases the demand for health care.

4. Cost shifting involves spreading uncompensated costs of charity Medicaid, or Medicare patients over patients who can pay for them. It increases costs for those with generous health insurance. The costs that the insurance companies reimburse the hospital are inflated.

5. Medicare is a type of national social insurance intended to benefit aged retirees and disabled persons. It does not cover all medical expenses, and many retirees also carry Medigap insurance to protect themselves. There is no means test for Medicare eligibility. Medicaid is a federal and state program to provide medical care for poor families. There is therefore a means test. Because the states administer and partially fund Medicaid, eligibility and coverage vary widely throughout the U.S.

6. The most commonly discussed features...