Final_2021

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Jan 9, 2024

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Name: _______________________________ 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 a. The Supreme Court ruled it unconstitutional in 2012 b. Congress repealed it c. Medicare expenses are projected to grow sufficiently slowly such that the IPAB has not yet been required to meet 3) Which of the following could be a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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