Author Question: Which of the following best describes how the government controls conditions that individuals ... (Read 75 times)

student77 · **on:** Jul 8, 2018

Which of the following best describes how the government controls conditions that individuals cannot?

a. Appeals to the common sense and good nature of the citizens
b. Establishes social mores that enable groups to control individuals' behaviors
c. Passes and enforces law
d. Uses fear reinforced by police power

Question 2

A health care provider has charged more than a managed care organization (MCO) typically pays for a procedure. Which of the following would most likely be the result?

a. Provider may be removed from the MCO's list of approved providers.
b. The MCO will re-examine the payment for that procedure.
c. Provider would get the typical payment instead of what was charged.
d. The MCO would be forced to increase its typical payment for that procedure.

shewald78 · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

ANS: C
Government regulates conditions that individuals cannot control and provides individual protection through a population-wide focus. These tasks are accomplished through passage and enforcement of laws. These laws control individuals' behaviors, which may lead to the establishment of social mores and common sense related to the laws that have been established.

Answer to Question 2

ANS: C
MCOs may deny reimbursement to health care providers who exceed the expected costs. Therefore, at least on the first occasion, the most probable result would be that the provider gets the listed payment, not what the provider charged.