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Chapter 112: Economics and Cost-Effectiveness in Cardiology

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According to the Centers for Medicare and Medicaid Services (CMS), what percentage of the United States gross domestic product (GDP) was spent on health care in 2014?

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A. 10%

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B. 15%

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C. 17.5%

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D. 21.5%

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E. 26%

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The answer is C. (Hurst’s The Heart, 14th Edition, Chap. 112) According to the Centers for Medicare and Medicaid Services (CMS), the United States spent 17.5% (option C) of its gross domestic product (GDP) on health care in 2014, amounting to approximately $3 trillion.1

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Which of the following is not a major reason that can be offered to explain why health care spending is expected to keep increasing?

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A. Technological innovations that improve medical care

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B. Aging of the population

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C. Inflation

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D. Raised expectations of the public

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E. All of the above are reasons to explain increasing health care spending

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The answer is E. (Hurst’s The Heart, 14th Edition, Chap. 112) Four major reasons can be offered to explain why health care spending is expected to keep increasing: (1) technological innovations that improve medical care2 (option A)—the care of the cardiovascular patient in 2017 is vastly different (and largely better) than it was in 1980, but innovation in diagnosis and therapy generally increases costs relative to the prior patterns of care, as is reviewed in the second part of this chapter; (2) the aging of the population (option B)—an issue for all developed countries and one that has just begun to manifest itself (the vanguard baby boomers born in 1945 reached retirement age in 2010); (3) inflation (option C), which refers to an increase in the cost of the same good or service (contrasted with an improved medical care service described in the first reason, above); and (4) raised expectations of the public (option D) regarding what medicine can and should offer them when they become ill, in part as a result of the global information revolution created by the Internet and search engines such as Google. Patients are no longer dependent on their doctors to tell them what is possible in a particular medical situation, and there appears to be no limit to the human desire to subdue morbidity and mortality technologically.

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Which of the following statements about methods of economic efficiency analysis is false?

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