Public general hospitals originated in the almshouse infirmaries estab

Question

Public general hospitals originated in the almshouse infirmaries established as early as colonial times by local governments to care for the poor. Later, in the late eighteenth and early nineteenth centuries, the infirmary separated from the almshouse and became an independent institution supported by local tax money. At the same time, private charity hospitals began to develop. Both private and public hospitals provided mainly food and shelter for the impoverished sick, since there was little that medicine could actually do to cure illness, and the middle class was treated at home by private physicians.

Late in the nineteenth century, the private charity hospital began trying to attract middle-class patients. Although the depression of 1890 stimulated the growth of charitable institutions and an expanding urban population became dependent on assistance, there was a decline in private contributions to these organizations which forced them to look to local government for financial support. Since private institutions had also lost benefactors; they began to charge patients. In order to attract middle-class patients, private institutions provided services and amenities that distinguished between paying and non-paying patients and made the hospital a desirable place for private physicians to treat their own patients. As paying patients became more necessary to the survival of the private hospital, the public hospitals slowly became the only place for the poor to get treatment. By the end of the nineteenth century, cities were reimbursing private hospitals for their care of indigent patients and the public hospitals remained dependent on the tax dollars.

The advent of private hospital health insurance, which provided middle-class patients with the purchasing power to pay for private hospital services, guaranteed the private hospital a regular source of income. Private hospitals restricted themselves to revenue-generating patients, leaving the public hospitals to care for the poor. Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services, the Blue Cross plans developed around the needs of the private hospitals and the inpatients they served. Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans, and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians. Additionally, since World War II, there has been a tremendous influx of federal money into private medical schools and the hospitals associated with them. Further, large private medical centers with expensive research equipment and programs have attracted the best administrators, physicians, and researchers. As a result of the greater resources available to the private medical centers, public hospitals have increasing problems attracting highly qualified research and medical personnel. With the mainstream of health care firmly established in the private medical sector, the public hospital has become a “dumping ground.”   1 
 1. According to the passage, the very first private hospitals

A. Developed from almshouse infirmaries
B. Provided better care than public infirmaries
C. Were established mainly to service the poor
D. Were supported by government revenues
E. Catered primarily to the middle-class patients

2 
 2. It can be inferred that the author believes the differences that currently exist between public and private hospitals are primarily the result of

A. Political considerations
B. Economic factors
C. Ethical concerns
D. Legislative requirements
E. Technological developments

3 
 3. It can be inferred that the growth of private health insurance

A. Relieved local governments of the need to fund public hospitals
B. Guaranteed that the poor would have access to medical care
C. Forced middle-class patients to use public hospitals
D. Prompted the closing of many charitable institutions
E. Reinforced the distinction between public and private hospitals

4 
 4. Which of the following would be the most logical topic for the author to introduce in the next paragraph?

A. A plan to improve the quality of public hospitals
B. An analysis of the profit structure of health insurance companies
C. A proposal to raise taxes on the middle class
D. A discussion of recent developments in medical technology
E. A list of the subjects studied by students in medical school

5 
 5. The author’s primary concern is to

A. Describe the financial structure of the healthcare industry
B. Demonstrate the importance of government support for health-care institutions
C. Criticize wealthy institutions for refusing to provide services to the poor
D. Identify the historical causes of the division between private and public hospitals
E. Praise public hospitals for their willingness to provide health care for the poor

6 
 6. The author cites all of the following as factors contributing to the decline of public hospitals EXCEPT.

A. Government money was used to subsidize private medical schools and hospitals to the detriment of public hospitals.
B. Public hospitals are not able to compete with private institutions for top flight managers and doctors.
C. Large private medical centers have better research facilities and more extensive research programs than public hospitals.
D. Public hospitals accepted the responsibility for treating patients with certain diseases.
E. Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital.

7 
 7. The author’s attitude toward public hospitals can best be described as

A. Contemptuous and prejudiced
B. Apprehensive and distrustful
C. Concerned and understanding
D. Enthusiastic and supportive
E. Unsympathetic and annoyed

8 
 8. The author implies that any outpatient care provided by a hospital is

A. Paid for by private insurance
B. Provided in lieu of treatment by a private physician
C. Supplied primarily by private hospitals
D. A source of revenue for public hospitals
E. No longer provided by hospitals, public or private

9 
 9. Which of the following titles best describes the content of the passage?

A. Public versus Private Hospitals: A Competitive Mismatch
B. Historical and Economic Factors in the Decline of the Public Hospital
C. A Comparison of the Quality of Care Provided in Public and Private Hospitals
D. A Proposal for Revamping the Health Delivery Services Sector of the Economy
E. Economic Factors That Contribute to the Inability of the Poor to Get Adequate Care

Sajjad1994 · Answer

Here is explanation of question #5

Explanation

5. The author’s primary concern is to

Explanation

This is a general purpose question, to answer such questions you should read and understand the complete passage though this is an easy level question. Look at the answer choice.

A.  Describe the financial structure of the healthcare industry 
In all three paragraphs of the passage no financial structure has been discussed, quality of care, medicines and medical facilities has been discussed which is very different from financial structure.

B.  Demonstrate the importance of government support for health-care institutions 
Very easy to eliminate this one as there is no importance has been discussed in the passage rather history of government hospitals has been discussed with respect to time frame.

C.  Criticize wealthy institutions for refusing to provide services to the poor 
Although quality of care, medicines, research and medical facilities of Private hospital has been discussed but we find no criticism on private hospitals.

D.  Identify the historical causes of the division between private and public hospitals 
This one is correct

E.  Praise public hospitals for their willingness to provide health care for the poor 
No praise for public hospital has been discussed. It is also out.

Answer: D

Hope it helps

nandeta · Answer

1. According to the passage, the very first private hospitals

A. Developed from almshouse infirmaries 
Wrong. The first hospital developed were Public General Hospitals and from there the private hospitals developed.

B. Provided better care than public infirmaries 
Wrong. Both private charity hospitals and public hospitals provided food and shelter for the sick.

C. Were established mainly to service the poor 
Right. Since middle class people were treated at their homes with private physicians.

D. Were supported by government revenues 
Wrong. Private hospitals were funded by donations.

E. Catered primarily to the middle-class patients 
Wrong. It catered to poor.

2. It can be inferred that the author believes the differences that currently exist between public and private hospitals are primarily the result of

A. Political considerations 
Wrong. No political considerations were involved.

B. Economic factors 
Right. Public hospitals did not have money and Private hospitals charged patients so could afford new technologies and doctors.

C. Ethical concerns 
Wrong. Both were ethically correct to serve the poor. One charged and another didn't.

D. Legislative requirements 
Wrong. Now laws or anything were passed.

E. Technological developments 
Wrong. This happened after the economic development.

3. It can be inferred that the growth of private health insurance

A. Relieved local governments of the need to fund public hospitals 
Wrong. Public hospitals did not have private health insurance. It was funded by the government.

B. Guaranteed that the poor would have access to medical care 
Wrong. Poor did have access to medical care. Just that, they didn't have better conditions and doctors like private hospitals.]

C. Forced middle-class patients to use public hospitals 
Wrong. Private health insurance was only in private hospitals.

D. Prompted the closing of many charitable institutions
Wrong. No charitable institutions closed. They evolved to private hospitals.

E. Reinforced the distinction between public and private hospitals 
Correct. As the private health hospitals grew, technological advancement happened and different social status people started visiting different
hospitals according to their pocket.

4. Which of the following would be the most logical topic for the author to introduce in the next paragraph?

A. A plan to improve the quality of public hospitals 
Right. In the last line, author states that public hospital has been used as dumping ground so as a personal voice, author will give its 
suggestion to improve the public hospital.

B. An analysis of the profit structure of health insurance companies 
Wrong. The author has not even touched the profit structure of health insurance companies.

C. A proposal to raise taxes on the middle class 
Wrong. This is political decision. We are not concerned with it here.

D. A discussion of recent developments in medical technology 
Wrong. Yes medical technology has been mentioned but talking specifics about it would digress from the topic.

E. A list of the subjects studied by students in medical school 
Wrong. Out of scope.

5. The author’s primary concern is to

A. Describe the financial structure of the healthcare industry 
Wrong. The passage talks about development of healthcare industry.

B. Demonstrate the importance of government support for health-care institutions 
Wrong. No importance has been cited.

C. Criticize wealthy institutions for refusing to provide services to the poor 
Wrong. The author has not critized anyone.

D. Identify the historical causes of the division between private and public hospitals 
Right. It documents the journey of hospitals from 19th century to present time.

E. Praise public hospitals for their willingness to provide health care for the poor 
Wrong. Author had a very neutral approach.

6. The author cites all of the following as factors contributing to the decline of public hospitals EXCEPT.

A. Government money was used to subsidize private medical schools and hospitals to the detriment of public hospitals. 
cities were reimbursing private hospitals for their care of indigent patients and the public hospitals remained dependent on the tax dollars.

B. Public hospitals are not able to compete with private institutions for top flight managers and doctors. 
 large private medical centers with expensive research equipment and programs have attracted the 
best administrators, physicians, and researchers

C. Large private medical centers have better research facilities and more extensive research programs than public hospitals. 
large private medical centers with expensive research equipment and programs have attracted the 
best administrators, physicians, and researchers

D. Public hospitals accepted the responsibility for treating patients with certain diseases. 
public hospitals continued to provide services for patients with communicable diseases

E. Blue Cross insurance coverage does not reimburse subscribers for medical expenses incurred in a public hospital. 
Right. Thus, reimbursement for ambulatory care has been minimal under most Blue Cross plans.
 
 7. The author’s attitude toward public hospitals can best be described as

A. Contemptuous and prejudiced 
Wrong.
 B. Apprehensive and distrustful 
Wrong.
 C. Concerned and understanding 
Right. the public hospital has become a “dumping ground.”
 D. Enthusiastic and supportive 
Wrong.
 E. Unsympathetic and annoyed 
Wrong.

8. The author implies that any outpatient care provided by a hospital is

A. Paid for by private insurance 
Wrong.Outpatient is someone who doesn't stay at hospital.

B. Provided in lieu of treatment by a private physician 
Correct.

C. Supplied primarily by private hospitals 
Wrong. It was provided by both private and public.

D. A source of revenue for public hospitals 
Wrong. There is not revenue for public hospitals. They run on government tax money.

E. No longer provided by hospitals, public or private 
Wrong. It is provided.

9. Which of the following titles best describes the content of the passage?

A. Public versus Private Hospitals: A Competitive Mismatch 
Wrong. They have not illustrated the comparison.

B. Historical and Economic Factors in the Decline of the Public Hospital 
Right.

C. A Comparison of the Quality of Care Provided in Public and Private Hospitals 
Wrong. No specific detailed specification has been given.

D. A Proposal for Revamping the Health Delivery Services Sector of the Economy 
Wrong. No proposal has been given yet.

E. Economic Factors That Contribute to the Inability of the Poor to Get Adequate Care 
Wrong. That is one part of it.

Gmattired · Answer

CAN SOMEONE EXPLAIN QUESTION 8?

Nowwk · Answer

Let's me try

and provision of outpatient care has not been a major function of the private hospital, in part because private patients can afford to pay for the services of private physicians.

This is the sentence from the passage that can be inferred to choice B.

some people might hesitate between B and D. However, be notice the word "Private" and "Public" on this choice. Hence, B is correct.

8Harshitsharma · Answer

Can someone share the reasoning behind Q6 and Q9??

For Q6, choice D: I agree that the author says that public hospitals continued to treat certain illnesses, BUT he doesn't imply that this is a reason for their decline.
Is choice E correct because it is not mentioned at all in the passage??

For Q9, how do we reject choice A? The author traces the history of developments in both public and private hospitals, and then compares their services and differentiating factors. Is that correct?

Sajjad1994 · Answer

Question 6 is a bit debateable. I am going to explain why (A) is wrong in question 9.  (A)  might seem reasonable at first glance because the passage does discuss the competition between public and private hospitals. However, the passage primarily focuses on the historical and economic factors contributing to the decline of public hospitals rather than directly comparing the two types of hospitals in terms of their services or quality of care. Although author discusses a competitive aspect between public and private hospitals, the main emphasis is on the decline of public hospitals rather than a direct comparison of their services or quality of care. Therefor B is better than A.

gullyboy09 · Answer

Hi, in Q9, even with option B issue I have is it talks about only public hospitals. Whereas both public and private discussed with the same granularity and independently. Only towards the end part, inlfux of money in private institutions created a difference is discussed.

guddo · Answer

9. Which of the following titles best describes the content of the passage?

The passage explains how public hospitals gradually declined in status and function while private hospitals grew stronger.  The main idea  is that a mix of historical and economic changes pushed private hospitals toward paying patients and left public hospitals increasingly responsible for the poor, with fewer resources and less prestige.  It is mainly a historical explanation of decline , not just a comparison or a policy proposal.

A. Public versus Private Hospitals: A Competitive Mismatch

This is too vague. The passage is not mainly about a general mismatch or competition between the two. It is specifically about how public hospitals declined over time because of historical and economic developments.

B. Historical and Economic Factors in the Decline of the Public Hospital

This fits best. The passage traces the history of public and private hospitals and shows how funding patterns, insurance, government support, and medical prestige all contributed to the weakening of public hospitals.

C. A Comparison of the Quality of Care Provided in Public and Private Hospitals

This is not right because the passage does not mainly compare quality of care. It focuses on funding, patient mix, institutional roles, and historical change.

D. A Proposal for Revamping the Health Delivery Services Sector of the Economy

This is clearly wrong. The passage describes and explains a development. It does not propose a reform plan.

E. Economic Factors That Contribute to the Inability of the Poor to Get Adequate Care

This is too narrow. Economic factors do matter in the passage, but the passage is broader than that. It discusses both historical and economic causes behind the decline of public hospitals, not just why the poor lack adequate care.

Answer: (B)

Veerenk · Answer

Question # 6
It is between Answer choice D & E

"   Private hospitals restricted themselves to revenue-generating patients, leaving the public hospitals to care for the poor. Although public hospitals continued to provide services for patients with communicable diseases and outpatient and emergency services, the Blue Cross plans developed around the needs of the private hospitals and the inpatients they served " 
As per Choice-D, Public hospitals accepted the responsibility for treating patients with certain diseases (communicable). As stated in paragraph, these are not income generating. Hence, this may also contributing for decline of Public hospitals.

Regarding Choice-E, it is not mentioned about Blue cross coverage reimbursement of medical expenses incurred in Public hospital. Hence it is out of the context.

So, Choice -E is right

Public general hospitals originated in the almshouse infirmaries estab

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Public general hospitals originated in the almshouse infirmaries estab

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