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Biomedical subjects

G C Benjamin

Publications and source records attributed to G C Benjamin.

At least 37 records · Page 2Linked to original sources
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The future of managed care: the debate continues.

The Patient Access to Affordable Care Act has acted as a catalyst in the health care debate over the future of managed care. The Employee Retirement Income Security Act, once a sacred cow, is now under intense scrutiny. Congress is laying the ground work to create consumer protections in health care, but time in this legislative session may run out. If Congress acts this year, there could be a fundamental shift in the control over health care.

Employee Retirement Income Security Act↗
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The tobacco wars: back to the states.

With the United States Senate's failure to pass comprehensive tobacco legislation, the fight to recover public health costs from big tobacco shifts back to the states. The question for those working to reduce youth smoking rates is whether that battle can be accomplished at the state level.

Adolescent↗
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Medicare private contracting: increasing patient choice and access?

Congress modified the Medicare program through the Balanced Budget Act of 1997 to expand patient choices for payment to physicians and certain other practitioners by allowing private contracting. This represents a shift in policy that has broad consequences for health care financing and program integrity. The effect of private contracting on quality and access to care remains unknown. Quality and access should be the most important measures of its success or failure. Out of pocket costs to seniors and vulnerable patients must also be watched closely.

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Nursing home care: ensuring quality.

There are more than 17,000 nursing homes in the United States providing care for 1.7 million disabled and elderly individuals. Medicare and Medicaid paid $28 billion in 1997 for nursing home services, more than one half of all nursing home expenditures. Improvements in the quality of care in these facilities and ensuring value for public expenditures has been a long sought after goal. Recent actions by the federal government are designed to strengthen state and federal authority and processes to accomplish this goal. Physician leadership in this area is essential to its success.

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Managed care liability.

Debate is heating up concerning proposals that patients have the right to sue their managed care plans for damages from wrongful denial of benefits or delays in care. Some states have recently passed legislation to address this issue and it is expected to be an area of intense legislative debate during this year. As managed care entities increasingly enter the realm of medical decision-making, the additional burden of this responsibility is taking shape. Whether managed care plans should be treated like providers of care and be held accountable for decisions that impact patient outcomes, or be viewed only as insurers is a policy question of immense proportion.

Employee Retirement Income Security Act↗
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Medicare HMO exodus: system correction or prediction?

In a blow to seniors, numerous HMOs made a hasty withdrawal from the Medicare market, citing increased costs and inadequate federal reimbursement. This action forced more than 400,000 Medicare recipients to scramble for health coverage. In some parts of the country, coverage through a managed care plan may not be available, resulting in higher out-of-pocket costs. Even more disconcerting is the potential loss of added non-Medicare benefits, such as prescription drugs, eyeglasses, and dental care for those who return to traditional Medicare. Policymakers at all levels are searching for solutions to this disruption in health care delivery. Events such as this demonstrate the critical relationship between the mechanism of financing and service delivery.

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Saving Medicare: premium supports.

Medicare, the universal health care program for the elderly and the disabled, is pending bankruptcy by the year 2008. Efforts to ensure its fiscal solvency are underway. The Bipartisan Commission on the Future of Medicare formed by the Balanced Budget Act of 1997 recently debated a bold new idea to transform this important program. There is some concern that this concept will not solve the problem without new funding. In addition, there are those who believe this is the time to correct one of Medicare's major flaws--the lack of a prescription benefit. Congressional action over the next several months will be critical to saving this program for future seniors.

Aged↗
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Medicare prescription drugs: a benefit whose time has come.

The Federal Medicare program's biggest flaw is the lack of an outpatient benefit for prescription drugs. One of the hottest legislative debates this summer will be whether or not to add this important therapeutic benefit to the Medicare program. Congressional planners will be weighing the positions of numerous stakeholders, as well as the fiscal implications of such a measure. The most important stakeholders are the elderly and the disabled, who depend on these medications for therapeutic relief.

Ambulatory Care↗
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The looming millennium bug.

Evaluating and fixing date sensitive systems by the year 2000 is a significant challenge for the health care industry. Health care executives will be engrossed in this important management activity over the next several months. By now all critical business functions should have been identified and remediated. Contingency planning to ensure the continuity of high quality systems is an essential next step. Physician executives need to have a contingency plan in case Y2K-related failures occur. Most health care facilities have a disaster plan that has been tested in clinical scenarios. These plans should be reviewed to ensure they include procedures for handling problems with office operations, power outages, equipment failure, supply or pharmaceutical shortages, and patient evacuation. Financial systems are at risk at multiple points, including determining eligibility, claims submission, billing, and payments.

Chronology as Topic↗
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Graduate medical education funding crisis.

Medicare, the major funding source for graduate medical education, is under intense scrutiny. Some think that Medicare should not continue to overtly pay to train graduate physicians, while others believe continued direct funding is an important social obligation. Recent policy discussions could dramatically transform the way graduate physician training is funded and teaching hospitals are paid. This is an important debate because of the strong influence Medicare has in determining the willingness of other payers to contribute to graduate medical education. Funding reductions are already threatening the viability of the U.S. teaching hospital system.

Education, Medical, Graduate↗
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Chemical and biological terrorism: planning for the worst.

Preparing for a chemical or biological terrorist event has recently become an intense area of focus for emergency health planners in every state and city in America. Many of these individuals believe that a chemical or biological terrorist event is likely in the near future and they raise concerns about the readiness of our nation's health system to rapidly identify and manage a disaster of this magnitude. In both types of events, physician leadership is essential to reduce death and disability and restore public order. Several policy issues need to be addressed in this complex issue. Physician executives play a key role in preparing the health system to respond to this type of disaster.

Biological Warfare↗
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Addressing medical errors: the key to a safer health care system.

A recent report on patient safety by the Institute of Medicine's Committee on Quality of Health Care in America noted that there are at least 44,000 patient deaths from medical errors each year, placing them as the eighth leading cause of death in the United States. They occur in every aspect of the practice of medicine. Some result in adverse events that harm patients. Can an organized effort to reduce medical errors be effective? Other complex industries have been successful in reducing errors and improving quality. The IOM report argues that the medical community must do the same to ensure a higher quality of care. Both the Clinton administration and Congress have expressed concerns about the frequency of medical errors, as has organized medicine. These findings raise significant policy questions for physician executives' charges with ensuring patient safety.

Delivery of Health Care↗
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The Supreme Court rules: the FDA and tobacco regulation.

The United States Supreme Court recently ruled that the U.S. Food and Drug Administration does not have the legal authority to regulate tobacco products. This ruling significantly affects public health efforts to reduce tobacco addiction, especially among the nation's youth. This decision has broader health implications as well, since tobacco-related diseases are among many of the top ten leading causes of death. Paradoxically, this decision comes at a time where states are developing new health programs to address tobacco-related illnesses using funds from the landmark tobacco lawsuit.

Consumer Product Safety↗
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The next administration and Congress: a new look at old problems.

The 2000 general election brings a new administration and Congress to Washington. It also provides the opportunity for a fresh look at the national health policy agenda. Both of the major parties have focused on health as one component of their national agendas. A booming economy and growing public concern about domestic issues presents policymakers with the opportunity to resolve some of the nation's long-standing concerns about the health of its citizens. The year 2001 can be a burst or boon for human health. Top health care issues include Medicare reform, prescription drug coverage, insuring the uninsured, managed care reform, the public health infrastructure, and health care quality.

Health Care Reform↗
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Public health infrastructure: creating a solid foundation.

The nation's public health system remains in disarray, despite the 1988 warning by the Institute of Medicine in its landmark report, "The Future of Public Health." Recent concerns about antibiotic resistance, inadequate disease surveillance capabilities, bioterrorism, and an increasing need for training the public health workforce have brought this problem into the forefront of congressional concern. Recent legislation aimed at addressing this problem was passed last Fall and signed into law. This program will take a significant step towards ensuring a solid public health system when it is fully implemented.

Communicable Disease Control↗
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Patient bill of rights 2001.

Breaking gridlock on managed care reform, a bipartisan coalition in Congress introduced the newest version of a patient bill of rights. Unlike last year's ill-fated Norwood-Dingell bill, the Bipartisan Patient Protection Act of 2001 has strong bipartisan support; concern remains, however, on the provisions that allow patients to sue their managed care plan. The debate now focuses on the type of liability reform that Congress and the White House can agree on. If they are able to agree, a patient bill of rights may soon become law.

Emergency Medical Services↗
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Federal budget helps drive health policy. A close-up look at the budget process and how it affects health care funding.

Crafting the budget is an annual process that Congress and the administration use to define the national policy agenda. It is a massive undertaking to decide how more than two trillion dollars is spent by the federal government. Over 20 percent of the budget is used for health care. The budget is a political document that defines the priorities of the federal government and directly influences overall health policy. Its construction deserves to be followed and influenced by physicians to ensure the health of the public.

Budgets↗