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Biomedical subjects

Victor R Fuchs

Publications and source records attributed to Victor R Fuchs.

9 recordsLinked to original sources
PubMed2004

Reflections on the socio-economic correlates of health.

Income, education, occupation, age, sex, marital status, and ethnicity are all correlated with health in one context or another. This paper reflects on the difficulties encountered in deriving robust scientific conclusions from these correlations or drawing reliable policy applications. Interactions among the variables, nonlinearities, casual inference, and possible mechanisms of action are discussed. Strategies for future work are suggested, and researchers are urged to pay special attention to possible interactions among health, genes, and socio-economic variables.

Demography↗
PubMed2004

More variation in use of care, more flat-of-the-curve medicine.

Variation in use of health care is ubiquitous in the United States. It is attributable to exogenous differences in supply of medical resources; to identified and unidentified economic, social, and cultural factors; and to the idiosyncratic beliefs of physicians. It is perpetuated by the parochial character of much clinical practice. Patients in high-intensity areas do not appear to have better health outcomes: Much care is "flat of the curve." A more robust scientific foundation for clinical decisions could help to reduce variations, but major reform of health care financing is probably necessary to achieve substantial improvement in the organization and delivery of care.

Health Services↗
PubMedDate not supplied

Air pollution and medical care use by older Americans: a cross-area analysis.

The case for reduction of air pollution has been predicated primarily on the frequently observed relationship between pollution and mortality and morbidity. Because pollution control usually involves costs, a rational public policy will weigh the benefits against the costs. This study investigates another potential benefit from pollution reduction: namely, decreased use of medical care. We find a strong relationship between particulate matter and inpatient and outpatient care at ages 65-84 across 183 metropolitan statistical areas (MSAs). The relationship is statistically significant at a very high level of confidence even after the region and population size of the areas, education, real income, racial composition, use of cigarettes, and obesity are controlled for.

Aged↗
PubMedDate not supplied

Health care reform: why? What? When?

Dissatisfaction with the U.S. health care system is widespread, but no consensus has emerged as to how to reform it. The principal methods of finance-employer-based insurance, means-tested insurance, and Medicare-are deeply and irreparably flawed. Policymakers confront two fundamental questions: Should reform be incremental or comprehensive? And should priority be given to reforming the financing system or to improving organization and delivery? We consider here several proposals for incremental reform and three for comprehensive reform: individual mandates with subsidies, single payer, and universal vouchers. Over the long term, reform is likely to come in response to a major war, depression, or large-scale civil unrest.

Health Care Reform↗
PubMedDate not supplied

Employment-based health insurance: past, present, and future.

We review the rise, stabilization, and decline of employment-based insurance; discuss its transformation from quasi-social insurance to a system based on actuarial principles; and suggest that the presence of Medicare and Medicaid has weakened political pressure for universal coverage. We highlight employment-based insurance's flaws: high administrative costs, inequitable sharing of costs, inability to cover large segments of the population, contribution to labor-management strife, and the inability of employers to act collectively to make health care more cost-effective. We conclude with scenarios for possible trajectories: employment-based insurance flourishes, continues to erode, or is replaced by a more comprehensive system.

Cost Allocation↗
PubMedDate not supplied

Floridian exceptionalism.

Elderly Floridians use much more medical care and have much lower mortality rates than do their peers in other regions of the country. After demographic and other variables are controlled for, the differential between Florida and the rest of the United States is 25 percent for utilization and 10 percent for mortality among whites ages 65-84. This paper summarizes the facts about Floridian exceptionalism and reviews various possible explanations: physician inducement of utilization, differences in preferences, selective migration into and out of the state, climate, and social interactions, among others. Readers are invited to suggest their own explanations and their policy recommendations, if any.

Aged↗