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At least 37 records · Page 2Linked to original sources
PubMed1976

The role of the Federal government in financing health and medical services.

Public sector spending and private sector spending for health and medical services have tended to parallel one another over the past four decades. Although total expenditures have grown dramatically, the relationship between the two sectors has not. Government gradually increased its support and provision of health care between 1929 and 1940. Between 1940 and 1966 government spending for health care remained at a plateau. The federal government's major participation since 1966 has been through its role as a transfer agent for the Medicare trust fund, acting as an intermediary, rather than through the expenditure of general revenues for health and medical care services. Rising costs and increased demand for medical services will probably force a larger financial role upon government.

Financing, Government↗
PubMed1995

Historical perspective on risk assessment in the federal government.

This article traces the evolution of risk assessment as an essential analytical tool in the federal government. In many programs and agencies, decisions cannot be made without the benefit of information from risk assessment. Although this analytical tool influences important public health and economic decisions, there is widespread dissatisfaction with the day-to-day practice of risk assessment. The article describes the sources of dissatisfaction that have been voiced by scientists, regulators, interest groups and ordinary citizens. Problems include the use of arbitrary exposure scenarios, the misuse of the 'carcinogen' label, the excessive reliance on animal cancer tests, the lack of formal uncertainty analysis the low priority assigned to noncancer endpoints, the poor communication of risk estimates and the neglect of inequities in the distribution of risk. Despite these limitations, the article argues that more danger rests in efforts to make decisions without any risk assessment. Recent Congressional and Administration interest in risk assessment is encouraging because it offers promise to learn from past mistakes and set in motion steps to enhance the risk assessment process.

Animals↗
PubMedDate not supplied

[AIDS model program of the Federal Government--an interim evaluation].

In 1986 the Government of the Federal Republic of Germany, started--with considerable financial and personal involvement--eight programs for AIDS-Prevention. An interimsreport of the associated research program gives first hints of success and compulsory modifications.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[The role of the Federal Government in the prevention and control of infectious diseases. Organizational structures, responsibilities and duties--an overview].

Health policy is faced today with the challenge of keeping the health care system up to a high standard and affordable at the same time. A comprehensive health protection system that is efficient and readily accessible to all is required. Although it is to a great extent the responsibility of every citizen to promote and sustain their own health, it is the duty of the Federal Government to provide for risks that can emanate from pathogens, products or environmental factors. Protection against all known risks should be improved, new health threats have to be countered and new scientific findings must be considered. Prevention, health promotion and health protection are important key factors to improve health in the general population and to reduce health care costs. The prevention of and protection from infectious diseases are high priority tasks in the further development of an effective health care system in Germany. In order to accomplish these tasks in the control of infectious diseases close collaboration between a number of federal agencies and federal institutes under the responsibility of the Ministry of Health and Social Security as well as the Ministry of Consumer Protection, Food and Agriculture has to be ensured.

Communicable Disease Control↗
PubMed2002

Selling health benefits to the federal government: pricing guidelines and pitfalls.

Approximately 300 health plans contract with the Office of Personnel Management (OPM) to provide health care services to federal employees and their families under the Federal Employees Health Benefits Program. Total enrollment in this program is approximately 10 million persons, making it by far the largest employer health plan in the United States. However, the federal government insists on getting the "best price." This article explores the uncertainties and pitfalls that a health plan faces when it contracts with OPM and does not offer the best price.

Actuarial Analysis↗
PubMed2000

Red Cross and federal government held liable for hemophiliacs' HIV infection.

After eight years of litigation, on 21 June 2000 three hemophiliacs infected with HIV finally won a judgment against the Canadian Red Cross Society and the federal government. An Ontario trial court ruled the Red Cross and the government were negligent for having delayed the implementation of heat treatment for blood products, which resulted in the plaintiffs' infections. Since starting their lawsuits in 1992, two of the three plaintiffs died of AIDS before the trial judgment. But the damage awards were criticized by the plaintiffs' lawyer.

Canada↗
PubMedDate not supplied

[Violence in families and its prevention. Also a plea for abolishing the parental right to inflict physical punishment. A report of the "Violence Commission" of the federal government].

Violence in families is rather frequent. Different forms of violent acts can be distinguished: violence between partners, violence between parents and children, violence among siblings, and violence against elder family members. This report gives an overview--with the emphasis on violence in families--of the work of the "Violence Commission" of the Federal Government. This commission worked out proposals for intervention in the case of intrafamiliar violence as well as for prevention. Two proposals of the commission are explained in detail: (1) Rejection of violence and prohibition of corporal punishment in education and (2) punishability of conjugal violation.

Child↗
PubMed1995

Immigration and cultural policies: a bone of contention between the Province of Quebec and the Canadian federal government.

"This article addresses the way in which the Province of Quebec has obtained increasing power in the area of immigration.... Data from interviews with key members of [the Ministry of Immigration] and from selected documents are drawn on to illustrate Quebec's cultural politics. The Quebec position on the question of immigration as it has evolved in the context of immigration policies defined by the federal government in Ottawa is examined.... In particular, the present article considers how attempts to construct a cultural identity and a nation-state in Quebec have had important consequences for immigration policy and for attitudes and policies concerning Quebec's cultural minorities. The emergence of the notion of 'cultural communities' as a result of the constitutional rivalry and the on-going struggle for legitimacy between Quebec and Ottawa is also explored."

Americas↗
PubMed1994

Preventive eye care in people with diabetes is cost-saving to the federal government. Implications for health-care reform.

OBJECTIVE: Diabetic retinopathy, which leads to macular edema and retinal neovascularization, is the leading cause of blindness among working-age Americans. Previous research has demonstrated significant cost savings associated with detection of eye disease in Americans with type I diabetes. However, detection and treatment of eye disease among those with type II diabetes was previously thought not to be cost-saving. Our purpose was to estimate the current and potential federal savings resulting from the screening and treatment of retinopathy in patients with type II diabetes, based on recently available data concerning efficacy of treating both macular edema and neovascularization along with new data on federal budgetary costs of blindness. RESEARCH DESIGN AND METHODS: We used computer modeling, incorporating data from population-based epidemiological studies and multicenter clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. RESULTS: Screening and treatment for eye disease in patients with type II diabetes generates annual savings of $247.9 million to the federal budget and 53,986 person-years of sight, even at current suboptimal (60%) levels of care. If all patients with type II diabetes receive recommended care, the predicted net savings (discounted at 5%) exceeds $472.1 million and 94,304 person-years of sight. Nearly all savings are associated with detection and treatment of diabetic macular edema. Enrolling each additional person with type II diabetes into currently recommended ophthalmological care results in an average net savings of $975/person, even if all costs of care are borne by the federal government. CONCLUSIONS: Our analysis indicates that prevention programs aimed at improving eye care for patients with diabetes not only reduce needless vision loss but also will provide a financial return on the investment of public funds.

Blindness↗
PubMedDate not supplied

The more things change...: the federal government's role in the evaluative sciences.

The unfortunate political history of the Agency for Health Care Policy and Research (AHCPR) illustrates the risks to the agencies attempting to evaluate the common practices of medicine and reform clinical decision making to take account of patients' preferences. The evaluative sciences have yet to regain the congressional attention they had when Senators George Mitchell and David Durenberger championed their cause. But the fundamental problems remain, and they are getting worse. Sooner or later Congress will need to revisit the debate over where in the federal government the evaluative sciences should find their base, and questions concerning the role of the National Institutes of Health (NIH) will be raised once again, as they were at the time of AHCPR's founding.

Health Services Research↗