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PubMed1991

The West German health care system: a critique.

Several leading health policy staff of the AFL-CIO and major unions met with the Board of Physicians for a National Health Program (PNHP) in May 1990. They described the active discussions currently ongoing within the AFL-CIO Health Care Committee, which is composed of 14 international union presidents and sets AFL-CIO policy on health care issues. Some union presidents reportedly favored a single-payer, Canadian-style approach, while others apparently preferred a proposal modeled after the West German system, which preserves a major role for insurance companies. The PNHP Board was emphatic in its preference for the single-payer approach. Board member Dr. Vicente Navarro wrote the following letter to the union presidents on the AFL-CIO Health Care Committee detailing his critique of the West German approach.

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PubMedDate not supplied

Periodic health examination: comparison of residency programs and national recommendations.

Health maintenance and disease prevention guidelines of primary care internal medicine residency (PCIM) programs were investigated and compared with recommendations of major national organizations. Preventive screening data were requested from 134 PCIM programs; 120 (90%) responded. Methods included seminars/lectures by 73 (61%), health maintenance flow sheets by 58 (48%), and a variety of other formats by 25 (21%) programs. A comparison of recommended flow sheet items (n = 33) from five major studies and 48 PCIM programs showed concordances (+/- SE) of 62% (+/- 5) with high-priority items (n = 15) and 33% (+/- 4) with low-priority items (n = 18). When an item's frequency or age range was examined, however, concordances were much lower. From our analysis, fewer than half the programs routinely used prompting systems, such as flow sheets, in their ambulatory clinics, and there was little uniformity in the frequencies and age ranges for those items employed. The data suggest that major study recommendations were underused and underemphasized.

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