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Results for “Universal Health Insurance”

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At least 793 records · Page 44Linked to original sources
PubMed1997

How managed care could coopt the public sector.

Since current public officials lack the courage and political will to significantly raise payroll taxes or constrain Social Security, Medicare, and Medicaid benefits, it can be expected that long-term deficit spending will continue, effecting a predictable series of events that have strong, negative ramifications for the American health care system. The author suggests modifications to how our nation's health system should be organized and financed in order to avert these dire predictions.

Cost Savings↗
PubMed1995

Good and bad models of market reform for managed care.

The author argues that free market competition has not been given a fair chance in the health care industry and that the basic characteristics of a sound market can be met in the United States if the problem of asymmetric information is efficiently addressed. He proposes the "Buy-Right" system as an effective model for market reform.

Community Participation↗
PubMed1996

Health care reform in the American states: administrative capacity building.

As the nation moves to reform Medicare and the health care industry becomes more competitive which will dramatically change the means by which health care is organized and financed, state governments ought to be establishing administrative capacity to administer new systems. This article describes past experiences of states in similar efforts and uses the legislation written in 13 states to analyze in greater detail current state health reform activities. Policies that create new central authorities have the greatest likelihood of building the appropriate administrative infrastructures. Provisions related to establishing data bases, creating regional authorities or advisory committees, establishing uniform claims, and facilitating integrated systems of care are common to several proposals. Previous state experiences with health planning and citizen involvement are evident in the schemes being proposed and enacted.

Health Care Reform↗
PubMed1997

Dialogue. Resource allocation: to those in the greatest need or those who will benefit most?

The behavioral healthcare community seeks universal coverage for mental health and addiction treatment services at parity with coverage for other medical conditions. To achieve this goal, our field must accept and work within realistic financial limits. The time has come to establish a framework for "rational rationing" of behavioral healthcare resources. What are the priorities? How should resources be equitably shared? Should we sacrifice people with mild and moderate disabilities and illness in order to spend most of our dollars on people who are severely impaired? Our first writer, Dr. Daniels, warns us that there are no moral tenets upon which we can easily or comfortably hang our hats, as he shares the current perspective of medical bio-ethics. Dr. Sabin is a practicing psychiatrist at Harvard Pilgrim Health Care. He highlights the Oregon health Plan as one example of political fortitude and wisdom in resolving healthcare resource allocation challenges. Mac Crawford, chairman of the board and chief operating officer of Magellan Health Services, is in one of the most influential positions in private sector integrated behavioral services delivery. He stresses the importance of managed care and clinical process standardization as fundamental requirements for the rational allocation of resources. One additional note: The lack of a consumer voice in this Dialogue is an unfortunate consequence of the mismatch between submissions received and our publication deadlines. It was our intention to present the perspective of a prominent individual from the growing field of consumer and family advocacy. We apologize for the lack of this perspective, which may have extended this discussion to the practical implications of this abstract question of resource allocation.

Cost-Benefit Analysis↗
PubMed1997

The dew of Jerusalem: the Israeli health care system.

The Israeli health care system is more advanced than the American system in its universal coverage, its financing mechanism, and in its implementation of a managed competition process. Yet, it trails American developments in management of inpatient and outpatient services and in the creative design of provider reimbursements. An MCO executive provides his observations from a trade/study mission to this Middle Eastern country.

Capitation Fee↗
PubMedDate not supplied

Measuring and improving quality and performance in an evolving health-care sector.

How can the challenges of quality measurement, assurance, and improvement be met at the national, state, and community levels? Can we sustain high levels of quality of care in an evolving health sector that wants to control costs and needs to extend access to millions of people? Can we find new ways to measure clinical practice performance and improve quality that will work more effectively in both the private and public sectors? All these questions demand answers in the context of contemporary circumstances.

Cost Control↗
PubMed1995

The uninsured consumer and hospital choice: an assessment of emergency department utilization.

The term "choice" has played an important role in the ongoing debate over health care reform in the United States. One of the major assumptions underlying reform efforts is that affordability drives consumers' choice of health care providers, particularly for the uninsured. In the state of Maryland, the issue of affordability is addressed by an "all-payor" system. In such a scenario, where enhanced choice opportunities are available for the uninsured, such consumers seem to be making choices which lead to the use of hospitals other than those which would be predicted based upon convenience or closeness of location alone.

Community Participation↗