Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Universal Health Insurance”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,243 records · Page 69Linked to original sources
PubMed2002

The medical examination and biological selection of university students in Nazi Germany.

This article looks at the history of the medical inspection and biological selection of students in the Weimar Republic and Nazi Germany. It discusses the emergence of regular medical inspection of various social groups, including students, in the 1920s and explains why the Nazis were so eager to make health inspections--complete with anthropological and racial surveys--an integral part of the admission process to German universities. It examines why certain individuals, mainly young physicians, complied with the Nazi laws and why others, such as female and fraternity students, older and established physicians in the university clinics, and university administrators, sought to sabotage the procedures. Finally, it explains the failure of biological selection on university campuses in the context of the evolving educational and social policies of the Nazi regime.

Germany↗
PubMed1990

National health insurance: prospects and problems.

The prospect of National Health Insurance raises key emotions and questions concerning the impact of NHI on hospitals. The ongoing debate is a reminder of the strategic shift such a development would impose on hospital executives. Major interest groups now are on record supporting universal access, if not universal insurance.

Forecasting↗
PubMed1992

The rationing of health care: should Oregon be transported to Australia?

The Oregon Plan is an ambitious attempt to address the widespread problem in the United States of a growing number of individuals who are without private health insurance and are not eligible for federal assistance programs. Its aim is to provide universal access for all Oregonians, without increasing total health care expenditure, by restricting the cover of some treatments. It has aroused interest in Australia and elsewhere. The appeal of the Oregon Plan lies in its explicit approach to rationing, in community participation in setting priorities, and the use of a cost-effectiveness framework. This paper describes the beginnings and the development of the Oregon Plan, and compares the actual development of the Plan with the rhetoric. There is a gap between the rhetoric of the Plan and its reality. The Oregon plan should be considered in the context of the United States health care system. We compare the American problems with those facing the Australian health care system and conclude that the answer to the question of whether Oregon should be transported to Australia is no. Nevertheless there are elements of the rhetoric of the Plan which could be applied in rationing health care in Australia.

Health Care Rationing↗
PubMed1980

Utilization of publicly insured health services in Saskatchewan before, during and after copayment.

This study examines the effects both of introducing and of removing copayment charges under a universal public medical care and hospital insurance program. For a period between 1968 and 1971, the Province of Saskatchewan imposed user charges of approximately 33 per cent and 6 per cent on medical and hospital services, respectively. The effects of these charges are analyzed using pooled cross-section samples of families and using both multivariate methods and experimental/control groups designs. Diagnostic- and procedure-specific analysis is also performed on the hospital data using the individual as the unit of observation. The findings of the study indicate a copayment effect of 5.6 per cent for physicians' services. No evidence could be adduced that would support the conclusion of a copayment effect for hospital services.

Deductibles and Coinsurance↗
PubMed1999

Financial burden of trauma care on a university hospital in a developing country.

BACKGROUND: Trauma care is expensive and more so for the hospitals not subsidized by the government, as is the case in developing countries. In this study, the burden of trauma care on a typical Level I trauma center in Turkey was investigated. METHODS: Medical, demographic, and financial records of trauma patients who were hospitalized in the calendar year of 1996 were analyzed. RESULTS: A total of 347 patients had complete data available for analysis. The mean Injury Severity Score was 13.3+/-0.5. Total hospital charges and charges per patient were $547,391 and $1,577, respectively. There was a positive correlation between the Injury Severity Score and the hospital charges. Although 54.2% of the patients were self-payer and the rest (45.8%) had some form of a health insurance, 5.5% ($30,496) of total hospital charges of these 347 trauma patients could not be collected by the hospital. CONCLUSION: Trauma care is expensive and reimbursement is not always possible, but the hospital's nonreimbursed money was within tolerable limits, and the overall financial balance of the hospital from the trauma care was on the positive side, even in the absence of government subsidy.

Adult↗
PubMed1998

Developing genetic privacy legislation: the South Carolina experience.

The availability of presymptomatic and predisposition genetic testing has spawned the need for legislation prohibiting health insurance discrimination on the basis of genetic information. The federal effort, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, falls short by protecting only those who access insurance through group plans. A committee of University of South Carolina professionals convened in 1996 to develop legislation in support of genetic privacy for the state of South Carolina. The legislation prevents health insurance companies from denying coverage or setting insurance rates on the basis of genetic information. It also protects the privacy of genetic information and prohibits performance of genetic tests without specific informed consent. In preparing the bill, genetic privacy laws from other states were reviewed, and a modified version of the Virginia law adopted. The South Carolina Committee for the Protection of Genetic Privacy version went a step further by including enforcement language and excluding Virginia's sunset clause. The definition of genetic information encompassed genetic test results, and importantly, includes family history of genetic disease. Our experience in navigating through the state legislature and working through opposition from the health insurance lobby is detailed herein.

Confidentiality↗
PubMedDate not supplied

The uninsured 'access gap' and the cost of universal coverage.

This study estimates the effect of universal coverage on the use and cost of health services by the uninsured. Adults lacking insurance for a full year have about 60 percent as many ambulatory contacts and about 70 percent of the inpatient hospital days they would have if they were covered by insurance. This "access gap" is only slightly smaller for children. Providing universal coverage would increase ambulatory contacts and inpatient days by less than 4 percent a year. The dollar cost of these new services is estimated to be $19.9 billion--a 2 percent increase in health spending.

Adult↗
PubMed1995

Health care system reform and public health. Protecting the safety net.

The most difficult to reach underserved populations are not likely to disappear even with universal insurance coverage. Universal coverage does offer all educated and motivated individuals, including those lacking financial resources, the opportunity to seek improved health through prevention services and treatment for illness. But, it would not guarantee that uneducated and unmotivated people, substance abusers, the chronically mentally ill, people with geographic or cultural barriers to access, or other traditionally underserved populations will use or be able to use a new system more wisely. These last groups, who, for various reasons, may underuse prevention services or delay contact until disease is transmitted or illness is advanced, will continue to add costs to a reformed health care system. Care must therefore be exercised in health care system reform to provide incentives for private-sector outreach to these problem populations. Even with incentives, however, history suggests that the private sector will either avoid or have difficulty incorporating the large groups of disadvantaged patients who in the past have relied on public health services and public hospitals for their health care. The public health sector will need to maintain the capacity to provide for the health care of many disadvantaged groups with historically poor access. It becomes critical in the budgetary trade-offs inherent in health care system reform that the infrastructure of the public health system not be damaged.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Care Reform↗
PubMed1995

Health for all in the Republic of Korea: one country's experience with implementing universal health care.

Health care reforms in many countries face the twin challenges of providing universal coverage while controlling spiraling costs. Sixteen years ago the Republic of Korea had no national plan for health insurance, and only 8.8% of the population was covered. In 1975, health care accounted for 2.8% of GDP with government providing 12% of the finances. In 1977, Korea adopted a policy designed to achieve universal coverage while maintaining fee-for-service reimbursement. Korea incrementally established an employer based health care scheme by first mandating coverage for businesses, then government employees and teachers. Coverage was later extended to the poor, the self-employed, and residents of rural areas. Independent insurance societies manage each scheme, set premiums and co-payments, and are responsible for maintaining financial viability. By 1991, 30% of Korea's health care expenditures were from public funds, and health care costs had risen to 7.1% of GDP. Health care reform in Korea has been successful in achieving universal coverage, providing for a full range of services, and eliminating adverse selection. The system is financially solvent, costs are equitably distributed with the government providing subsidies when necessary, and small businesses have not been unduly burdened economically. Attempts to limit costs, however, have been unsuccessful. Patient demand for health care has remained surprisingly resistant to increasing co-payments. Providers have responded to lower physician and hospital fees by providing shorter, more frequent patient visits, relabeling services, and increasing hospital admissions. Competition between insurance societies has not materialized in a meaningful way to control costs.

Health Care Costs↗
PubMed1987

Selecting health insurance: the importance of prescription drug coverage and pharmacy factors in consumer decision making.

This study determined how important prescription drug coverage was to consumers in selecting their health insurance plans, the specific pharmacy factors they considered, and the importance of factors considered. A mail survey questionnaire was sent to 800 state government and university employees residing in the Madison, Wisconsin area; 453 questionnaires were returned. The majority (59.0 percent) of respondents aware of health insurance prescription coverage placed at least moderate importance on that coverage when selecting their health insurance plan. The specific factors considered most often were cost, location, convenience, and flexibility to choose or change pharmacies. The importance ratings for cost, location, flexibility, and the pharmacist varied among respondents enrolled in different health insurance plans.

Community Participation↗
PubMed1996

Insurance for autosomal dominant polycystic kidney disease patients prior to end-stage renal disease.

There recently has been substantial dialogue about access to health insurance for Americans. This discussion has highlighted the issues of pre-existing diseases and portability as barriers to adequate health insurance coverage. For these reasons we decided to investigate the issues relating to health insurance and life insurance coverage experienced by patients with autosomal dominant polycystic kidney disease (ADPKD). A questionnaire-based study was conducted. Two hundred thirty-eight of 354 subjects responded. There was no significant difference in gender, age, number of children, or level of renal function between responders and nonresponders. Twenty-eight of the 238 respondents had eight-stage renal disease and were eligible for Medicare; these patients were not used in the analyses relating to health insurance, but were used in the analyses relating to life insurance. Although 87% of the ADPKD patients were concerned about the availability of health insurance, 88% were currently insured. Eight-three percent of subjects with health insurance obtained it through their own or their spouse's employer. Of those individuals with employer-based health insurance who were aware of their ADPKD, only 25% informed their employer and 35% informed their insurer at the start of coverage. Fifty-seven percent of those with employer-based health insurance had this availability determine their job choice and 37% stayed in the job because of health insurance. Thirty percent of the subjects had previously been denied health insurance. Although subjects were less concerned about life insurance, many of the same types of issues and factors were present. Thus, the current lack of universal health care in this country creates anxiety and difficulties for patients with ADPKD. The effect of a pre-existing condition and the lack of portability resulted in denials, work choice limitation, and unwillingness to share health information for this patient population with a hereditary, systemic disease.

Adult↗
PubMed2001

Quality programmes, accreditation and certification in Switzerland.

PURPOSE: To report on current quality initiatives in health care in the context of accreditation and certification in Switzerland. SOURCE OF INFORMATION: A review from the Swiss Accreditation Service, the Swiss Medical Association and the University of Zurich. SETTING: In Switzerland, health care providers and health insurers are obliged by law to sign contracts on quality of care. The law texts and related ordinances do not state explicitly the content and format of quality contracts between providers and costs payers. Finding adequate practical solutions is the responsibility of the partners involved. Six different possibilities of quality initiatives are studied and discussed in this report. These include initiatives to create independent certification or inspection bodies for health care organizations accredited by the national accreditation body. FINDINGS: So far, there is only one established standardized system with clear requirements. This accreditation and certification model is an adaptation of the International Standards Organization but so far it has not been used often in the public domain. Each of the other five approaches are more frequently applied but none of them lead to full external peer review certification including medical outcome yet. CONCLUSIONS: A lot of harmonization work still has to be done and clear branch specific requirements need to be agreed upon. Practicability and validity of external peer review schemes may also need further evaluation and improvement to reach the goals of health care systems in the future.

Accreditation↗
PubMed1994

President Clinton's proposal for health care reform: key provisions and issues.

Shortly after his election in 1992, President Clinton appointed a health care reform task force to develop a proposal for providing health care benefits for all American citizens and legal residents. Between February and May 1993 the Interdepartmental Working Group, composed of more than 30 working groups addressing specific health care issues, prepared options for the task force. The Health Security Act was introduced in November 1993. Besides universal coverage and a basic benefit package, provisions included health insurance reform, regional alliances for structuring competition among health insurance plans, consumer choice of health plans, and provisions for Medicaid beneficiaries. Proposed mental health and substance abuse provisions included coverage of intensive nonresidential services, medical management, evaluation and assessment services, and case management. Initial limitations on coverage of inpatient mental health services and psychotherapy would be removed by 2001. The Clinton plan also called for integration of public mental health and substance abuse services into the full range of health services offered by local health plans. Major issues that will have to be resolved if health care legislation is to be enacted include whether regional alliances should be mandatory and whether employers should be required to contribute to insurance premiums.

Health Care Reform↗
PubMed1997

Antigovernment sentiment and support for universal access to care: are they incompatible?

OBJECTIVES: Attitudes toward universal access to medical care were examined to determine whether support for it among people opposed to government involvement in health care was modified by three proxy measures of self-interest: being uninsured, in poor health, or a high user of medical care. METHODS: Data on support for universal access, attitudes toward government involvement in health care, and the indicators of self-interest were obtained from a representative sample of adult Oklahomans (n = 1547) surveyed between October 1992 and December 1994. Forced-order multiple regression with interaction terms was the data analysis technique. RESULTS: People opposed to government involvement in health care were found to be less likely to favor universal access to medical care, but poor health, lack of insurance, and high usage of medical care moderated this effect. CONCLUSIONS: The findings support the view that antigovernment sentiment need not foreclose the public option for health policymakers. Other considerations such as self-interest may modify the effect of unfavorable attitudes toward government.

Adult↗
PubMed1995

[Positive experiences in Scandinavian patient insurance].

Voluntary insurance for the compensation of patients for damage sustained in health care was introduced in Sweden 20 years ago and similar systems exist in Finland, Denmark and Norway. This type of insurance is, or is in the process of becoming, statutory. The basic principle is that the apportioning of blame to any individual(s) is not a prerequisite for compensation to be paid out for injury sustained by a patient. Owing to hospital proprietors and care givers having taken out patient insurance policies with approved insurance companies, it has been possible for damages to be compensated in accordance with current insurance norms and the frequency of lawsuits arising from injury sustained in health care has been minimised. This type of insurance is universally accepted, and has often enabled unfortunate confrontations between doctors and patients to be avoided.

Clinical Competence↗