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At least 1,279 records · Page 71Linked to original sources
PubMed1999

Money, politics, and medicine: the American Medical PAC's strategy of giving in U.S. house races.

We examine contributions by the American Medical Association's political action committee (AMPAC) to candidates for seats in the U.S. House of Representatives during two electoral cycles (1989-1990 and 1991-1992). In contrast to earlier studies, we do not find any systematic evidence to support the conventional wisdom that AMPAC contributes to influence legislators' positions on roll call votes or that AMPAC's contribution decisions are influenced by legislators' voting positions. We do find that AMPAC contributes to promote access to decision makers and to help elect (or reelect) legislators who would be expected to be more generally sympathetic to the economic and practice concerns of AMA physicians. As points of comparison, we also examine contributions from the top five tobacco PACs and the National Rifle Association's (NRA) PAC and find that legislators' roll call voting positions are strongly related to contributions received from these organizations.

American Medical Association↗
PubMed1999

The American Medical Political Action Committee: which senators get the money and why?

Previous research has heightened the debate over what motivates the American Medical Political Action Committee (AMPAC), the campaign financing arm of the American Medical Association (AMA). Analyses of roll call votes typically assume that vote-buying is the reason AMPAC contributes to members of Congress, a hypothesis consistent with the theory of economic regulation, but one that has seldom been tested empirically.

American Medical Association↗
PubMed1993

Future pharmacists and public initiatives to control retail drug prices: a political economy framework.

While pressures mount for public policy makers to intercede in the pricing structure of pharmaceutical products, most pharmacists remain reluctant to substitute generic equivalents for branded drugs. This study suggests that pharmacist' aversion to external factors embedded in their channel environments. An adaption of the political economy paradigm reflects the complexity of the pharmaceutical channel relationships.

Attitude of Health Personnel↗
PubMed1996

Political elites and regulatory bureaucrats: a case study concerning age discrimination.

In 1988, the U.S. Senate Special Committee on Aging held a hearing on effectiveness of the Equal Employment Opportunity Commission (EEOC) with regard to age discrimination cases. The Hearing reported that approximately 7,500 age-based claims had run the statute of limitations. The article analyzes the ideological context of regulation, first, by explaining the purpose, procedures, and effectiveness of the EEOC in enforcing the Age Discrimination in Employment Act. Secondly, the article analyzes the 1988 Senate Hearing, including background issues and immediate outcomes. Thirdly, it discusses what has happened since 1988 from the perspectives of political elites, regulatory bureaucrats, and interest-group members.

Aged↗
PubMed2002

Economic, political and ethnic influences on end-of-life decision-making: a decade in review.

Implementation of the Patient Self Determination Act (PSDA) a decade ago has been followed by considerable research examining usage of advance directives among patient populations as well as among health care professionals. This article summarizes the history of end-of-life medical treatment options and provides a discussion of critical economic, political, and legal events that preceded passage of the PSDA. A review of the literature during the decade that followed is presented including research exploring ethnic factors in the completion of advance directives. Barriers to completing advance directives by minority populations are discussed and considerations for policy makers are provided.

Advance Directives↗
PubMed1997

The politics, economics, and ethics of "appropriateness"

The terms "appropriate" and "necessary" are crucial determinants in decisions regarding the use and reimbursement of medical treatments. This paper encourages greater awareness of the political, economic, and normative assumptions that give meaning to these concepts.

Biomedical Technology↗
PubMed1992

Political evolution of federal health care regulation.

Although federal regulation of health care faces cultural obstacles and skepticism among policymakers, it has grown markedly over the past two decades. Beginning in the 1970s with decentralized programs aimed at regulating provider behavior (Health Systems Agencies and certificate of need) and budgets (state rate setting), health care regulation grew more centralized in the 1980s as federal policymakers expanded their influence on behavior (peer review organizations and medical practice guidelines) and budgets (Medicare prospective payment and the resource-based relative value scale). Behavioral regulation has increased the heavy micromanagement that providers face in the United States, while budgetary regulation falls well short of the fiscal macromanagement (global budgets, for example) that other Western nations use. As cost increases intensify, the coalitions that supported limited regulation as a compromise designed to forestall more threatening intrusions may yield to political pressure for firmer central budget controls.

Delivery of Health Care↗
PubMed2005

The politics of recognition in culturally appropriate care.

Over the last 20 years, the concept of culturally appropriate health care has been gradually gaining popularity in medicine and public health. In calling for health care that is culturally appropriate, minority groups seek political recognition of often racialized constructions of cultural difference as they intervene in health care planning and organization. Based on interview narratives from people involved in community organizing to establish a federally funded community health center in a mid-size New England city, I chart the emergence of a language of "culturally appropriate health care" in language used to justify the need for a health center. An identity model of recognition underlies the call for ethnic resemblance between patient and provider seen in many culturally appropriate care programs. I contrast this model of health care with earlier calls for community access and control by activists in the 1970s and explore the practical and theoretical implications of each approach.

Community Health Services↗
PubMedDate not supplied

[Nursing course of the State University of Ceara -- history and current political-pedagogical project].

This paper describes important moments along the route of the Nursing Program at State University of Ceará and their influences on their current process of professional education. It outlines their program, their professors and students, as well as their political-pedagogical project. Finally, it highlights the importance of this instrument to warrant professional qualification.

Brazil↗
PubMed2000

[Contribution to the development of political-pedagogical nursing projects].

Based on the concepts of project and political-pedagogic project, authors presented a proposal for the development of such a project. The framework includes: the reference, the philosophy, the concept and the structure. The reference is the starting point, meaning the knowledge and critical view of reality; the philosophy represents the faith and the community's values involved in the project; the concept represents the theory that gives support to the proposal; and, finally the structure establishes the competences and the profile of the professional to be formed as well as the methodologic option for the organization and development of courses and disciplines. The Habermas' theory of communicative action is proposed as a methodology for the development of projects.

Education, Nursing↗
PubMedDate not supplied

[The political dimension of auxiliary personnel education: nursing and the unified health system (SUS)].

The change in the administration of the municipality of São Paulo in 1989 innovated the management of health services aiming at implementing the Unified Health System (SUS) and using as a fundamental strategy the workers' qualification. Thus, the purpose of this work was to analyze the incorporation of the SUS principles in the programs for the capacitation of nursing auxiliary personnel. Based on the concepts that nurtured the Sanitary Reform and the construction of SUS principles, the methodological framework comprehended interviews with the coordinators of the program. Data analysis enabled authors to recognize that the municipal management policies and practices were committed to SUS guidelines, giving priority to the qualification of health workers who did not have this opportunity and adopting a pedagogy directed to the agents' transformation. The coordinators were motivated to develop the qualification program, recognizing this process as a tool for the SUS implementation. In addition, the coordinators at the regional level understood the technical dimension of this process, isolated from its political dimension.

Brazil↗
PubMed2005

Hospice utilization: political, cultural, and legal issues.

The provision of end-of-life care is considered a substantive part of nursing, and hospice is often considered the "gold standard" of optimal end-of-life care. Unfortunately, however, only an estimated 43% of patients eligible for hospice actually receive hospice services (Harrison, Ford, & Wilson, 2005). The purpose of this article is to describe the political cultural, and legal issues associated with the underutilization of hospice care. Specifically, this article will outline the policy issues for accessing hospice under Medicare and Medicaid, the cultural and social issues in hospice utilization, and the legal implications of these issues. In addition, this article will serve to offer initial solutions to the problems at hand in order to guide nurses in promoting effective, efficient, and realized access to hospice services.

Cultural Diversity↗
PubMed2005

Public health and the politics of school immunization requirements.

Compulsory vaccination has contributed to the enormous success of US immunization programs. Movements to introduce broad "philosophical/personal beliefs" exemptions administered without adequate public health oversight threaten this success. Health professionals and child welfare advocates must address these developments in order to maintain the effectiveness of the nation's mandatory school vaccination programs. We review recent events regarding mandatory immunization in Arkansas and discuss a proposed nonmedical exemption designed to allow constitutionally permissible, reasonable, health-oriented administrative control over exemptions. The proposal may be useful in political environments that preclude the use of only medical exemptions. Our observations may assist states whose current nonmedical exemption provisions are constitutionally suspect as well as states lacking legally appropriate administrative controls on existing, broad non-medical exemptions.

Arkansas↗
PubMed1982

A political economic theory of the dental care market.

A theory of the dental care market is introduced which proposes that the vertically integrated (local/state/national) structure of the profession services as an organizational vehicle both for intra-professional debate and for developing provider-oriented dental care policy. We suggest that a special relationship exists between professionalism and professional regulation. Such regulation has functioned simultaneously to limit competition and to foster a prized consumption commodity for providers: professionalism and professional esteem. The organized pursuit of this commodity inherently dampens competition. Professionalism itself plays a crucial role in: 1) securing for organized dentistry a form of state regulation in which the providers themselves are the principal decision-makers; and 2) influencing provider and consumer market behavior in several significant respects, the net result being the formation of maintenance of a type of "leadership cartel" in the local market. Thus, a political-economic theory of the dental care market formally acknowledges professionalism as valued by established dentists and recent graduates as a central determining influence. Traditional models of pure competition and monopoly emerge as special, extreme cases of the general theory. Hypotheses are offered regarding consumer and provider behavior, market dynamics, and health policy and regulation.

Dental Health Services↗
PubMed1995

Politics and practice: introducing Norplant into a school-based health center in Baltimore.

As one element of Baltimore's effort to combat its high rate of teenage pregnancy, the Baltimore City Health Department added the implantable contraceptive Norplant to the array of services offered at one of its school-based health centers in early 1993. The initial findings with the adolescents who received this contraceptive at the school were favorable, particularly regarding condom use, parental involvement, and patient acceptance of the contraceptive. This new policy garnered a significant amount of attention, both nationally and locally. It attempts to address problems that have complicated etiologies as well as diverse clinical, social, and ethical ramifications, all complicated by political realities. The Norplant experience offers useful lessons regarding controversial health initiatives that address problems facing public health practitioners today.

Adolescent↗
PubMed1998

The emergence of managed care in Europe. Some thoughts on the politics of healthcare reform.

It is the purpose of this paper to demonstrate that healthcare reform in Europe can be successful only if it leads to more efficient resource use while maintaining a large degree of equity in the system. Globalisation is undermining the social contracts that established Europe's egalitarian societies after World War II. While socialised healthcare will continue to be an essential building block of social cohesion, public expenditures must be contained. The only approach to maintaining equity of access and financing in the face of a mounting resource constraint is to embark upon a radical re-engineering of the entire healthcare supply chain, introducing and adapting proven US managed-care techniques to the European environment. Through enabling legislation, most European countries are in a phase of testing the feasibility, cost effectiveness and quality enhancement potential of managed-care approaches, before applying them more broadly. While political opposition to change on the part of those whose current positions are threatened continues to run high, the practice of medicine can be expected to converge on the basis of standards of care and information technology over the next 10 to 15 years.

Cost Control↗
PubMed2004

Are the economics of pharmaceutical research and development changing?: productivity, patents and political pressures.

Pharmaceutical research and development (R&D) competition in the 1980s and 1990 s was characterised by rising R&D expenditures, favourable returns to innovators and the introduction of many new classes of drugs with high social benefits. However, in the past 3 years, the number of new drug introductions has been well below the historical trend, while the cost per new drug continues to increase. In addition to lagging R&D productivity, the industry has been characterised by other economic and policy uncertainties. These include a wave of early patent challenges and growing political pressure to contain pharmaceutical expenditures. This paper examines the consequences of these developments.

Drug Approval↗
PubMed1990

Rethinking homicide: violence, race, and the politics of gender.

Although homicide is the fourth leading cause of premature mortality in the United States and the leading cause of death for young blacks, the health professions have been largely oblivious to violence. Prevailing explanations contribute to this neglect by emphasizing biological or psychiatric factors that make homicide unpredictable and cultural and environmental factors such as the emergence of a new "underclass" that link violence to race. Focusing on instances where no other crime is involved, this article proposes that "primary" homicide be reconceptualized as a by-product of interpersonal violence, a broad category of social entrapment rooted in the politics of gender inequality and including wife abuse, child abuse, and assaults by friends and acquaintances. The data show that blacks are no more violent than whites, though they are arrested and die more often as the consequence of violence. In addition, a majority of homicides are between social partners or involve gender stereotypes, are preceded by a series of assaults that are known to service providers, and grow out of "intense social engagement" about issues of male control and independence. Professional failure to respond appropriately is a major reason why assaults become fatal, particularly among blacks. An international strategy that combines sanctions against interpersonal assault, gun control, and the empowerment of survivors might prevent half of all homicides.

Adolescent↗