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Results for “Universal Health Insurance”

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PubMed1987

Changing patterns of health insurance coverage: special concerns for women.

Health care expenditures and utilization have increased dramatically in recent years, but gaps in health insurance coverage restrict access to care for a growing portion of the population. Women are especially vulnerable given the structure of insurance coverage and demographic factors. The erosion of insurance coverage can be attributed to several trends, particularly employer cost containment strategies, restricted public program eligibility and changes in the characteristics of the work force. Numerous measures have been adopted at the federal and state levels to maintain or expand coverage on an incremental basis. As broader segments of the population suffer reduction or loss of coverage, a comprehensive approach will be necessary to ensure universal access to health care.

Adolescent↗
PubMed1993

Universal health coverage.

Although over 12% of our gross national product is spent on health care, approximately 14% to 17% of Americans are not covered by any form of health insurance. The cost, benefits, and deficiencies of private insurance and government programs are discussed in this article. The increasing percentage of persons surviving into older age, improved technology, patient demands and expectations, administrative costs, medical malpractice and defensive medicine, and other factors contribute to the steadily increasing cost of care. Physicians must participate in health care reform or passively accept determinations made in their absence.

Health Care Costs↗
PubMed2006

Bridging the divide: global lessons from evidence-based health policy in Mexico.

During the past 6 years, Mexico has undergone a large-scale transformation of its health system. This paper provides an overview of the main features of the Mexican reform experience. Because of its high degree of social inequality, Mexico is a microcosm of the range of problems that affect countries at all levels of development. Its health system had not kept up with the pressures of the double burden of disease, whereby malnutrition, common infections, and reproductive health problems coexist with non-communicable disease and injury. With half of its population uninsured, Mexico was facing an unacceptable paradox: whereas health is a key factor in the fight against poverty, a large number of families became impoverished by expenditures in health care and drugs. The reform was designed to correct this paradox by introducing a new scheme called Popular Health Insurance (Seguro Popular). This innovative initiative is gradually protecting the 50 million Mexicans, most of them poor, who had until now been excluded from formal social insurance. This paper reports encouraging results in the achievement of the ultimate objective of the reform: universal access to high-quality services with social protection for all.

Adult↗
PubMedDate not supplied

Health USA. A national health program for the United States.

The Health USA Act of 1991 addresses two fundamental health services financing problems: the more than 30 million uninsured persons and the rising costs for health care and for health insurance. Health USA would provide coverage of the entire resident population for comprehensive medical and preventive health and long-term care services through a universal tax-funded financing system. The federal government would contribute an average of 87% of program costs to each state, which would establish, under federal guidelines, a state health program. Each individual or family may enroll in any health plan approved by the state program, including many private plans, or a plan run by the state program. Through the approved plan of their choice, enrollees would receive covered services and obtain their care from participating physicians and other professional practitioners, hospitals, and other facilities. The state program would pay approved plans a capitation payment for every person enrolled. The plans would pay professional providers fees, as part of an all-payer system of fee schedules and expenditure targets, or capitation payments or salary. Hospitals would be financed through global budgets negotiated by the state program with each hospital. The plan run by the state program would pay the health care costs of any person who does not enroll in an approved plan, making the state plan the payer of last resort and eliminating uncompensated care and cost shifting by providers. Health USA would separate health care coverage from employment, ensuring uninterrupted coverage and eliminating employers' administrative role in providing coverage. Federal and state taxes would replace present methods of financing by private insurance premiums and large out-of-pocket expenditures. Building on the present system of health plans, Health USA would offer all persons a wide choice of competing plans in which to enroll and offer professional providers a wide choice of plans in which to practice. It would control costs by increasing financial accountability of providers and health plans, reducing present reliance on intrusive utilization review and on patient cost sharing. By controlling health care and administrative costs, Health USA would cover the entire population and, according to independent cost estimates, reduce national health expenditures by $11.5 billion in 1991.

Cost Control↗
PubMed2005

Developing techniques for determining sperm morphology in today's andrology laboratory.

PURPOSE: To investigate three areas: the staining of spermatozoa; the Computer Assisted Semen Analysis (CASA); and the variability of technicians. METHODS: Staining experiment: sperm from 15 beef bulls were randomized to one of three staining protocols. CASA experiment: slides were evaluated using the Integrated Visual Optical System and compared to technician results. Variability of technicians: five laboratorians analyzed the same set of 20 slides six different times. RESULTS: Staining experiment: the size of the sperm increased in proportion to increased time and heat associated with each successive protocol. CASA experiment: coefficient of variation ranged from 18.3 to 101.7% (12 slides). Variability of technicians: the mean sperm morphology results ranged from 7.3 to 15% normal forms. CONCLUSIONS: Until laboratories adhere to the universal standard set by the World Health Organization to evaluate sperm morphology, a laboratory must rely on its own quality control to insure repeatable results.

Adult↗
PubMed1996

Early versus late prenatal care in New Mexico: barriers and motivators.

BACKGROUND: Adequate prenatal care is important for ensuring a good outcome for pregnant women and their children, and its initiation in the first trimester is a major component. We investigated barriers and motivators for women receiving early versus late prenatal care. METHODS: A self-administered questionnaire was distributed to 205 women who began prenatal care at the University of New Mexico Hospital Obstetrics Clinic in Albuquerque, New Mexico. The questionnaire assessed demographic information, insurance status, feelings about the pregnancy, health behaviors, and barriers and motivators to initiating prenatal care. The participants were Hispanic (41%) and non-Hispanic white (46%), low-income women with Medicaid (42%) or no health insurance (41%). They were divided into early (1st trimester 67%) and late (after 1st trimester 33%) care groups. RESULTS: Ethnicity, education, income, and age did not predict initiation of prenatal care. Late initiators cited financial problems (26%), not being aware of the pregnancy (15%), and dislike of going to doctors (14%) as reasons for the delay in seeking prenatal care. Over two-thirds of the pregnancies were unplanned, but 82 percent of the women felt positive about the pregnancy. CONCLUSIONS: Our study documents the continuing need for public health efforts to encourage women to seek early prenatal care. Specific attention should be directed toward women's perceived reasons for not initiating early care.

Adolescent↗
PubMed1997

Social consequences of psychiatric disorders, II: Teenage parenthood.

OBJECTIVE: The subject of this study was the relation between retrospectively reported early-onset psychiatric disorders and subsequent teenage parenthood in the general population. METHOD: The data were from 5,877 respondents aged 15-54 years in the National Comorbidity Survey, a nationally representative household survey. Information on respondents' DSM-III-R anxiety disorders, mood disorders, substance abuse disorders, and conduct disorder, age at the birth of the first child, and teenage sexual activity was collected in face-to-face interviews. RESULTS: Early-onset psychiatric disorders were associated with subsequent teenage parenthood among both females and males, with significant odds ratios of 2.0-12.0 and population attributable risk proportions of 6.2%-33.7%. Disaggregation analyses showed that disorders were associated with increased probability of sexual activity but not with decreased probability of using contraception. CONCLUSIONS: These results add to a growing body of evidence that psychiatric disorders are associated with a variety of adverse life consequences. The current policy debate concerning universal insurance coverage needs to take this into consideration. Planners of interventions aimed at preventing teenage pregnancy should consider including a mental health treatment component in their intervention packages. Mental health professionals treating adolescents need to be sensitized to their higher risk of pregnancy, while family doctors and specialists treating teenage mothers or their children need to be sensitized to the mothers' higher risk of psychiatric disorder.

Adolescent↗
PubMed2004

Case fatality and health care costs in HIV-infected patients: evolution from 1992 to 2000 at Rouen University Hospital, France.

Vital prognosis in HIV-infected patients has been improved by new therapies, leading to an increase in treatment and outpatient costs but lower inpatient care costs. The aim of the study was to compare the health care costs between 1992-1996 (first half) and 1996-2000 (second half) in HIV-infected patients at Rouen University Hospital. Hospitalization costs (including inpatient and outpatient care), infectious complication treatment and antiretroviral therapy costs were evaluated from a National Health Insurance viewpoint. Between 1992 and 2000, 1212 patients were admitted at least once. Total expenditure increased between the two periods from 13,660 Euro to 27,567 Euro, i.e., a two-fold increase. During the same period, 125 deaths were avoided, and 3602 years of life were gained. The cost of one avoided death was 108,320 Euro and the cost per life-year gained was 3776 Euro.

Adolescent↗
PubMedDate not supplied

A preliminary study on travel health issues of medical students undertaking electives.

BACKGROUND: With the inclusion of elective programs, often overseas, in many medical courses, it was decided that a preliminary retrospective analysis of health problems associated with these programs in medical students from the University of Tasmania would be desirable. METHODS: A questionnaire covering general travel health issues was distributed to all medical students in the University of Tasmania, on return from their elective. They were asked to complete the questionnaire and return it on an anonymous and voluntary basis. In addition, student elective submissions were consulted for information relating to their chosen destination. RESULTS: Results of the study indicate that general practitioners were the most common source of pretravel advice for Tasmanian medical students. Overall, 64% of students experienced some sort of health problem of which travelers' diarrhea was the most common. Most problems were mild and self-limiting, but a number of serious infections were recorded, including acute leptospirosis, paratyphoid, and Staphylococcus aureus cellulitis. Of particular concern were the reports of assault and sexual harassment recorded by several students. CONCLUSIONS: Elective programs are an important part of many medical courses. With the widespread destinations chosen by students, it is important that they be given adequate pretravel health advice. Most of the health problems encountered by students from the University of Tasmania were mild, but exposure to serious infections was recorded. It is thus imperative that students take out travel health insurance and that they are counseled on how to avoid dangerous situations while abroad.

Animals↗
PubMedDate not supplied

Access: the most critical issue facing reform.

In the present reform environment, businesses can effectively work with insurers and provider networks to construct and monitor a basic benefits design that would enlist the public more fully in providing universal health care.

Health Benefit Plans, Employee↗
PubMed1991

Factors driving costs must figure into reform.

Employers and employees seeing their health plan premium costs rise faster than physician and hospital costs is one indication that the U.S. healthcare system is in a state of crisis. Examining factors behind providers' and health plans' costs--demographics, increased hospital expenses, insurance overhead, fragmentation among managed care plans, and failure of some cost-containment initiatives--indicates the shape healthcare reform must take if it is to succeed. Reform proposals in the 1990s likely will entail simplification and consolidation, such as providing universal access, consolidating managed care, and establishing a single-payer system.

Canada↗