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PubMed1991

Political action committees: how much influence will $7.7 million buy?

The influence of health-related political action committees (PACs) continued to grow during the 1990 election campaign. During the first 18 months of the election cycle, contributions from medical and health care PACs to congressional candidates reached a total of $7.7 million. Among the leading PACs were the American Medical Association, American Dental Association, and American Hospital Association, which contributed a total of $3.3 million to congressional races through September 1990. For its study, HealthWeek monitored the contributions and Federal Election Commission reports of 52 leading health care PACs, including professional and trade associations, drug companies, insurers, and other groups. Trade groups made up about two-thirds of all PAC dollars spent, and several of these groups increased their spending significantly in the 1990 election cycle. Key lawmakers on health-related congressional committees received nearly $1.5 million from health care PACs, the study found. In all, 16 senators and representatives received more than $30,000 each from health care PACs. Senator John D. Rockefeller IV (Democrat, West Virginia) and Representative Thomas Tauke (Republican, Iowa) led the Senate and House, respectively, in total PAC receipts.

American Dental Association↗
PubMed1997

The costs of mergers and acquisitions in the U.S. health care sector.

Important trends are emerging from evidence of health care industry concentration in the United States. Some of these are the durable consumer concerns--cost, choice, and access--which have received attention throughout the introduction of managed care. But with the intensified industry concentration, these have been joined by concerns about pricing power, control and quality, integrity of health system and health policy-making, and clashing institutional mandates. Such trends are particularly evident in the hospital and pharmaceutical industries.

Cost Control↗
PubMed1994

Clinton's health plan: Prudential's choice.

President Clinton has proposed a managed competition model for health care reform. This strategy would accelerate the corporatization of U.S. health care resulting in more bureaucracy, less patient choice, and a health system owned by a few insurance giants. There is no evidence that competition or other central features of Clinton's plan can lower costs or improve quality. Because cost containment is doubtful, the promised expansion of coverage is unlikely to be implemented.

Competitive Medical Plans↗
PubMed1995

Unhealthy money: health reform and the 1994 elections.

Health and insurance interests have substantially increased their contributions to members of Congress in response to the debate over national health care. During the 21 months from January 1, 1993, through September 30, 1994, campaign contributions from the health and insurance industries reached $37.9 million, a 51 percent increase over the same time period in the last election cycle. Health- and insurance-related large donor contributions ($200 or more) increased at the fastest rate, although both health- and insurance-related large donor and political action committee (PAC) contributions increased far faster than contributions by other industries. Contributions from health interests increased the fastest. The American Medical Association PAC was the leading contributor among health and insurance PACs. In the Senate, Republican incumbents received an average of 22.5 times as much from health and insurance interests as their Democratic challengers. No Democratic challenger was favored over an incumbent Republican. Democratic incumbents averaged only 3.5 times as much as their Republican challengers. Health and insurance interests favored seven of the nine Republicans seeking open Senate seats. Of course, one of the two Democrats favored was Jim Cooper, a leading opponent of comprehensive reform.

American Medical Association↗
PubMed2003

Trusted online sources of health information: differences in demographics, health beliefs, and health-information orientation.

BACKGROUND: The recent surge in online health information and consumer use of such information has led to expert speculations and prescriptions about the credibility of health information on the World Wide Web. In spite of the growing concern over online health information sources, existing research reveals a lacuna in the realm of consumer evaluations of trustworthiness of different health information sources on the Internet. OBJECTIVE: This study examines consumer evaluation of sources of health information on the World Wide Web, comparing the demographic, attitudinal, and cognitive differences between individuals that most trust a particular source of information and individuals that do not trust the specific source of health information. Comparisons are made across a variety of sources. METHODS: The Porter Novelli HealthStyles database, collected annually since 1995, is based on the results of nationally-representative postal-mail surveys. In 1999, 2636 respondents provided usable data for the HealthStyles database. Independent sample t tests were conducted to compare the respondents in the realm of demographic, attitudinal, and cognitive variables. RESULTS: The most trusted sources of online health information included the personal doctor, medical university, and federal government. The results demonstrated significant differences in demographic and health-oriented variables when respondents who trusted a particular online source were compared with respondents that did not trust the source, suggesting the need for a segmented approach to research and application. Individuals trusting the local doctor were younger (t2634 = 4.02, P <.001) and held stronger health beliefs (F1 = 5.65, P =.018); individuals trusting the local hospital were less educated (t2634 = 3.83, P <.001), low health information oriented (F1 = 6.41, P =.011), and held weaker health beliefs (F1 = 5.56, P =.018). Respondents with greater trust in health insurance companies as online health information sources were less educated (t2634 = 1.90, P =.05) and less health information oriented (F1 = 4.30, P =.04). Trust in medical universities was positively associated with education (t2634 = 11.83, P <.001), income (t2634 = 10.19, P <.001), and health information orientation (F1 = 10.32, P <.001). Similar results were observed in the realm of federal information credibility, with individuals with greater trust in federal sources being more educated (t2634 = 7.45, P <.001) and health information oriented (F1 = 4.45, P =.04) than their counterparts. CONCLUSIONS: The results suggest systematic differences in the consumer segment based on the different sources of health information trusted by the consumer. While certain sources such as the local hospital and the health insurance company might serve as credible sources of health information for the lower socioeconomic and less health-oriented consumer segment, sources such as medical universities and federal Web sites might serve as trustworthy sources for the higher socioeconomic and more health-oriented groups.

Academic Medical Centers↗
PubMed1996

The work hardening program and subsequent return to work of a client with low back pain.

Billions of dollars are spent annually for the costs associated with workers' compensation cases. Chronic low back injuries have been traditionally the most costly cases. In addition to the physical problems, psychosocial issues emerge which confound conventional treatment and prolong resolution. Work hardening programs were developed to address the many issues of the occupationally injured chronic patient. This case study examines the treatment of a 54-year-old male who sustained an injury to his lumbar spine during employment as a boiler mechanic and subsequently had been out of work for 8 months. The article describes the interdisciplinary work hardening treatment (5-week duration) and the progressive resistive work circuit which preceded the client's return to work. It is concluded that work hardening programs can be cost-effective for insurers, as in this case, saving an estimated $44,000. An aggressive return to work program should also be considered in earlier stages of injury as a way of preventing the development of chronic disability for which the human costs are immeasurable.

Chronic Disease↗
PubMed1997

Patient referrals to a multispecialty asthma clinic. Asthma Care Center Clinical Consortium.

A total of 656 patients with asthma have been referred to a multispecialty pediatric asthma clinic for evaluation; 52 (7.9%): mild; 406 (61.9%): moderate; 177 (27%): severe; and 21 (3.2%): incomplete data. No significant differences in demographics or payer source were observed across disease severity levels. Only 25% of the patients with primary care providers were referred by these practitioners. Over 20% of the mild asthmatics were using inhaled bronchodilators regularly. Only 40% and 50% of the moderate and severe asthmatics, respectively, were using inhaled bronchodilators regularly, and only 19% and 36%, respectively, were on maintenance inhaled corticosteroids. Pressures to reduce subspecialty services may place some of these asthma patients at increased risk for complications from this chronic lung disease.

Administration, Inhalation↗
PubMed2006

A physicians' agenda for partnering with employers and insurers: fresh ideas.

We report the results of the second phase of a multiphase qualitative investigation of the ways physicians, employers, and insurers can work together more effectively to provide better ambulatory care to employees and their dependents. This article focuses on ways physicians can develop more useful relationships among these groups. We used a grounded theory approach to conduct 71 interviews from August 12, 2004, to December 27, 2005, with 25 practicing physicians in large and small groups, urban and rural areas, private and academic settings, and primary care and specialty practices; 33 hospital administrators, medical association executives, health insurance medical officers, and health policy analysts; and 13 senior executives of large and small companies. The study identifies 2 approaches to the structuring of ambulatory care that can lead to improved health care outcomes and value. In the first approach, direct contracting between physicians and employers transfers tasks previously performed by insurers to employers or other intermediaries who may be able to provide better service or lower cost. In the second approach, insurer-mediated relationships between physicians and employers are restructured, particularly in ways that improve information flow. Such relationships may strengthen physicians' ability to provide quality services while enabling patients to make more informed decisions about physician selection, treatments, and spending. We believe that broader use of these approaches may improve the quality and efficiency of ambulatory care for the large proportion of the population that has work-related health insurance. Although the findings are promising, our intent is not to claim broad external validity but rather to encourage greater experience with these approaches and more formal studies of their effectiveness.

Attitude of Health Personnel↗
PubMedDate not supplied

The association of two productivity measures with health risks and medical conditions in an Australian employee population.

PURPOSE: To investigate the impact of health on job performance using two measures of productivity loss: (1) a self-reported measure of health-related presenteeism and (2) an objective measure of absenteeism. DESIGN: A cross-sectional survey using a Health Risk Appraisal (HRA) to evaluate self-reported presenteeism and the prevalence of 12 health risks and eight medical conditions. SETTING AND SUBJECTS: Employees (n=224) of a private insurance provider in Australia. MEASURES: A Health Risk Appraisal (HRA) questionnaire was used to evaluate self-reported presenteeism on different aspects of job demands and to assess the prevalence of 12 health risks and eight medical conditions. Illness absent hours were obtained from company administrative records. RESULTS: Increased presenteeism was significantly associated with high stress, life dissatisfaction, and back pain, while increased illness absenteeism was significantly associated with overweight, poor perception of health, and diabetes. Excess presenteeism associated with excess health risks (productivity loss among those with medium- or high-risk status compared to those with low-risk status) was independently calculated at 19.0% for presenteeism and 12.8% for illness absenteeism. CONCLUSIONS: This study demonstrates an association between health metrics and self-reported work impairment (presenteeism) and measured absenteeism. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss.

Absenteeism↗