Search PubMedSearch

SEARCH · Search PubMed

Results for “Financing, Government”

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 19 recordsLinked to original sources

The role of the Federal government in financing health and medical services.

Public sector spending and private sector spending for health and medical services have tended to parallel one another over the past four decades. Although total expenditures have grown dramatically, the relationship between the two sectors has not. Government gradually increased its support and provision of health care between 1929 and 1940. Between 1940 and 1966 government spending for health care remained at a plateau. The federal government's major participation since 1966 has been through its role as a transfer agent for the Medicare trust fund, acting as an intermediary, rather than through the expenditure of general revenues for health and medical care services. Rising costs and increased demand for medical services will probably force a larger financial role upon government.

Financing, Government

NYC public hospitals.

Explore the source record for details and available documents.

Economics, Hospital

Abortion in the United States, 1977-1978.

There were 1.32 million legal abortions in the United States in 1977 and a projected 1.37 million in 1978, an increase of four percent between 1977 and 1978 compared with one of 12 percent between 1976 and 1977. In 1978, 29 percent of pregnant women chose to terminate their pregnancies by abortion. Almost three percent of U.S. women of reproductive age obtained an abortion in 1978. From 1967 through 1978, approximately six million women obtained almost eight million legal abortions; about one in eight U.S. women of reproductive age has had a legal abortion. The number of hospitals reporting that they provided abortion services dropped slightly from 1,695 in 1976 to 1,661 in 1977, but the number of nonhospital abortion clinics increased from 448 to 522, and the number of physicians who reported performing abortions in their offices grew from 424 to 533. Between 1976 and 1977, the average number of abortions per hospital facility decreased from 246 to 237, while the average number per nonhospital provider increased from 875 to 879. The percentage of abortions performed in hospitals declined from 35 in 1976 to 30 in 1977, while the percentage reported by free-standing clinics increased from 61 to 66; the percentage performed in physicians' offices remained at four. Ninety-five percent of abortions in 1977 occurred in metropolitan areas, where 75 percent of the women in need of abortion services live. In 1977, there were identified abortion providers in only 23 percent of U.S. counties. Nine percent (more than 118,000) of the women who obtained abortions in 1977 had to travel to another state for services, and many traveled to other, often distant, counties in their home states. One in three abortions in 1977 were obtained by teenagers, and three in four were obtained by unmarried women. Twenty-eight percent of the women estimated to be in need of abortion services in 1977, and 26 percent in 1978, were unable to obtain them. In FY 1977, before Hyde amendment restrictions on government financing of abortions for poor women, 133,000 of the estimated 427,000 Medicaid-eligible women in need of publicly funded abortion services were unable to obtain them.(ABSTRACT TRUNCATED AT 400 WORDS)

Abortion, Legal

The malaise in internal medicine.

Internists today are discomforted by uncertainty of identity, governmental interference with practice, total responsibility for patients' health, and by waning of faith in science. As personal "caring" physicians, internists are secure in primary care but should maintain their distinctive scholarly leadership as master clinicians and consultants. Humanism and science are one in patient care. Future practice patterns depend on physicians themselves participating in policy decisions for inevitable controls and rationing of government financed health services. The public must understand that good health depends not only on physicians but also on a better society and what people are willing to do for themselves. Western culture has been shaken by the cruel paradoxes of progress and technology. But, human choice not science is at fault, and only wisdom in the use of science will save us.

Decision Making

Control of fraud and abuse in Medicare and Medicaid.

This Comment explores issues concerning the control of fraud and abuse in health programs financed with public funds, specifically the Medicare and Medicaid programs. It summarizes the nature, scope, and possible causes of what some regard as a fraud and abuse "crisis," and points out the difficulties and obstacles facing those who attempt to develop legislative and executive action aimed at controlling fraud and abuse. Recent federal initiatives in fraud and abuse control are examined, and a brief summary of key provisions of H.R. 3 (the Medicare-Medicaid Anti-fraud and Abuse Amendments, which may prove to be a landmark piece of legislation in this area) is provided. The author emphasizes that more effective control of fraud and abuse is necessary if further expansion of government financing of health programs, including national health insurance, is to occur in the near future. At the same time, caution must be taken not to neglect the appropriate use of other mechanisms necessary for reducing the costs of medical care and improving its quality. In addition, it is likely that efforts to stem fraud and abuse will raise important medicolegal and public policy issues that will require careful interdisciplinary consideration.

Crime

Community mental health centers and the "seed money" concept: effects of terminating federal funds.

What happens to community mental health centers when federal funding ends? Analysis of the funding patterns of a cohort of "graduate" community mental health centers indicates that these centers remained fiscally viable subsequent to termination of basic federal grants. However, further analysis revealed two distinct funding patterns within the cohort. One group relied primarily on increased third-party reimbursements to offset the end of basic federal grants. The other sought more state funds and additional federal grants available through the Community Mental Health Center Amendments of 1975. As more centers "graduate," federal "floor funding" may be necessary to insure the survival of some of them.

Community Mental Health Centers

State planning of mental health services.

Planning is the vital process that links needs to solutions. The interorganizational field of human services constitutes a "turbulent environment," a condition of rapid change, and there needs to be greater receptivity toward comprehensive planning on the part of state departments of mental health. Increased overlap with various welfare and educational service, advances in scientific knowledge, and shifts in general attitudes and social philosophy lead to demands for new and different types of service and require changes in approach and method. Generalized findings of a study of 14 state departments of mental health are presented.

Attitude of Health Personnel

Possible programmatic consequences of community mental health center funding arrangements: illustrations based on inpatient utilization data.

Funding arrangements have a direct and substantial influential effect on the delivery of mental health services. Despite the original intent of the community mental health center philosophy, centers have not been freed from programmatic limitations imposed by the fiscal systems. The focus of this article is the inpatient unit that has the key role as relates to a center's ability to raise revenue. Using data from a study of community mental health center inpatient utilization patterns, the authors demonstrate that centers face the problem of becoming revolving doors (for a recidivist population). Existing fiscal arrangements, it is suggested, reinforce this pattern and tend to downplay innovative alternatives to traditional inpatient care.

Ambulatory Care

Fiscal resource development for state mental health agencies.

As funds for human service programs grow scarcer, state mental health departments must become more aggressive in seeking out new funding sources. The development of a fiscal resource development unit at the state level is proposed as one approach to the problem.

Community Mental Health Services