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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↗
PubMed1992

Why the United States does not have a national health program: the medical-industry complex and its PAC contributions to congressional candidates, January 1, 1981, through June 30, 1991. Common Cause.

The Common Cause study presents data on medical-industry PAC contributions to Members of Congress during the period January 1, 1981, through June 30, 1991. Included are listings of the top 25 congressional recipients, the top 25 Senate recipients, and the top 50 House recipients of contributions from medical-industry PACs; medical-industry PAC contributions to members of the four key congressional committees and to the congressional leadership; top congressional recipients of contributions from medical professionals' PACs, including the American Medical Association, from health insurance PACs from pharmaceutical PACs, and from hospitals and care-provider PACs; and the top medical-industry PACs. State-by-state lists of medical-industry PAC contributions to Senators and to Representatives, including breakdowns of insurance, AMA, and pharmaceutical contributions, are given in the appendixes.

American Medical Association↗
PubMed1978

Utilization of records of the National Health Insurance programs for study on cancer morbidity and survival.

Potential value of the records of National Health Insurance programs for study on cancer morbidity was investigated by examination of those preserved in two towns in Japan. By using such records, population at risk and incidence of cancer can be readily and precisely determined. Deaths with load of cancer and survival rate of cancer were also determined without difficulty. In spite of a few limitations involved in the use of records, they are considered to be highly valuable for study on cancer morbidity and survival, mainly due to absence of under-reporting and to the feasibility of obtaining medical and other informations pertaining to cancer patients throughout the specific period.

Adolescent↗
PubMed1979

Factors affecting physician participation in a state Medicaid program.

Critical to policy planning for a program of national health insurance or a National Health Service is an understanding of the strengths and weaknesses of current federally-supported health programs. One program which has been subjected to criticism is Medicaid. A major problem facing Medicaid is the high proportion of physicians who refuse to participate in the program, thus preventing the target population from obtaining access to medical care. A telephone survey was conducted to assess the attitudes and behavior of a stratified random sample of physicians regarding their participation in a Medicaid program. Physicians were asked to identify major advantages and disadvantages of the program to individual patients, to society and to their medical practice. Non-participants were asked to identify the major reasons why they did not participate in the program. Medical specialty was the only significant demographic determinant of participation. Inadequate reimbursement, excessive paperwork, patient abuses of the program and bureaucratic complexity were among the most prominent factors contributing to nonparticipation. Implications of these findings are discussed with respect to the role of primary care providers' perceptions in the planning of future national health programs.

Adolescent↗
PubMed1991

Integration of AIDS program activities into national health systems.

In this paper we have defined integration as being the health unit team acceptance of responsibility for all aspects of care at the health service/community interface level. The health unit functions within a system whose elements (hospitals, laboratory, pharmacy, etc.) function in complementarity with those of the FLHS. Vertical approaches are often adopted because of weaknesses in some elements of the NHS, thereby further undermining such an NHS. The development of innovative community-based approaches in some areas and countries has resulted from this type of situation. However, isolated from the NHS, such approaches cannot be expected to be sustainable or to have long-term impact. Integration is the best choice of approach; it offers a chance to influence the course of the AIDS epidemic and the response of health systems in each country. The basic structure of the NHS and the characteristics of a FLHS are analyzed. The challenge to AIDS programs is to define more exactly objectives and activities at the operational, interface levels. Based on this analysis, planning of operations should be delegated to the district. Weakness of some elements and aspects of the NHS which are relevant to AIDS control program implementation can be overcome, not by organizing the program vertically and independently from the NHS, but rather by sharing resources to strengthen the weak elements. Integration may be more difficult in the early stages of implementation, but in the long term it offers sustainable development of AIDS prevention and control activities.

Acquired Immunodeficiency Syndrome↗