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The article presents a memorandum of the Royal Medico-Psychological Association on the Second Green Paper on the future of the National Health Service in Great Britain. The association aims to coordinate the National Health Service and the Local Government services and welcome the participation of legal professionals and consumers. Policies concerning the management are given more importance rather than the daily administration activities. Furthermore, a single authorities should be recognized in each areas of the Health Service, including the social work and medical services.

Health planning in this paper is considered as a developmental process in which different types of planning appear at different times. These types are discussed and the place in the complex health care system developing in the United States is assessed. [ABSTRACT FROM AUTHOR]

In a recent article Lindsay [16][2] invented a theory of the National Health Service (NHS), which in its normative form implies the possible Pareto optimality of a nationalized health care system, and in a positive form shows that such a system may be an implication of rational collective behaviour by individuals having certain arguments in their utility functions. In common with other rationales for government intervention in the market for health care, Lindsay's "sharing" hypothesis is based upon the externality relation in health care consumption. The sharing hypothesis differs, however, from more conventional approaches in that the externality-affected parties (e.g. the relatively rich) have their utility levels affected by the quantity of health care each individual receives in relation to others rather than only the absolute amount each receives. The present paper seeks to re-instate the more traditional approach as a "philanthropy" hypothesis in which it is the quantity of "suffering" felt by people rather than the distribution of "suffering" that forms the basis of the externality relation, and which affords a better explanation of the NHS. In this paper the normative interpretation of Lindsay's theory will not be considered since a necessary condition for testing propositions in collective welfare economics (i.e. consensus decision-making) is clearly not fulfilled (Buchanan [2], Buchanan and Tullock [5]). For positive analysis, however, we might proceed faute de mieux on the assumption that collective decisions are made "as if" this condition were fulfilled, or introduce modifications where appropriate. [ABSTRACT FROM AUTHOR]

This paper provides information on contraceptive practices of women in certain low-income areas useful for family planning agencies, and examines the utilization patterns of the medically indigent poor as compared with others in low income areas. [ABSTRACT FROM AUTHOR]

This paper describes the program of the U.S. Army to identify heroin users in Vietnam and how it operates. Whether methadone can be used with servicemen is discussed. [ABSTRACT FROM AUTHOR]

This paper discusses principles of group activity and bases their validity on behavior in an actual setting, as applied to health planning. [ABSTRACT FROM AUTHOR]

The article reports that the health policy issues become increasingly more salient to political scientists as a whole series of major decisions about future causes of action in health emerge before the U.S. President and Congress. State and local governments are also responding to the continued pressure of rising expenditures in health, especially for care of the poor and the medically indigent. On the current national legislative agenda are such items as a major expansion of national health insurance, restructuring of local and state health planning, continuing the commitment to health research and increasing health manpower training support.

Since June 1963 official groups in all fifty states, plus the District of Columbia, Puerto Rico, and the Virgin Islands, have been participants in the most exciting and comprehensive attacks on the problems of mental illness and mental health ever to be attempted in this nation on the state level. With the financial assistance of the federal government, each of these mental health planning projects will be engaged in the process of developing a comprehensive mental health plan. This nation ride effort has stimulated the attention of many citizen and professional groups. To social work, which still looks to the heritage of the settlement movement, there is a familiar ring to the concept of meeting the nation's mental health needs in the community. This paper reports the early stages of the effort in one state, Massachusetts. It is not intended to reflect directly the situation or experience of other states, but much of what is reported will sound familiar. Though the focus will be local rather than national, the Massachusetts Mental Health Planning Project can best be examined within its historical perspective.

This paper endeavors to overcome one difficulty in health planning, namely, the transformation of general goals and ideas into operational objectives for programs. A method is developed to be used for generating such program objectives. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper is concerned with the differential impact of the Medicaid program on state incomes in 1967-68. Benefits and costs of the program are calculated for each state and the results are evaluated in terms of the perceived original intent of the program planners. It was found that although the program favors the poor in all states with Title XIX plans, it does so at the expense of extreme horizontal inequity. The conclusion is that federal incentives for the development of comprehensive state Medicaid programs are inadequate to insure an equitable system for the distribution of program benefits and costs. [ABSTRACT FROM AUTHOR]

This paper deals with the political strategies employed by the Minnesota Comprehensive Health Planning Program to remove legal impediments to effective manpower planning, as well as the consequences. Conclusions as to alternative courses of action are stated. [ABSTRACT FROM AUTHOR]

This paper emphasizes the need to bring environmental health into the framework of comprehensive health planning. The author discusses how this can be done. [ABSTRACT FROM AUTHOR]

The author of this paper argues that we need a national system for collection of health data which will meet the needs of planners, evaluators and investigators at local, state and federal levels and that national health insurance legislation should require the collection of these data as well as the facts needed for fiscal management. [ABSTRACT FROM AUTHOR]

The article offers information on the challenges faced by the American Public Health Association on the development of the association's Medical Care Section in the U.S. On November 10, 1948, the American Public Health Association's Governing Council voted to approve the petition requesting the establishment of a Medical Care Section. In 1972, the association expanded their health services because of the changes on their needs and demands. In 1920, the association created a committee to study the municipal health departments and determine the extent of variation on the health services and procedures offered in a specific community.

Information about several papers discussed at a lecture on psychiatric issues among developing countries is presented. Several medical personnel identified these problems that had apparently limitless concept of morbidity. These include infection, faulty sanitation, malnutrition and diseases which had a minimal number of trained personnel to cope. Public health planning prioritize the deployment of preventive measures against debilitating disease and focuses on a campaign for adequate nutrition.

The article focuses on the development of neighborhood health center approach to health care delivery in the U.S. The neighborhood health centers have proliferated under a variety of federal grant-in-aid programs and private sources of support. It was mentioned that neighborhood health center approach demands an increasing emphasis on cost-effective management of neighborhood health centers and increased revenue generation activities. In addition, changes in federal health service funding policies have necessitated a reevaluation of sources of future support for neighborhood health centers.

A theoretical model using mainly the theory of absorbing Markov chains is applied to several human-blood-issuing policies. The objective of the model applications is to determine the effects of the Suing policies on average inventory levels, which determine blood shortage probabilities, and on the average age of blood at the time it is transfused. Issuing policies that issue (transfuse) fresher blood with a higher probability than older blood are defined as modified LIFO policies, and issuing policies that issue older blood with a higher probability than fresher blood are defined as modified FIFO policies. Application of the theoretical model to the various issuing policies allows complete evaluation of the policies, and a policy choice can be made on the basis of the evaluation. [ABSTRACT FROM AUTHOR]

The article presents a discussion on medical care policies. The detailed analysis of costs and the changing character of medical expenditures is very useful. The interpretation of the statistics is confined to those facts on which an economist can rightly pass judgment. Monopsonistic buying by government may eliminate some selling and advertising expense but the procurement experience of the United States government does not augur well for efficiency. The amount of the total cost to be allocated is of considerable importance in discussing methods of financing compulsory health insurance. The actual cost of compulsory health insurance would depend on several variables. These include: the efficiency with which the government operated its ventures in general, the number of people covered, the number and kinds of medical services and facilities made available, the extent to which people made use of the system, the number of governmental payrollers involved in addition to medical personnel, and the volume of abuses that developed.

A list of articles related to public health published in several journals are presented including "Integration of Medical Research and Health Policies," by S. P. Strickland, and "Strokes and Hypertension," by A. B. Carter.

The article reports on the final Hover Commission report, which focuses on the subject of government research and development in the U.S. According to sources, the report reversed its usual plea for reduction of federal spending by recommending increased support for research activities. Moreover, the report stressed the overriding importance of basic research, in which the safety, the increase in productivity, and the advance of health in the country must come from constantly increasing knowledge through fundamental research. Thus, five overall recommendations were made, including increased support for basic research, and establishment of assistant secretaryships in research and development in the Army.

The article examines the role of public health to promote family planning in the U.S. In 1965, the Office of Economic Opportunity have made domestic grants in family planning wherein the Children's Bureau were then given the authority after two years. By 1970, legislation have been implemented which made all components and methods of family planning available to the public to include abortion and sterilization. The possible costs of complete family planning services for the population was also taken into account.

The article examines a federally funded guidance clinic to determine its treatment for lower classes and minorities. It was found that this clinic provides treatment without bias in all groups, regardless of ethnicity, education, or occupation. Its nondiscriminatory policy in the selection and treatment of those belonging to ethnic and social classes is undermined by its complex intake procedures and long waiting lists. About 49 percent of clients requesting services was never seen by the clinic.

The study assess the extent of utilization of preventive health care services by eligible residents of low income neighborhoods in the U.S. Previous studies have indicated that preventive health services are underutilized by poor Americans. In fact, this relative lack of preventive care seems to be one of the reasons why poverty and a minority status tend to correlate with higher morbidity and mortality rates. This study was undertaken based on the assumption that the new comprehensive clinics set up in Los Angeles in the late nineteen-sixties afforded new possibilities for preventive health care.

This study reports on the representational composition of several areawide and subarea comprehensive health planning boards in New York State. [ABSTRACT FROM AUTHOR]

To deal more appropriately with elderly patients, a program utilizing a newly developed geriatric preadmissions evaluation was employed. The results of experience with more than 990 patients over a 12-month period are reported. [ABSTRACT FROM AUTHOR]

The article focuses on the occupational survey about the interest, attitudes and involvement of the forty-four dentists who are serving on a comprehensive health planning advisory committees in the U.S. The survey aims to help dentists in formulating ideas on planning, as well as background and guidelines on legislation and provide some of their experience in the planning process. The data gathered in the survey were used as base of the short-term training course offered by the Columbia University School of Public Health and Administrative Medicine. The training course covers a wide range of materials that pertains on the comprehensive health planning legislation, public health law, and regional medical program legislation.

The article focuses on the efficiency of the version of the Comprehensive Health Planning (CHP) Certification Program, a certification-of-need program in Maryland. This has been developed by the Maryland Comprehensive Health Planning Agency and other related organizations. It will be used in considering the certification-of-need concept when designing and modifying other certification-of-need programs. The author provides information on the criteria and health planning process for the state's CHP Certification Review.

A method was developed for the evaluation of alternative primary health care team compositions and for the examination of skill levels for new categories of personnel. This procedure determines the appropriate composition of primary health care teams for differing demand levels and facility availabilities. A simulation model of a general primary health care delivery unit was developed as part of this procedure. This simulation model given demand schedules, team compositions, and facility levels, produces information relating to the efficiency and effectiveness of that alternative. An application of the simulation model and the evaluation procedure was made to the area of pediatrics. A time study was taken of pediatric office practice. The data gathered therein were analyzed and used to create various demand schedules. Task-capability lists were created for various proposed categories of allied child health personnel, and these personnel were incorporated into various alternative team compositions and tested against varying facility and demand levels. Results indicate there are instances where a team structure is inappropriate and that the first member added to aid the physician is probably a person to assume lower level repetitive tasks. [ABSTRACT FROM AUTHOR]

Improvement is required in the theoretical bases of health planning in order for needed advances to occur in health planning practice. Four major planning strategies are utilized in other public policy sectors: the rational, the incremental, the mixed scanning and the radical strategies. All four strategies are potentially useful in health planning and their impact is suggested in a health planning situation. [ABSTRACT FROM AUTHOR]

Two articles are presented on the new federal provisions for health care for the aged. The first, by Melvin A. Glasser, contends that there are two systems of medical care--one for the rich and one for the poor--and offers some bold suggestions for using the new Title XIX of the Social Security Act to move toward a single system. The second article, by the U. S. Commissioner of Welfare, Ellen Winston, describes the provisions of the new legislation and the significance of some of the amendments for public welfare. [ABSTRACT FROM AUTHOR]

The article comments on the article "What Would Medicare Cost?," by Barkev S. Sanders previously published in the journal. The 180-day option deductible initially is 92.50 dollars or less if the hospital average is less is erroneous because the if less proviso is not based on the particulars average per diem cost of the hospital. Deductibles are apt to encourage overuse instead of discouraging that is contrary to the belief of experts. The Forand Bill includes surgical benefits and could be believe as radically different from the King-Anderson Medicare Bill. The failure to study the actuarial reports because of failure to recognize the basic assumption in the cost estimates of Actuarial Study Number 57. Another failure is the consideration of all factors and comparing of similar things in the British National Health Service.

The article analyzes the development of prepaid drug plans sponsored by pharmacists in the U.S. In 1965-1966, pharmacists and their organizations in various states vocalized the demand of creating prepaid drug plans. Promotion of the prepaid scheme is at a peak because of some reasons: approximately 10-15 percent of written prescriptions are not filled; pharmacists acknowledge that they will be paid for prescriptions they fill; it is possible to shift the high cost of drugs from the consumer to a third party; first-dollar prepaid drug concept has attained momentum; and the enactment of Medicaid activated the druggists' reception of prepaid drug schemes. While protection against first-dollar drug costs opposes long-espoused insurance principle and consumer demand for the product is substantial and persistent, the coverage will be available.

National provisions for medical care in western societies fall broadly into three categories. The Government may provide a comprehensive range of services universally available and financed wholly or largely by taxation, as in Great Britain and a number of European countries. Alternatively, private individuals and institutions may be the main providers of medical services whose range, quality and availability is determined by the price which the patient is willing to pay, as in the U.S.A. Between these two extremes there may be a combination of government subsidy to private institutions which provide a range of limited cash benefits financed on a voluntary insurance basis by the recipients, as in Australia. The emphasis of each system largely reflects the predominant orientation of public thinking on social welfare, and on health in particular. The British system is broadly collectivist, the American unmistakably individualistic and the Australian a curious combination of the two. [ABSTRACT FROM AUTHOR]

A report is presented giving up-to-date information on State Boards of Health covering composition, functions, method of appointment, term of office, professional representation, consumer representation, recent changes, and a number of other topics. This is a useful review for all concerned with the health services. [ABSTRACT FROM AUTHOR]

The article focuses on the shortcomings in the health planning which is required to advance with the changes in social institutions. The lack of social planning at the national level and the differing rates of change in social institutions has created serious gaps between the purpose of some institutions and the degree to which they are effective in satisfying human needs. The proper structure of planning at community level is offered by the ecological approach, which requires teamwork across disciplines and the contributions of the team towards a common goal. It is viewed that fragmentation and discontinuity of health care can be reduced when planning is undertaken from an ecological approach.

The article focuses on the use of political platforms for health issues in the U.S. It is commonly found that public and private interests does not appropriately represent their constituencies when they fail to participate in the platform process. The platform process is divided into three closely related phases including preparation, participation, and propitiation. The first phase starts prior to the platform committee hearings when a platform is drafted by appointed writers. The health planks of the political parties are considered as the predictor instrument for the introduction of new health programs or policies. Since 1952, the chief parties of the U.S. have had good records when it came to transforming these programs into action legislation.

A review is presented of experience over a two year period with a liberalized abortion program in New York City. Findings are presented and discussed. The abortion program has been associated with a decline in maternal and infant mortality and a decline in births. Needs still to be recognized are outlined. [ABSTRACT FROM AUTHOR]

A study of fertility and family planning in Maryland since 1965 revealed that a decrease of fertility cannot be simply associated with an increase in the number of women participating in family planning programs. Findings are analyzed for methodological limitations and implications for research are presented. [ABSTRACT FROM AUTHOR]

What actions can bring the health and population fields more closely together? The final report of the Commission on. Population Growth and the American Future in recommending action to achieve population and health goals, provides a framework for expanding cooperation between the two fields. [ABSTRACT FROM AUTHOR]

A list of articles related to public health that were published in several journals is presented including "Mutual Help for the Widowed," by R. B. Abrahams, and "Finnish Goals of Health Policy and Medical Research," by H. Vuori.

A major issue in public health today is the place and function of the local health agency with respect to the multiplicity of health problems in American communities. Here the problem of environmental quality and the changing responsibilities of the official health agency are examined within this broader context. [ABSTRACT FROM AUTHOR]