Search

In the health insurance movement, the provision of drugs has been one of the medical needs least well met. One prepaid medical care plan has pioneered in an effort to meet this need, and its precise experience is reported in this paper. [ABSTRACT FROM AUTHOR]

The activities and place of nurses in a group practice organization are reported and discussed. The material is of considerable significance for the development of new patterns of health care. [ABSTRACT FROM AUTHOR]

The article presents information about this special "Medical Care Issue," which presents reports of several specific programs that illustrate contributory streams in this larger movement of medical care organization. The variety in the movement derives from locality as well as content. One report in this issue comes from the Appalachian coalfields, where new forms of consumer-sponsored prepaid group medical practice are evolving. Another comes from the nation's capital, where a long established health insurance plan has added drugs to its benefits. Another comes from New York City, where organized "home care" has been explored, for the first time as a feature of hospitalization insurance. Another comes from Southern California, where efforts are being made to up-grade the quality of nursing homes. Another comes from a college town in Kentucky, where a great new medical center is being established. Two papers of generic orientation are then presented: one is on the economic characteristics of health services and how they differ from other services or commodities. The final paper offers a review of sociological research conducted on the organization of medical care over the years.

This study of the factors leading to enrollment in a prepaid group health practice was undertaken from a framework that viewed enrollment as a decision reflecting life style. Occupational type was examined for effect on life style and thus indirectly on enrollment. Data gathered in a household survey in a planned community revealed that individuals with bureaucratic occupational backgrounds were more mobile but tended to utilize community resources earlier and more readily. Higher mobility led to lower rates of enrollment; participation in community activities led to higher rates of enrollment. [ABSTRACT FROM AUTHOR]

In an era when the number of existing health careers is at an all-time high, a family health team involving three new careers has been developed. Why? First, this career is designed to obviate problems of the traditional physician- nurse educational tracks. Also, it allows for vertical and horizontal mobility with few educational requirements at entry level, and it provides for equal participation by men and women. The curriculum is built on educational objectives derived from a clear functional analysis of the job to be performed. The training builds teams; its care concepts emphasize psycho-social aspects of health service; it is people and health oriented, and is not constrained by the limits of existing professional images. It is designed for use in any present or proposed health care system; and, finally, it produces qualified personnel without having to fight the decades of tradition within existing careers. Hopefully, innovations in this program will permeate medicine and nursing in order to change them rapidly to fit into the newly developing health care system. [ABSTRACT FROM AUTHOR]

ABSTRACT Minimum premium plans involve apparent self-insurance by group policyholders for normal medical expense claims, with excess risk coverage above such claims' levels, the major intent of such plans being to eliminate state premium taxes on the portion of the coverage self-insured. Some of the nation's largest firms have insured on this basis. The minimum premium approach results in a reduction of approximately 90 percent of the regular group premium, and the tax advantage of the plan, if allowed, may cause insurers to lose premiums approaching, if not exceeding, $1.4 billion. Some insurers could have a premium reduction of more than $250 million. A few states have taken action to disallow the tax advantages of minimum premium arrangements. The legality of the tax advantage hinges largely on whether self-insurance exists. The author suggests a different basis for levying the tax on the plans and all health insurance coverages. [ABSTRACT FROM AUTHOR]

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.

Three directions in health policy in the United States (health maintenance organizations, allied health personnel, social reform) are discussed in terms of strengths' weaknesses and implications. The author provides much food for thought. [ABSTRACT FROM AUTHOR]

Taking a critical view of national health insurance, the author asserts that it is not a popular movement but rather a means of providing public subsidies for financially shaky elements of the health power structure. An alternative plan is proposed. [ABSTRACT FROM AUTHOR]

What are some of the day-to-day problems with which social service must cope in order to meet health needs? Illustrative is the experience of the social service department of a large voluntary hospital in New York City. [ABSTRACT FROM AUTHOR]

The major thrust of this year's presidential address is the urgent need for a clearly defined national health program. By offering an outline in which specifics are used for illustration, the reader is given an opportunity to consider the basic aspects and how to develop and implement such a program. [ABSTRACT FROM AUTHOR]

The implications of federal legislation of health care services and of health maintenance organizations for planning are presented and discussed. The elements of a plan to anticipate coming changes are offered. [ABSTRACT FROM AUTHOR]

Elaborates on the trends in negotiated health plans in the U.S. Broadening of the scope of benefits to cover more kinds of health care; Increase of the efficiency of expenditures; Union bargain for dental, psychiatric, prescription and optical services.

The model presented here describes the diffusion of a prepaid group practice plan in terms of spatial dimensions of personal influence. In its present form, the model has utility in identifying inconsistencies from expected spatial diffusion patterns. As such, it provides information on the spatial variability of acceptance patterns suggesting research and policy directions. If future models reach acceptable levels of overall accuracy, the posited hypothesis relating diffusion of a particular innovation to spatial networks of personal influence may be accepted as an adequate explanation. Therefore, future research must reduce the operational errors to a level where the validity of the model itself may be tested. If such validity is established, it will equip health planners with an analytical tool that enables them to predict independently the extent, direction, and rate of acceptance of an innovative health care plan. [ABSTRACT FROM AUTHOR]