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The fundamental problems that beset the U.S. health care system--cost, quality, and access--differ in scope and intensity in inner cities. Current trends in health care are systemwide but are more difficult to accommodate in inner cities because of scarce resources and stresses to the health care system. In this position paper, the American College of PhysiCians seeks to highlight directions and innovations in public policy for inner-city health care with renewed determination that health care problems in the United States must be solved, especially in cities, where they are most extreme. Many persons in inner cities experience an urban health penalty because of the concentration of economic decline, job loss, and major health problems. Because the problems originate in a complex interaction of socioeconomic factors, behavior, environment, and disease that is related to race and ethnicity, multifaceted approaches that extend beyond the medical model are needed to improve health status. The College argues for tackling health problems of the inner city in the context of a comprehensive urban policy that addresses the root: causes of poverty. In addition, this position paper contains more specific recommendations to improve health care delivery to inner cities. The College calls for a comprehenSiVe urban partnership initiative to address all aspects of the urban penalty-social, economic, and health-related--and recommends solutions through public and private collaborations that can be adapted to the circumstances of each Community in addition, policy recommendations address health care coverage, providers, public hearth initiatives, community involvement, and short-term improvements to such existing programs as Medicaid. [ABSTRACT FROM AUTHOR]

This paper analyzes the evolution of consumer-driven health care in terms of its original vision, its subsequent implementation, and the transformations it has endured as it moves into its second decade. The market is generating product designs that combine elements of consumerism with elements of managed care, but the trend is always toward a stronger role for consumer choice and a weaker role for management of those choices by physicians, insurers, employers, and regulators. [ABSTRACT FROM AUTHOR]

This article documents the public positions taken by the American Academy of Pediatrics, the American College of Physicians, and the American Medical Association on five topics with implications for public health: access to care for undocumented patients, fracking, gun control, climate change, and same-sex marriage. There are stark divisions on each of these issues between political parties, and taking a strong public position on them runs the risk of alienating some members of Congress, but each of these associations has done so. At the same time, there is a clear distinction between the public positions of these organizations and the priority given to them by their offices in Washington, DC. Drawing on an organizational maintenance framework, the author argues that taking these public positions is explained, in part, by a growth in the number of women and the number of physicians that affiliate with the Democratic Party in the United States. [ABSTRACT FROM AUTHOR]

The article focuses on the implications of a medical service known as contract or lodge practice to the health insurance in the U.S. In a lodge practice, a medical practitioner agrees to provide medical service to group of patients, such as members of benevolent organizations, fraternal lodges, or employees of industrial companies, for a fixed remuneration per year. It has been noted that this form of medical practice usually leads to substandard applications because some of the physicians provide slipshod services. They are pursuing this service as a means of obtaining a reputation and a clientele. The prevalent practice of these physicians was rooted from the point of view of a practitioner who felt exploited and threatened economically, particularly by the health insurance.

The article focuses on the public health insurance in the U.S. This article is a study of the economic and social hazards of ill health and accidents and of the ways in which health insurance can lessen these hazards. This method of payment also operates on the insurance principle. Under this arrangement medical and hospital expenses would be paid from a government created insurance fund supported by employer-employee contributions through pay roll deductions. The Catholic Church's attitude toward the sick is best indicated by her practice. For almost two thousand years, the Church has founded and encouraged hospitals, institutions, and charitable agencies to aid the sick, infirm, lame, and blind. Religious communities dedicate their lives to serve the sick in the name of Christ. A health insurance program should provide all the basic medical and hospital needs. In the home there should he provision for medical care by a general practitioner and specialist, visiting nurse service, and ambulance service. In the doctor's office the patient should be allowed eye examinations, psychiatric advice, medical attention by general physicians and specialists, vaccinations, diagnostic and laboratory tests, periodic check-ups, physiotherapy, etc.