scholarly journals Will Social Values Influence the Development of HMOs?

2002 ◽  
Vol 11 (4) ◽  
pp. 418-421
Author(s):  
JOHN B. DAVIS
Keyword(s):  
Health Insurance ◽  
The United States ◽  
Federal State ◽  
Public And Private ◽  
Rational Allocation ◽  
Industrialized Nations ◽  
Capitated Payment ◽  
Public Responsibility ◽  
State Programs ◽  
Private Financing

Among industrialized nations the United States is relatively unique in relying on a mix of public and private financing and delivery of healthcare: federal and federal-state programs, such as Medicare and Medicaid; employment-based health insurance (primarily HMOs); and state-subsidized insurance pools for high-risk individuals. In recent years, however, there have been efforts to apply the principles of private employment-based health insurance to the other forms of healthcare, and there is speculation that rising healthcare costs can only be addressed by further extending capitated payment plans. This suggests that U.S. healthcare may increasingly be organized according to market principles. For some, this represents a historic departure from an emphasis on public responsibility for healthcare and a sacrifice of the value principles embodied in health relationships between patient and provider. But defenders of HMOs and a larger role for markets argue that managed care allows for a more rational allocation of scarce healthcare resources by minimizing inefficient low-benefit–high-cost care. More individuals receive essential care if inessential care is eliminated. HMOs are also said to encourage non-HMOs to provide lower priced healthcare.

Emergency management and homeland security: Exploring the relationship

2016 ◽  
Vol 13 (6) ◽  
pp. 483
Author(s):  
Jerome H. Kahan, BA, BS, MSEE
Keyword(s):  
Emergency Management ◽  
Homeland Security ◽  
Urban Areas ◽  
The United States ◽  
Federal State ◽  
Public And Private ◽  
Preparedness Planning ◽  
Efficiency And Effectiveness ◽  
State And Local ◽  
Public And Private Stakeholders

In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions.

Health Insurance, Health System Planning, and Rationing

2017 ◽  
Author(s):  
Robert M. Veatch ◽  
Amy Haddad ◽  
E. J. Last
Keyword(s):  
Health Insurance ◽  
Prescription Drugs ◽  
Private Insurance ◽  
The United States ◽  
Brand Name ◽  
Insurance Risk ◽  
Public And Private ◽  
Risk Pooling ◽  
The Common ◽  
Brand Name Drugs

This chapter begins with a description of the various reasons for the accelerating costs of prescription drugs in the United States. It then discusses benefits and burdens of drug therapy within public and private insurance programs. Insurance risk pooling is examined in light of the requirement in the Affordable Care Act to buy health insurance and the consequences when people decide not to buy insurance. Disagreements between the personal beliefs of the owners of a privately held company and the Affordable Care Act’s requirement to cover contraceptives through employee insurance plans are discussed. The chapter also addresses co-pay coupons that encourage patients to ask for expensive, brand-name drugs and the increasing costs of specialty or biotechnology pharmaceuticals, highlighting the problems insurers face in their efforts to manage costs. Finally, the common problems of high-cost drugs that have marginal impact and off-label uses of drugs are examined.

Financing Hospital Disaster Preparedness

2007 ◽  
Vol 22 (5) ◽  
pp. 436-439 ◽  
Author(s):  
Robert A. De Lorenzo
Keyword(s):  
Disaster Preparedness ◽  
Local Governments ◽  
Private Insurance ◽  
The United States ◽  
Federal State ◽  
Federal Grants ◽  
Public And Private ◽  
Hospital Preparedness ◽  
State And Local ◽  
Disaster Preparedness And Response

AbstractDisaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to sub- sidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of pre- paredness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk.

scholarly journals The National Plant Diagnostic Network: Partnering to Protect Plant Systems

Plant Disease ◽  
2014 ◽  
Vol 98 (6) ◽  
pp. 708-715 ◽  
Author(s):  
James P. Stack ◽  
Richard M. Bostock ◽  
Raymond Hammerschmidt ◽  
Jeffrey B. Jones ◽  
Eileen Luke
Keyword(s):  
Plant Protection ◽  
Disease Outbreaks ◽  
The United States ◽  
Federal State ◽  
Data Repository ◽  
Plant Resources ◽  
Public And Private ◽  
Agricultural Plant ◽  
Local Plant ◽  
State And Local

The National Plant Diagnostic Network (NPDN) has developed into a critical component of the plant biosecurity infrastructure of the United States. The vision set forth in 2002 for a distributed but coordinated system of plant diagnostic laboratories at land grant universities and state departments of agriculture has been realized. NPDN, in concept and in practice, has become a model for cooperation among the public and private entities necessary to protect our natural and agricultural plant resources. Aggregated into five regional networks, NPDN laboratories upload diagnostic data records into a National Data Repository at Purdue University. By facilitating early detection and providing triage and surge support during plant disease outbreaks and arthropod pest infestations, NPDN has become an important partner among federal, state, and local plant protection agencies and with the industries that support plant protection.

A Mosaic of Land Tenure and Ownership Creates Challenges and Opportunities for Transboundary Conservation in the US-Mexico Borderlands

2019 ◽  
Vol 3 (1) ◽  
pp. 1-10
Author(s):  
Miguel L. Villarreal ◽  
Sandra L. Haire ◽  
Juan Carlos Bravo ◽  
Laura M. Norman
Keyword(s):  
United States ◽  
Land Tenure ◽  
The United States ◽  
Land Ownership ◽  
Collaborative Management ◽  
Federal State ◽  
Public And Private ◽  
Mountain Ranges ◽  
The Us

In the Madrean Sky Islands of western North America, a mixture of public and private land ownership and tenure creates a complex situation for collaborative efforts in conservation. In this case study, we describe the current ownership and management structures in the US-Mexico borderlands where social, political, and economic conditions create extreme pressures on the environment and challenges for conservation. On the United States side of the border, sky island mountain ranges are almost entirely publicly owned and managed by federal, state, and tribal organizations that manage and monitor species, habitats, and disturbances including fire. In contrast, public lands are scarce in the adjacent mountain ranges of Mexico, rather, a unique system of private parcels and communal lands makes up most of Mexico’s Natural Protected Areas. Several of the Protected Area reserves in Mexico form a matrix that serves to connect scattered habitats for jaguars dispersing northward toward public and private reserves in the United States from their northernmost breeding areas in Mexico. Despite the administrative or jurisdictional boundaries superimposed upon the landscape, we identify two unifying management themes that encourage collaborative management of transboundary landscape processes and habitat connectivity: jaguar conservation and wildfire management. This case study promotes understanding of conservation challenges as they are perceived and managed in a diversity of settings across the US-Mexico borderlands. Ultimately, recognizing the unique and important contributions of people living and working under different systems of land ownership and tenure will open doors for partnerships in achieving common goals. Una versión en español de este artículo está disponible como descarga.

THE “ONE PLAN” PROJECT: GOVERNMENT AND INDUSTRY WORKING TO SIMPLIFY FACILITY EMERGENCY RESPONSE PLANNING

1997 ◽  
Vol 1997 (1) ◽  
pp. 261-263
Author(s):  
Jim Staves ◽  
Jim Taylor
Keyword(s):  
Emergency Response ◽  
The United States ◽  
Current Approach ◽  
Federal State ◽  
Environmental Groups ◽  
Public And Private ◽  
Contingency Plan ◽  
Response Planning ◽  
Response Team ◽  
State And Local

ABSTRACT The current approach to preparedness for oil and hazardous materials spills in the United States is a maze of federal, state, and local programs that often overlap. The National Response Team (NRT), in cooperation with the Region 6 Response Team (RRT), has developed a contingency plan format that simplifies existing federal regulatory requirements into a single integrated contingency plan (ICP). This format, which was developed by a working group chaired by the EPA Region 6, with representatives from government, industry, labor, and environmental groups, can be used as a model for cooperative projects involving the public and private sectors. The purpose of the ICP is to simplify emergency response plans at facilities. A facility using the ICP format would benefit from the reduced costs of maintaining and updating plans and from the simplified training for responders. Use of the ICP format should also reduce confusion about which plan to use during a response and should improve coordination between facilities and state and federal response agencies.

Financing and Insurance

2018 ◽  
Author(s):  
Samuel H Zuvekas ◽  
Earle Buddy Lingle ◽  
Ardis Hanson ◽  
Bruce Lubotsky Levin
Keyword(s):  
Public Health ◽  
United States ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Safety Net ◽  
The United States ◽  
Public And Private

The complexity of US healthcare systems is staggering. In 2015, Americans spent approximately $3.7 trillion on healthcare, averaging almost $10,000 per person. Further, Americans rely on a mixture of public and private health insurance coverage to pay for the bulk of the healthcare services they receive. To provide a better understanding of the financing of healthcare in the United States, this chapter examines major government healthcare programs and funding. It begins with a look at the US public health insurance system and the healthcare “safety net,” comprised of a patchwork of public, private, and philanthropic providers and programs. The next sections look at how US insurers and families pay doctors, hospitals, nursing homes, and other healthcare providers to deliver services in the United States and how pharmacy services are financed in public health.

scholarly journals Change in Perceived Health Insurance Coverage Among People with Multiple Sclerosis

2014 ◽  
Vol 16 (3) ◽  
pp. 132-139 ◽  
Author(s):  
Alyssa Pozniak ◽  
Louise Hadden ◽  
William Rhodes ◽  
Sarah Minden
Keyword(s):  
Multiple Sclerosis ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Public And Private ◽  
Perceived Change ◽  
Publicly Insured ◽  
Privately Insured

Background: Previous research suggests that most people with multiple sclerosis (MS) in the United States have health insurance. However, little is known about their coverage or how it differs between public and private insurance. We examined whether the perceived change in health insurance coverage from the previous year differs between individuals with MS who are privately insured compared with those who are publicly insured. Methods: We present descriptive statistics and odds ratios (ORs) from a multivariate logistic regression using data from the 2009 wave of the Sonya Slifka Longitudinal Multiple Sclerosis Study. Results: We found that individuals with Medicare were significantly less likely to perceive worse coverage compared with those with private health insurance (OR = 0.53; P < .01). Individuals aged 55 to 64 years were more likely to perceive worse coverage than those aged 18 to 34 years (OR = 2.5; P < .05), while the odds of perceiving worse coverage were significantly lower for individuals who had been diagnosed more than 15 years previously relative to those diagnosed in the past 2 years (OR = 0.48; P < .05). Conclusions: Individuals with MS and other chronic illnesses who can choose between public and private insurance should be aware that there are important differences in perceptions of health insurance coverage between publicly and privately insured individuals.

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