The role of the Federal government in financing health and medical services

A detailed examination on a group of oxen naturally infested with Parafilaria bovicola suggested a prepatent period varying from 238 to 250 days. In these animals 54% of all lesions bled only once, 22% a second time and 24% more than twice. Of all active lesions 42% occurred in the shoulder region and decreased from this area both cranially and caudally. The same tendency was noticeable on carcasses after slaughter. During the observation period May 1974 to February 1975 the number of positive animals increased, reaching peak values during September - October 1974, after which a decline was noticed. The filaricidal effects of nine compounds were tested. These were suramin (used in combination with diethylcarbamazine citrate), thiacetarsamide sodium, fenchlorphos, phosmet, mebendazole, fenbendazole, levamisole hydrochloride and trichlorphon.     

Toward implementation of an urban health agenda: the role of government

Government has several essential roles in the implementation of an urban health agenda. Government acts as a direct agent in the financing and delivery of services, as a rule maker for the financing and provision of care by others, and as a forum for political debate. Discussions of access to care, control of health care costs, and the maintenance of quality all include a role for government. A period of apparent rejection of comprehensive governmental health care policy has nevertheless included numerous examples of the persistence of government's many roles.     

The struggle for the soul of health insurance

The politics of American health insurance is a struggle over which vision of distributive justice should govern: the solidarity principle or the logic of actuarial fairness. Actuarial fairness is central to American private health insurance. It is both an antiredistributive ideology and a method of organizing mutual aid by fragmenting communities into ever-smaller, more homogeneous groups, leading ultimately to the destruction of mutual aid. This fragmentation is accomplished by fostering in people a sense of their differences and their responsibility for themselves, rather than their commonalities and interdependence. Actuarial fairness developed as a business strategy for gaining market share. Medical underwriting, which is far more extensive than commonly known, is the information technology used for implementing actuarial fairness. Despite significant changes in the political context of health insurance which are leading toward restraints on underwriting, the logic of actuarial fairness is so deeply embedded in the structure of competitive markets in insurance and so deeply consonant with social divisions in American society that eradicating it will take more than any current reform proposals contemplate.     

The anatomy of psychotherapy under national health insurance.

Experience has demonstrated that when all barriers to medical care are removed, the medical model encourages somatization, and medical facilities become overburdened by the 60% of physician visits that are from sufferers of emotional distress rather than organic illness. When psychotherapy is properly provided within a comprehensive health system, the costs of providing the benefit are more than offset by the savings in medical utilization. Furthermore, it is not the provision of a psychotherapy benefit that can bankrupt a system, as has occurred in a number of programs, but the manner in which the service is delivered that makes the difference for cost-therapeutic effectiveness. Cost-therapeutically effective programs can be developed for problems in living that traditionally have been regarded as too resistant and, therefore, too costly to be insurable. The implications for national health insurance are that the inclusion of an appropriate, realistic psychotherapy benefit is both essential and economically feasible. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The new child health insurance expansions: how will school-based health centers fit in?

In June 1998, the Making the Grade National Program Office and the National Assembly on School-Based Health Care sponsored a workshop on the relationship between the State Child Health Insurance Program (SCHIP) and school-based health centers. Workshop participants used the health centers' experience with Medicaid managed care as a window for understanding their prospects for negotiating contracts with health plans under SCHIP. Speakers representing the federal perspective, state agencies, health plans, and local school-based health centers offered their views on the challenges of developing contracts, incentives, and disincentives that health plans have to contract with school-based health centers, and what has accounted for success where relationships are moving forward. Experiences in Colorado and Connecticut were presented as case studies on these evolving issues.     

The selection of graduate students in public health education.

Using as criteria ranking of the students on academic performance by 3 faculty judges, and of those who subsequently graduated on field performance, the validity of the SVIB, MMPI, Concept Mastery Test, and the American Public Health Association Examination for selecting graduate students for a public health education curriculum was studied. Only the APHA Examination, an achievement test, ranked the students in approximate order of later success, although the others gave evidence of usefulness for negative screening to eliminate poor students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Employer-based health insurance in a changing work force

The loss of manufacturing jobs and the expansion of service jobs and part-time employment have contributed to a decline in the rate of employer-sponsored health insurance among workers. Not only does manufacturing provide more of its own workers with coverage compared with other industry groups, but it also is a significant net "exporter" of coverage to dependent workers in other industries. In 1991 the net export of coverage represented a 20 percent tax on manufacturing employers per covered worker, while professional services--the fastest-growing industry group-collected a subsidy from other industry groups equal to more than 12 percent per covered worker. Similarly, larger firms--those that employed 100 workers or more--paid a self-imposed tax of as much as 13 percent per covered worker to support dependent workers employed in smaller firms.     

A shifting picture of health insurance coverage

Data from the Current Population Survey are used in this DataWatch to explore the changing composition of health insurance coverage of the U.S. nonelderly population. The authors analyze coverage trends across various subpopulations for 1988-1993. During this time significant declines in employer-sponsored coverage coincided with equally significant increases in Medicaid coverage. Thus, the increase in the proportion of nonelderly persons without health insurance appears relatively small. However, this analysis reveals that the relative stability of the uninsurance rate for the entire nonelderly population belies more significant changes in insurance coverage--and lack of coverage--among various groups. The authors also discuss the extent to which a growing level of public insurance "crowds out" (or substitutes for) private health insurance.     

Health care structure legislation--reform of health insurance

On January 1st, 1993, the German Health Care Structure Reform Act has come into effect. It will fundamentally change the system of health insurance as well as the health care system. By the reform act, new structural and controlling elements have been installed in all central branches of health care, and, at the same time, a new order for the competition between the sickness funds has been established. Far-reaching structural alterations affect the hospital sector, the drug market and the system of ambulatory care. In the hospital sector, there will be a change-over to a price system consisting of special payments, payment according to diagnostic-related groups, and differentiated per-diem rates. On the drug market there will be introduced, besides a drug budget for doctors, a positive list for pharmaceuticals which will be worked out jointly by representatives of the medical profession and the sickness funds. In the ambulatory sector, licensing restrictions for doctors intending to set up practice will be introduced and the importance of the general practitioner or family doctor will be enhanced. The Health Care Structure Reform Act provides for self-government of the sickness funds and the medical profession with a wide range of controlling and shaping instruments. It also places the Ministry of Health in a better position to take influence. After the expire of the budgeting phase, competitive elements resp. extended controlling measures in the contracts sector will become more and more important features of the health care system. It remains to be seen whether the new controlling instruments will suffice to cause the intended limitation of expenditure.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of mentors for women in animal science: perspectives from government

The purpose of a mentor is to empower individuals to succeed in a professional career in animal science. Effective mentorship programs in animal agriculture will guarantee that more qualified women are retained in our profession, and thereby contribute to workforce diversity. Good mentors are the single most significant contributor to building a successful career. Mentorship programs can be informal or formal. Effective informal mentoring depends on selection of a mentor with a positive attitude that can be a trusted advisor and good listener. The Beltsville Area of USDA, ARS, offers a Mentor Program in which employees voluntarily participate as mentors or protégés. The participants are paired according to individual objectives with the overall goal to enhance their career development. The program has approximately 35% of mentors and 88% of protégés that are women. A key to its success has been improving the supervisor's understanding of mentoring as it relates to employee productivity. There are many other programs within the Equal Employment Opportunity (EEO) Program that affect women in science as government employees, including a special emphasis program called the Federal Women's Program, as well as annual evaluation for performance in Civil Rights, supervisory training, and flexible work schedules. Improving our mentorship of women in animal science will benefit animal agriculture. Behind successful women in animal science there has been encouragement from a network of mentors.