Health care reform in the states.

Challenged by relentless increases in health care spending, state governments have been forced to experiment with health care system reform. Medicaid has been expanded by Congress, forcing states to provide a broader array of health benefits to more recipients. As states consider reform, federal limitations mandated by Medicaid and by the Employee Retirement Income Security Act (ERISA) of 1974 on state activity pose significant obstacles. ERISA sharply limits a state's ability to raise revenue to fund these health programs. Several states have responded to these limitations by seeking waivers. Despite these obstacles, 8 states already have enacted comprehensive health reform measures, and virtually every state is considering legislative reform. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care reform is coming.

During my career in Congress, we have achieved some success in expanding health insurance coverage and keeping services affordable, but the problem of 46 million uninsured and 25 million underinsured must be addressed. In February 2009, I introduced the Healthy Americans Act (S. 391/H.R. 1321; Wyden, 2009), a comprehensive bipartisan health care reform bill that covers all Americans without breaking the bank, by weaving together the Democratic idea that we need to give every single person in the country health care coverage and the Republican belief in a private-market approach. This bill would favorably affect providers in nonprofit institutions, public institutions, and school systems, by ending cost shifting from public program underpayments to the privately insured. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care reform in Chile

This is a document presented to the Chilean Academy of Medicine by the Health Minister, the economist Carlos Massad, First of all, he refers to the general context of the reform, that he considers a process and not a breakpoint. Afterwards, he enumerates the change task: a) to generate awareness of the change and to convert health in a State issue; b) to adequate programs to population's new health profile; c) to install new management instruments in the health system; d) to decentralize decisions and to promote the participation of beneficiaries; e) to establish incentives and to flexibilize the Health System and f) to introduce correctives to private health insurance. He believes that Chile must drift to a economical protection system for universal and solidary health events. The additional assurances that people wants to buy, must be delimited.     

Health care reform and psychological practice in schools.

National policy calls for the placement of comprehensive, customer-oriented, and accessible health and social services programs for America's children and youth. Schools have been targeted as the ideal location for such services. Numerous models of school-based and school-linked programs have been initiated. The role of psychology in these emerging models and programs is highly variable; however, it is an essential service that increasingly is being recognized as necessary in order for schools to address complex and diverse student and staff health needs. In this article, models for the delivery of school health services are profiled. Implications for practitioners who currently work in schools and for psychologists who are not currently working in schools but who are interested in maximizing psychology's contribution to school health services are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care systems in transition: People's Republic of China. Part I: An overview of China's health care system

The People's Republic of China for the first 30 years of its existence had a centrally directed health care system which achieved impressive health gains for its population. By emphasizing prevention; organizing innovative, low-cost, locally controlled health services; and promoting accessible primary health care in rural areas, China increased life expectancy for most of its people, dramatically reduced levels of infant mortality, and eradicated or controlled a range of infectious and parasitic diseases. Since 1978, however, China's leadership has come to depend more upon market forces than central direction and planning to achieve economic growth. These new orientation has had major effects upon the organization and financing of health services. After more than a decade of economic and agricultural reform, China still has problems providing good-quality, affordable, and equitable health services for the majority of the rural population and both urban and rural poor. The need to pay for health care considerably exacerbates poverty in China. This paper describes the structure of government and the health care system, the nature of change during 1978-90, the impact of the reforms upon health status and health care delivery, and future challenges.     

Health care reform in Croatia: the consumers' perspective

AIM: Assessment of the Croatian health care system (under the reform) from the perspective of the users of health care services. We analyzed the consumers' satisfaction with health care system, health care expenses and access, and described the consumers' attitudes toward health reform, examining the differences among sociodemographic groups. METHODS: The study is based on a data set collected in 1994 through the interviews with randomly selected adults in two major cities of Croatia: Zagreb and Split. RESULTS: A great proportion of respondents were dissatisfied with the current health care services, quality of health care facilities and equipment, and encountered difficulties in access. The elderly, women, and those with lower socioeconomic status were more likely to be dissatisfied and to consider out-of-pocket payments for health services as a problem. A great number of the respondents believed that the reform would either fail or would not achieve significant results. Compared to the younger and higher socio-economic group, the older and lower socioeconomic groups were more likely to evaluate the health care reform negatively. CONCLUSION: Croatian government decided to rationalize the health care system without taking much account of the impact of health reform on the consumers. Revealed dissatisfaction with the health care services might be linked with the expressed doubts in health care reform and concern that changes could worsen the consumers' position as patients.     

Health care reform: The 1993–1994 evolution.

Health care costs in the US continue to increase, as does the number of individuals who lack health care coverage. The magnitude of these critical problems assures that reform of the health care system will continue to be debated over the next decade. Increasing health care costs are associated with increased complexity of services and a greater number of health care providers. As health costs increase and the number of individuals covered by private insurance decreases, states will face increasing pressure to develop effective methods of providing coverage for those without health insurance. Employer mandates will be viewed as one method of extending health coverage. Psychologists must be involved in policy issues so as to ensure the utilization of psychological knowledge and attention to psychological and behavioral health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Report of the treasurer, 1993: Health care reform and APA finances.

Presents the Report of the Treasurer regarding the 1993 finances of the American Psychological Association (APA). The report addresses the funding of health care reform efforts, the Second Century membership drive, the Traveling Psychology Exhibit, the $60,000,000 building loan, the dues-exempt criteria, and the status of accounting/investing for divisions. Revenues and expenses are discussed in terms of a comparison between 1992 and 1993 and in terms of major programs. Information is also presented in regard to changes to APA's fund balance or "net worth," the corporate balance sheets for 1990–1993, the refinancing of the building loan, and new nondues revenues. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Organization of laboratories in the German Democratic Republic

The effectivity of the clinical medicine becomes increasingly dependent on the efficiency of medico-experimental subjects, to which belong pathological chemistry and clinical biochemistry as well as haematology. The scientifically proved increasing demands made on the laboratories concern the quality of the results of investigations, constantly increasing numbers of investigations as well as a considerable enlargement of the investigation programmes. Adequate developments of workman are not to be expected. The requirements are to be met by the increase of the working productivity, for which a good organisation of work the use of mechanisation and automatisation means for the elaboration of large series of investigations are the prerequisite. A high degree of centralisation ascertains the effectivity of the adequate investments. Exceeding the ascertained foundations for a project of organisation of the laboratory work in the GDR in the next time still various problems must be solved which especially influence the organisation. Among others they concern the necessary investigation programme for the general practitioner in an out-patient practice, moreover the establishment of investigation programmes for several levels of care, the necessary quality (precision and exactness) of the results of investigations, the suitableness of stripe tests and the influence of preanalytic factors and especially of the biorhythmics on the findings of investigations. The tendencies described are accompanied by the danger that the reciprocities between clinic and laboratory becoming increasingly more necessary for the interpretation and classification of laboratory findings into the symptom complex become rather loose. Therefore, it will be one of the most important tasks of future to develop together reorganisation and collaboration.     

Doomed and double doomed?: Health care reform and the mental health policy challenge.

Comments on C. A. Kiesler's (see record 1993-10935-001) article on health care reform and mental health policy. Much of the current debate is driven by economists, sociologists, political scientists, and physicians, who specialize in health policy analysis and research. To the degree that psychologists are not involved in health policy analysis and research, their interests and perspectives are not likely to be sufficiently represented. Kiesler's work and that of others can serve as models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)