PubMed Health⌕ Search

Biomedical subjects

J Retsinas

Publications and source records attributed to J Retsinas.

16 recordsLinked to original sources
PubMed1998

COBRA: legislation and its import.

COBRA refers to the provision in the 1985 Consolidated Omnibus Reconciliation Act that allows terminated employees to continue to buy health insurance at group rates, and that allow families who lose their coverage through the death or divorce of the employee also to continue to buy coverage. Analysis of COBRA shows that it is too expensive and too exclusionary for many workers, particularly low-income ones, to benefit.

Budgets↗
PubMed1995

Small businesses: the health insurance bind.

This paper discusses the structural and regulatory barriers that stymie small businesses' efforts to provide health insurance for employees. Specifically, small businesses face lower revenues and higher health insurance costs than large businesses. Furthermore, small businesses cannot gain the administrative, as well as cost, advantages of self-insurance. The two options for pooled insurance-Taft-Hartley groups and Multiple Employer Wellness Arrangements-are increasingly difficult to pursue. Even state-developed "basic insurance" packages have not proven a genuine solution for small businesses. However much we as a nation want to tie health insurance to employers, the small business sector cannot easily fill that function for its employees.

Commerce↗
PubMed1993

Traumatic brain injury: the lag between diagnosis and treatment.

Ogburn described the "culture lag" between technology and attitudes, as people take time to assimilate new technologies, and new facts, into their worldviews. Traumatic brain injury is now a common diagnosis, thanks to neurosurgical expertise. Where thirty years ago mortality from head injuries was high, today mortality rates have improved dramatically; yet even while neurosurgeons spare thousands of people each year, our society struggles to develop appropriate rehabilitation protocols. To date, we are in the lag phase, between diagnosis and treatment. This paper discusses that lag, including reasons for the lack of an effective rehabilitation protocol (the paucity of funds for research, the nature of brain injuries per se), the reluctance of insurers to cover brain injury rehabilitation (the lengthy time involved in rehabilitation, the blurring between rehabilitation and long term care, the nature of experience-rated contracting to businesses for health care insurance, the burgeoning of proprietary brain injury rehabilitation centers), and the prospects for closing the gap in the near future. The paper concludes that preventive measures (seat belt laws, motorcycle helmet laws, laws for helmets in contact sports) allow policy-makers to confront the growing societal problem of the mounting census of head-injured, by avoiding that census and focusing instead on the prevention, or diminution, of future head injuries.

Attitude to Health↗
PubMed1991

Accessory apartment conversion programs.

In recent years, state housing finance agencies have joined with state units on aging to develop programs to help the frail, elderly homeowner. Under an accessory apartment conversion program, a low-income homeowner will borrow money at a reduced interest rate to underwrite conversion of excess space into a rental apartment. The tenant will provide additional income as well as, ideally, certain kinds of personal assistance and a friendly presence. To date, few elderly clients have used this option. The initial rationale for the program is explained as are plausible reasons for the fact that it has not met expectations.

Aged↗
PubMed1991

The mandation of insurance coverage for in vitro fertilization.

For many infertile couples, in vitro fertilization represents a last hope; yet few couples can afford this expensive procedure, which health insurers do not routinely cover. To force health insurers to pay for in vitro fertilization, infertile couples have successfully lobbied in six state legislatures for "mandation" legislation, which will force insurers to pay for the procedure. This paper discusses the legislative battlefield for in vitro fertilization mandation and the long-term implications of such victories.

Bioethics↗
PubMed1989

The illusory home, or the 24 percent fallacy.

Although many elderly people live for years in nursing homes, death certificates routinely obliterate nursing home residence. Data gathered from records of one proprietary nursing home show that of 128 residents, from 45 percent to 66 percent could be classified as "permanent," depending on the definition. Nevertheless, the death certificates for those 128 residents list the nursing home as the residence for only 24 percent. This article explores that bias.

Aged↗
PubMed1988

Testing nursing home iatrogenesis.

Many nursing home residents, admitted for "temporary" stays, are expected to return to the community. To test the notion of iatrogenesis, this research examined the discharge status of "temporary" residents discharged from a proprietary nursing home during the first six years of its operation. The research noted 1) the extent to which those residents did not return home and 2) reasons for their derailment. The results of the research did not support the notion of iatrogenesis. Of 419 residents, seventy-nine were expected to return to the community. Only 16 percent of those seventy-nine did not. Content analysis of histories, moreover, showed that two chose to remain, four had families who declined to fill caregiver roles, and two quickly deteriorated. Even the histories of the five who generally lost the ability to function independently did not suggest institutional life was to blame.

Aged↗
PubMed1987

Nursing home myths.

Adverse publicity about nursing homes increases the anguish of many people as they face the decision of placing a loved one in a nursing home. It is true that there are shortcomings in some nursing homes: poorly trained staff, unesthetic environment, little privacy, few activities and loss of identity. Nevertheless, in many nursing homes, the care is exemplary and residents are treated with compassion. Knowledgeable family physicians can dispel the myths about nursing homes and relieve some of the concerns of patients and their families.

Aged↗
PubMed1986

Geriatric myths reconsidered.

The four-generational family is becoming increasingly common. As investigators learn more about family dynamics and relationships, some familiar myths must be reconsidered. The destitute retiree, the lonely widow craving attention from grandchildren and the abandoned nursing home resident are stereotypes that may not reflect reality. The family physician who cares for elderly patients should understand the fallacies inherent in many such stereotypes.

Aged↗