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Biomedical subjects

M Moon

Publications and source records attributed to M Moon.

At least 37 records · Page 2Linked to original sources
PubMed1997

Establishment of a standardized assay system of fibronectin activity using fibronectin-mediated cell adhesion.

An in vitro assay of fibronectin (FN) was established based on the adhesion of baby hamster kidney (BHK) cells through the cell-binding domain of FN. Each well of a microtiter plate was coated with samples or various concentrations of standard FN. Bovine serum albumin was further coated to prevent the non-specific adhesion of the cells. Various numbers of BHK cells were plated and incubated. After washing out the non-attached cells, the number of attached cells was measured using neutral red (NR)-staining. The conditions for the assay were optimal when 1 x 10(5) cells/well were plated and incubated for 90 min. The linear relationship between the concentration of FN coated and the absorbance of NR was observed in the range of 0.1-1.0 micro/ml of FN. The inhibition of cell binding by the peptides containing an Arg-Gly-Asp (RGD) sequence demonstrated that this assay system depended on FN-mediated cell adhesion through the major cell-binding domain.

Animals↗
PubMed1997

Winners and losers under medical savings accounts.

As legislators wait to see how the MSA approach to health care reform plays out in the laboratory of the states, authors Marilyn Moon, Len M. Nichols and Susan Wall have put the numbers to work. The researchers simulated the effects of introducing MSAs into the health insurance market. What they found is what critics of MSAs suspected: As the young and healthy shift to MSAs, the premiums for those left in the remaining insurance pool will escalate. However, the authors conclude that if you are male, young and healthy, you stand to gain a lot from the MSA experiment.

Cost Sharing↗
PubMed1996

The special health care needs of the elderly.

Interest in Medicare, the government's second largest social program after Social Security, reached a new high in 1995, not as part of health care reform, but as a vehicle for deficit reduction and because of a desire by Congress to restructure the program to encourage enhanced choice for beneficiaries and greater use of managed care. Medicaid, a major payer of long-term care and financer of coverage for low-income elderly, also is slated to undergo major restructuring in the next few years. As Congress and the nation debate the future of these key programs for older Americans, a number of critical issues deserve attention. Medicare's costs are very high--but not necessarily unreasonable in the face of the demands on health care services for this part of the population. And even with these high costs, a number of important gaps in coverage remain a problem for seniors. Deductibles and copayments are also high--especially for hospital and skilled nursing services. But pressure for change may well lead to higher, not lower, cost-sharing requirements. Medicare remains a largely fee-for-service program at a time when the national health care system is shifting increasingly to a managed care environment. Moving Medicare in that direction is one likely option for change. While it is desirable to have Medicare move in concert with the rest of the system, a number of issues stand in the way of an effortless move to managed care for the elderly. Moreover, coordination of long-term and acute care services may be even more challenging in such an environment. Medicaid covers long-term care services for older Americans, but only for those who have depleted most of their assets and income. Even when people do become eligible, Medicaid covers primarily institutional care. But little is likely to change this picture in the next few years, and private efforts through expansion of long-term care insurance will likely provide only a partial solution.

Aged↗
PubMed1995

Preserving and strengthening Medicare.

Any restructuring or reform of Medicare should first and foremost preserve the integrity of the program. Contrary to current rhetoric, Medicare offers mainstream medical care for the most difficult-to-insure Americans, and over the past ten years its record of holding down costs has been better than that of the private insurance sector. For the very long term, when demographic changes place even greater pressures on Medicare, all dimensions of the program need to be considered in the search for a long-range solution, including asking beneficiaries and/or taxpayers to contribute more to the program. Expansion of managed care choices should certainly be part of any restructuring, but careful attention to improving the basic fee-for-service Medicare program--which will continue to serve a majority of beneficiaries for many years to come--also is needed.

Cost Control↗
PubMed1995

Medicaid expansions for pregnant women and infants: easing hospitals' uncompensated care burdens?

Hospitals' bad debt and charity care increased by nearly 30% between 1987 and 1990. However, beginning in 1987, federal legislation expanded Medicaid eligibility to pregnant women and infants with family incomes up to 133% of the federal poverty level, and gave states the option to extend coverage up to 185% of poverty. These expansions likely reduced the need for free hospital care. Controlling for other factors associated with provision of uncompensated care, this analysis shows the Medicaid expansions reduced uncompensated care by roughly 5.4%. For hospitals with a significant commitment to maternity and infant care, the burdens of uncompensated care were 28.5% lower than they would have been without the expansions.

Economics, Hospital↗
PubMed1994

Invasive squamous cell carcinoma of the conjunctiva.

A 73-year-old man had been treated for a sore, red, left eye for 4 months before a clinical diagnosis of squamous cell carcinoma of the limbus was made. This diagnosis was confirmed on examination of a biopsy specimen, but after an initial surgical attempt to fully excise the tumor, there was clinical evidence of intraocular spread. An extensive corneoscleral resection and iridocyclectomy appeared to completely excise the tumor, as indicated by frozen section review. However, 1 year later, the patient re-presented with obvious residual squamous cell carcinoma of the iris and trabecular meshwork, well away from the original tumor site. Subsequent exenteration has resulted in a tumor-free patient for 1 year. Apparent surgical clearance of an extensive squamous cell carcinoma does not ensure total intraocular clearance of residual tumor, which may be remote from the original tumor site.

Aged↗
PubMed1994

Medicare: challenges and future directions in a changing health care environment.

In this GSA-sponsored Congressional Briefing Seminar, authorities from several disciplines summarize the history, rationale, strengths, weaknesses, and future challenges of the Medicare program. In the current arena of health care reform, the role of Medicare is far from certain, and it is crucial to understand and confront a multitude of issues, many of which are raised in this briefing.

Aged↗
PubMed1994

Medicare and health care reform.

Although Medicare constitutes one of the most popular programs of the federal government, even its most ardent supporters would likely agree that improvements could be made and likely should be part of any package of comprehensive health care reform. While some changes could be made as stand-alone reforms, it would be better to integrate changes for the under 65-population with those for the Medicare program. For example, cost-containment strategies would work best if they applied to the population as a whole rather than creating differences that lead to cost-shifting and possible discrimination across groups. The generosity of services covered also ought to be balanced between Medicare and whatever happens elsewhere. This would allow Medicare's cost-sharing structure to be less severe in terms of hospital and skilled nursing care, for example. Finally, while it is tempting to use reductions in spending on Medicare as a means for helping to finance other expansions, the impact of such changes needs to be carefully assessed before assuming that they would create no lasting problems. This essay examines some of the options and likely consequences for Medicare as part of comprehensive health reform.

Aged↗
PubMed1992

International infant mortality rankings: a look behind the numbers.

The very unfavorable infant mortality ranking of the United States in international comparisons is often used to question the quality of health care there. Infant mortality rates, however, implicitly capture a complicated story, measuring much more than differences in health care across countries. This article examines reasons behind international infant mortality rate rankings, including variations in the measurement of vital events, and differences in risk factors across countries. Its goal is to offer a broader context for more informed debate on the meaning of international infant mortality statistics. These statistics offer opportunities to identify strategies for improving the U.S. health care system and learn from other countries that have been more successful.

Adolescent↗
PubMed1991

An American approach to health system reform.

In terms of the major objectives one would have for health system reform, this plan makes the following choices: 1. It would cover everyone, through Medicare (the elderly), employer-based coverage (some workers and dependents) or a state-level public program that would replace Medicaid (the poor, unemployed, and other workers and dependents). 2. There would be a standard minimum package of required benefits for employer-based and public programs, with legislative requirements on maximum cost-sharing. Choice of provider might be restricted in some states. 3. Administration of the private programs would be the responsibility, as now, of the employers and/or insurance companies. Administration of the public program would be the responsibility of the states, with the objective of maximizing responsiveness to local needs and conditions. 4. It would control costs through giving the states a substantial financial stake in ensuring that the public program costs did not grow faster than nominal GNP. State control would also allow the testing of different mechanisms for cost control, with the ultimate objective of identifying the most effective cost-containment strategies. 5. The cost would be borne by employers, employees, and taxpayers. Employers would be protected from exorbitant costs by being allowed the option of paying into a public plan rather than providing health insurance themselves. The poor and unemployed would be protected by having their coverage under the public program subsidized on a sliding scale. 6. The political feasibility test would be met by retaining a major role for insurance companies and by retaining the role of employer-based coverage--thus reducing the tax increase needed to ensure universal coverage. By allowing flexibility in design of cost-containment strategy, some of the controversy over this issue would also be deflected. Our proposal is also not without problems. First, our approach would still have adverse effects on the profitability of small businesses and on the employment prospects for low-wage workers--although these effects would be less than under conventional mandates and less than under proposals with higher tax rates. Second, some states may not want the responsibility we envision or have the capacity to carry it out. But several Canadian provinces are relatively small and are able to perform the same administrative functions within the Canadian national health system. In addition, since the federal government would continue to administer the Medicare program, states would have the option of tying their policies for hospital and physician payment and utilization control to those of Medicare.(ABSTRACT TRUNCATED AT 400 WORDS)

Canada↗
PubMed1991

Medicare future: increasing pressure for radical reform.

Despite efforts to trim the Medicare budget, some predict that the program will consume nearly one-eighth of the federal budget by 1995. Keeping this in mind, the federal government may pursue other avenues of reform--some perhaps radical--to restrain Medicare cost growth.

Cost Control↗