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Biomedical subjects

R J Blendon

Publications and source records attributed to R J Blendon.

At least 109 records · Page 6Linked to original sources
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The new medical marketplace: physicians' views.

The transformation of the medical marketplace has major implications for the physician workforce. Findings are reported here from national surveys of physicians, hospitals, health maintenance organizations (HMOs), preferred provider organizations (PPOs), and medical group practices conducted in 1995 to measure the impact of those changes. Physicians in higher HMO penetration states were more likely to report serious problems with several aspects of medical practice and patient care and were more likely to perceived oversupply in their specialty areas and changes in their practice arrangements. Some divergence is noted in views of supply between physicians and those that employ them. The majority of physicians would still recommend medicine and their specialty as a career.

Attitude of Health Personnel↗
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Understanding the managed care backlash.

This paper examines the depth and breadth of the public backlash against managed care and the reasons for it. We conclude that the backlash is real and influenced by at least two principal factors: (1) A significant proportion of Americans report problems with managed care plans; and (2) the public perceives threatening and dramatic events in managed care that have been experienced by just a few. In addition, public concern is driven by fear that regardless of how well their plans perform today, care might not be available or paid for when they are very sick.

Adult↗
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The cost of health system change: public discontent in five nations.

Many nations have undergone changes in health care financing and services. The public notices policy changes in health care and frequently bears new and unexpected costs or barriers to care unwillingly. This paper presents data from surveys of about 1,000 adults conducted during April-June 1998 in each of five countries--Australia, Canada, New Zealand, the United Kingdom, and the United States--to measure public satisfaction with health care. In no nation is a majority content with the health care system. Different systems pose different problems: In systems with universal coverage, dissatisfaction is with the level of funding and administration, including queues. In the United States, the public is primarily concerned with financial access.

Adult↗
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The uninsured, the working uninsured, and the public.

Recent opinion surveys show a high level of public support for the current employer-based health insurance system. Many Americans are not aware that this system is endangered or that the number of uninsured persons is growing. The public appears to favor a two-track system for the working uninsured--strengthening the existing employer-based system and developing a parallel system for those without employer coverage.

Attitude to Health↗
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The elderly in five nations: the importance of universal coverage.

This paper reports 1999 survey results on the population age sixty-five and older in five nations--Australia, Canada, New Zealand, the United Kingdom, and the United States. The majority of respondents were generally satisfied with the quality, affordability, and availability of health services in their nations. In many measures of access to and cost of care, the United States looks much like the other nations surveyed. However, as the elderly view their health systems, the direction they have taken in recent years with respect to caring for the elderly, and the future affordability of care in old age, U.S. respondents tended to be more pessimistic than were those in other nations.

Aged↗
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Health care in the upcoming 2000 election.

Health care will be one of the top issues in the year 2000 election, but voters' interest in health care is not as great as it was in 1992. There is no single unifying theme to the health care issue. Rather, there are multiple concerns: making Medicare financially sound, providing coverage for prescription medicines for seniors, covering the uninsured, and addressing patients' rights. Voters favor an incremental approach to expanding health insurance coverage rather than a major program. They express about equal levels of support for plans similar in concept to those proposed by presidential candidates Al Gore and George W. Bush.

Attitude to Health↗
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Health information, the Internet, and the digital divide.

Through an analysis of recent data on adults' and children's computer use and experiences, this DataWatch shows that use of computers and the Internet is widespread and that significant percentages of the public are already using the Internet to get health information. The surveys also show that the Internet is already a useful vehicle for reaching large numbers of lower-income, less-educated, and minority Americans. However, a substantial digital divide continues to characterize computer and Internet use, with lower-income blacks especially affected. Implications for the future of health communication on the Internet also are explored.

Adolescent↗
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Americans' views on health policy: a fifty-year historical perspective.

A review of data from more than 100 public opinion surveys conducted over a fifty-year period finds that the American public has conflicting views about the nation's health policy. They report much dissatisfaction with the health care system and with private health insurance and managed care companies, and they indicate general support of a national health plan. However, most Americans remain satisfied with their current medical arrangements, do not trust the federal government to do what is right, and do not favor a single-payer type of national health plan. The review also finds that confidence in the leaders of medicine has declined but that most Americans maintain trust in the honesty and ethical standards of individual physicians.

Attitude to Health↗
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The public versus the World Health Organization on health system performance.

The World Health Organization (WHO) ranked health systems in 191 countries based on measures developed by public health experts. This paper compares the WHO rankings for seventeen industrialized countries with the perceptions of their citizens. The results show little relationship between WHO rankings and the satisfaction of the citizens who experience these health systems. The health systems of some top WHO performers are rated poorly by their citizens, including the low-income and elderly. The two rated most highly by the public rank at the bottom of the WHO ratings. These findings suggest that both public and expert views should be considered in international rankings.

Consumer Behavior↗
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Physicians' views on quality of care: a five-country comparison.

Interest is resurging in the problems relating to the quality of patient care. This paper provides a comparative perspective on this issue from a five-country physician survey conducted in Australia, Canada, New Zealand, the United Kingdom, and the United States in 2000. Physicians in all five countries reported a recent decline in quality of care and concerns with how hospitals address medical errors. Physicians in four countries expressed serious concerns about shortages of medical specialists and inadequate facilities. U.S. physicians reported problems caused by patients' inability to pay for prescription drugs and medical care. Asked about efforts to improve quality of care in the future, physicians indicated support for electronic medical records, electronic prescribing, and initiatives to reduce medical errors.

Attitude of Health Personnel↗
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Americans' health priorities: curing cancer and controlling costs.

In this paper we provide a comprehensive examination of Americans' priorities within both health and health care. We find that Americans do have a clear set of priorities in each of these areas. Americans rated cancer, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and heart disease, and medical research to address these conditions, as top priorities among eighty health problems. However, they did not rank many leading causes of death very high as serious problems. On the issue of health care, problems of costs, prescription drugs, and the uninsured top the list. Americans are very concerned about emerging international infectious diseases that they believe threaten their health.

Attitude to Health↗
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The 1991 Pennsylvania Senate race and national health insurance.

Voter interest in reform of the American health care system played a central role in the November 5 come-from-behind reelection victory of Democratic Senator Harris Wofford of Pennsylvania over Republican candidate Richard Thornburgh. In a post-election poll of 1,000 Pennsylvania voters, over 50 percent identified "national health insurance" as one of two issues that mattered most in deciding how to vote. And 21 percent of voters said the issue was the "single most important factor" in their voting decision. The results of the Pennsylvania Senate race suggest that universal health care has arrived as a mainstream political issue and that political candidates who fail to address the issue do so at their peril.

Attitude to Health↗
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New Hampshire, health care, and the 1992 election.

A poll of New Hampshire voters who participated in the February 17 presidential primary shows that the recession and overall concern for the economy was the most important factor in determining the outcome of the election. Health care and national health insurance ranked second, significantly outranking concerns over all other issues. When presented with the leading policy options for health care reform, the majority of voters favored a plan that would guarantee universal coverage by law--either a "play or pay" plan or an all-government plan. However, even though a majority of voters favored universal coverage, they also preferred plans that would make insurance available through private insurers rather than through an all-government plan.

Adolescent↗