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At least 19 recordsLinked to original sources
PubMed1978

Health care cost containment experiments: policy, individual rights, and the law.

In a climate of increasing pressure to contain health care costs, legislators and health services researchers from time to time have proposed experiments involving reductions in benefits currently authorized under the Medicare and Medicaid programs. This paper examines three court challenges to the conduct of such experiments in California, New York, and Georgia. The rulings on the California and New York cases were in favor of continuing the experiments on the grounds that the Secretary of Health, Education, and Welfare had judged the projects to be helpful in promoting the objectives of Titles XIX and IV-A, respectively, of the Social Security Act. In the Georgia case, however, the plaintiffs contended that federal regulations protecting human subjects were applicable to the experiment at issue. While the precedent of past cases upholding the Secretary's authority to approve benefit-reducing experiments was not overturned in Georgia, the Court held that the human subjects regulations were applicable and, consequently, that such experiments must be reviewed prior to implementation by an Institutional Review Board. If the experiment places human subjects at risk, the regulations require that informed consent be obtained from participating subjects. The paper concludes by examining the implications of the Georgia ruling in terms of future efforts to contain health care costs while ensuring that the rights of individual beneficiaries are adequately safeguarded.

California↗
PubMed1978

Health care cost control will affect total U.S. economy.

The crisis in health care costs in being attributed primarily to hospitals although it has many causes and sources. Moreover, it typically is viewed simply as being one industry's inflation even though it affects, and is affected by, finances and spending in many other sectors of society and the economy.

Costs and Cost Analysis↗
PubMed1979

Health care cost containment.

Upper respiratory infections make up 90 per cent of the practice of the general medical doctor during the winter months. The common cold and related complications lead the list of causes of acute morbidity during the cold weather. The medical expense resulting from these ailments is a substantial part of the cost of health care, which is in urgent need of containment. Man, migrating from the warm climates of his origin, quickly learned how to protect himself against the cold but is still very much remiss in compensating for the low humidity created by indoor heating. A viral etiology for the common cold has been established, but efforts to produce an effective vaccine have failed except in special circumstances. It has been shown, however, that the virus is destroyed in the presence of adequate humidification. Furthermore, maintenance of proper indoor humidity will not only improve health but will also act to make more acceptable the 65 degrees F. limit to indoor heating newly mandated by law as an energy conservation measure. A graphic representation and pertinent relative humidity tables are used to develop the subject.

Common Cold↗
PubMed1979

Health care cost containment in West Germany.

The West German health care system has experienced a serious escalation of expenditures since about 1970. For a variety of reasons, many features of the national health insurance program that might have provided restraints on costs were gradually eliminated. Most notably, some restrictions on the supply of physicians and hospital facilities were ended, as was an earlier system of fixed budgeting for ambulatory care services. In addition, legislative and judicial decisions have continually expanded both the benefits and the standard of care that must be provided to publicly insured patients. In 1977, the government passed a Health Care Containment Act which ordered several measures to curb costs: prospectively negotiated ceilings on expenditures for physicians' services, dentists' services and prescription drugs; strengthening of utilization review; composition of a unified fee schedule; small increases in cost sharing and limitations on insurance benefits; and some changes in financing. The reform efforts seem to have had a significant effect, though it is still too early to tell exactly what caused the declining growth rate of health expenditures, and whether the new trend will persist.

Cost Control↗
PubMed1977

Controlling health care costs: strengthening the private sector's hand.

The council on Wage and Price Stability recently has discovered evidence suggesting "an unackonwledged potential of the private sector to exert influence and control in the area of health care cost inflation." This article examines the limitations on private-sector cost-control efforts and suggests actions which would permit and encourage private decision makers to be more effective. In particular, private health insurers' potential role in cost control is explored, and some promising insurer strategies are adumbrated. Carefully designed coverage limitations and plan-initiated reviews to exclude nonessential care from coverage are suggested, together with wider use of fixed indemnity payments or negotiated fees and charges (instead of paying unusual and customary rates or incurred costs). Among the steps needed to permit insurers to provide this added service to cost-conscious customers is enforcement of the antitrust laws to prevent doctors' organized resistance to unwanted measures. In general, it is argued that private-sector efforts are likely to be more effective than government-sponsored controls as well as more appropriate in a pluralistic society.

Cost-Benefit Analysis↗
PubMed1978

Marrying regulatory and competitive approaches to health care cost containment.

The aim of this paper is to demonstrate that the problems which arise from simultaneously developing regulatory and competitive approaches to health care cost containment can be solved, if recognized, and that those problems deserve more systematic investigation than they have so far received. It is suggested that public regulation which accommodates the special characteristics of health maintenance organizations (HMOs) allows for effective competition. Although there are formidable difficulties in formulating the appropriate regulatory strategies, there are some encouraging signs, such as the renewed commitment of the Carter Administration and Congress to the development of HMOs and the active interest of the Federal Trade Commission in health care, that future policy may minimize conflict between regulation and competition.

Costs and Cost Analysis↗
PubMed1975

[An analysis of the rise of health care costs in institutions in Canada and Quebec].

The author compares increases in institutional care costs in Quebec with the rest of Canada revealing the following: The 14 per cent annual increase reported by federal health minister Marc Lalonde is well above the increase in the Canadian population of 4 per cent. The 12 per cent rise in costs of Quebec health services is far above the increase in the population of 15 per cent. Therefore, population is not a major factor in cost increase. The rate of cost increase in Quebec is below the national rate, 12 per cent against 14 per cent. Cost of institutional care in dollars per capita is appreciably lower in Quebec than in the rest of Canada. The average increase in health care costs in Canada between 1970 and 1973 is actually above the average deseasonized increase rate of the gross national product (GNP). The average cost increase of institutional care remained, however, below the increase of the GNP in Canada. The increase in the number of patients admitted is far above the increase in population, in both Quebec and the other provinces, the difference being more important in Quebec than in the rest of Canada. Utilization has partly been possible through decrease in the average length of stay in both Quebec and the other provinces. The decrease in average length of stay is higher in other Canadian provinces than it is in Quebec. However, it is lower in Quebec for a day. The occupancy rate has consistantly been rising in Quebec while it remained stable in other provinces. The number of patients admitted per 1,000 population has remained much lower in Quebec as compared to the rest of Canda. The difference tends, however, to decrease. The number of institutional care facilities remains higher in other Canadian provinces than in Quebec in proportion to the population The number of visits in emergency units per 1,000 population has doubled in Quebec, as compared to the rest of Canada with half that increase. It would be interesting to establish the trend in institutional care for outpatient departments other than emergency units; complete data about this not as yet availble.

Canada↗
PubMed1976

Demographic differences in support for government measures to control health care costs.

This paper uses longitudinal data from representative samples of national and southern California populations in an analysis of public opinion regarding proposals for health care cost controls. After examining ethnicity in conjunction with sex, socioeconomic status, age and party identification, it appears that this variable has significant explanatory power. This suggests that community may be a more useful concept than class in assessing public support for various forms of national health insurance and regulatory policies.

Black or African American↗
PubMed1979

Health care costs of laryngeal surgery.

The total costs of various laryngeal surgeries were considered from initial visit through one year postoperatively. For the four most widely used procedures, average costs were: laryngoscopy with biopsy, $1,000.00; hemilaryngectomy, $5,035.00; total laryngectomy $6,010.00; and supraglottic laryngectomy and neck dissection, $12,096.00. Most ancillary service charges decrease as length of hospitalization increases except for pharmacy and respiratory therapy. Physicians whose decisions affect health care should also take cognizance of health care costs.

Biopsy↗