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At least 19 recordsLinked to original sources
PubMed1991

Liberal benefits, conservative spending. The Physicians for a National Health Program proposal.

The Physicians for a National Health Program proposes to cover all Americans under a single, comprehensive public insurance program without copayments or deductibles and with free choice of provider. Such a national health program could reap tens of billions dollars in administrative savings in the initial years, enough to fund generous increases in health care services not only for the uninsured, but for the underinsured as well. We delineate a transitional national health program budget that would hold overall health spending at current levels while accommodating increases in hospital and physician utilization. Future national health program spending would be indexed to the growth in gross national product adjusted for demographic, epidemiologic, and technologic shifts. Financing for the national health program would transfer funds into the public program without disrupting the general pattern of current revenue sources. We suggest a funding package that would augment existing government health spending with earmarked health care taxes. Because these new taxes would replace employer-employee insurance premiums and substantial portions of current out-of-pocket expenditures, they would not increase health costs for the average American.

Budgets↗
PubMed1991

A national long-term care program for the United States. A caring vision. The Working Group on Long-term Care Program Design, Physicians for a National Health Program.

The financing and delivery of long-term care (LTC) need substantial reform. Many cannot afford essential services; age restrictions often arbitrarily limit access for the nonelderly, although more than a third of those needing care are under 65 years old; Medicaid, the principal third-party payer for LTC, is biased toward nursing home care and discourages independent living; informal care provided by relatives and friends, the only assistance used by 70% of those needing LTC, is neither supported nor encouraged; and insurance coverage often excludes critically important services that fall outside narrow definitions of medically necessary care. We describe an LTC program designed as an integral component of the national health program advanced by Physicians for a National Health Program. Everyone would be covered for all medically and socially necessary services under a single public plan, federally mandated and funded but administered locally. An LTC payment board in each state would contract directly with providers through a network of local public agencies responsible for eligibility determination and care coordination. Nursing homes, home care agencies, and other institutional providers would be paid a global budget to cover all operating costs and would not bill on a per-patient basis. Alternatively, integrated provider organizations could receive a capitation fee to cover a broad range of LTC and acute care services. Individual practitioners could continue to be paid on a fee-for-service basis or could receive salaries from institutional providers. Support for innovation, training of LTC personnel, and monitoring of the quality of care would be greatly augmented. For-profit providers would be compensated for past investments and phased out. Our program would add between $18 billion and $23.5 billion annually to current spending on LTC. Polls indicate that a majority of Americans want such a program and are willing to pay earmarked taxes to support it.

Aged↗
PubMed1989

Why it's time for a national health program in the United States.

The United States lacks a coherent national health program. Current programs leave major gaps in coverage and recently have become more restrictive. Influential policies that have failed to correct crucial problems of the health-care system include competitive strategies, corporate intervention, and public-sector cutbacks with bureaucratic expansion. A national health program that combines elements of national health insurance and a national health service is a policy that would help solve current health-care problems. Previous proposals for national health insurance contained weaknesses that would need correction under a national program. Based on the experiences of other economically advanced countries, a national health program could provide universal entitlement to health care while controlling costs and improving the health-care system through structural reorganization. Current proposals for a national health program contain several basic principles dealing with the scope of services, copayments, financing, cost controls, physician and professional associations, personnel and distribution, prevention, and participation in policy making. Support for a national health program is growing rapidly. Such a program would help protect all people who live in this country from unnecessary illness, suffering, and early death.

National Health Programs↗
PubMed1989

Health care for the homeless in a national health program.

To assess the impact of adoption of a national health program on homeless care in the United States, care for this group in Britain's National Health Service (NHS) was evaluated. Although hospital and medication charges are eliminated, primary care for the homeless lacks central government directive, suffers from overlap of statutory agencies and mechanistic biases, is disproportionately delivered in emergency rooms, and has relied on advocacy by the non-profit sector. Disadvantages of this void in NHS provision are marginalization of the homeless and continuation of a two-class care system. Removal of financial barriers to care by enactment of a national health program in the US would not solve all issues related to delivery of quality care for the homeless unless its structure addressed the special needs of disenfranchised groups.

Fees, Medical↗
PubMed1987

Physicians for a National Health Program.

A new organization called Physician's for a National Health Program (PNHP) is mobilizing physician support for a universal, comprehensive public system of health care for the United States. Recent changes in power relations within medicine (the so-called proletarianization of physicians) are prodding many physicians to abandon their traditional reactionary role in health policy. PNHP is working with elderly, labor, community, and health care activist groups to put a national health program (NHP) back on the U.S. health policy agenda. In this article, five key features of an NHP needed to simultaneously assure access, control costs, and minimize bureaucracy are noted.

Cost-Benefit Analysis↗
PubMed1989

A national health program for the United States. A physicians' proposal.

Our health care system is failing. Tens of millions of people are uninsured, costs are skyrocketing, and the bureaucracy is expanding. Patchwork reforms succeed only in exchanging old problems for new ones. It is time for basic change in American medicine. We propose a national health program that would (1) fully cover everyone under a single, comprehensive public insurance program; (2) pay hospitals and nursing homes a total (global) annual amount to cover all operating expenses; (3) fund capital costs through separate appropriations; (4) pay for physicians' services and ambulatory services in any of three ways: through fee-for-service payments with a simplified fee schedule and mandatory acceptance of the national health program payment as the total payment for a service or procedure (assignment), through global budgets for hospitals and clinics employing salaried physicians, or on a per capita basis (capitation); (5) be funded, at least initially, from the same sources as at present, but with all payments disbursed from a single pool; and (6) contain costs through savings on billing and bureaucracy, improved health planning, and the ability of the national health program, as the single payer for services, to establish overall spending limits. Through this proposal, we hope to provide a pragmatic framework for public debate of fundamental health-policy reform.

Budgets↗
PubMed1988

The arguments against a national health program: science or ideology?

This article provides empirical information that questions some of the major arguments put forward against the establishment of a comprehensive and universal health program in the United State. The positions that (1) "Americans do not want a further expansion of government roles in their lives," (2) "a National Health Program would further increase the rate of growth of health expenditures," (3) "the federal deficit is too large and needs to be reduced before establishing a National Health Program," and (4) "people do not want to pay higher taxes," are shown to be ideological rather than scientific. The author presents evidence that questions each of these assumptions.

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PubMed1989

The rediscovery of the National Health Program by the Democratic Party of the United States: a chronicle of the Jesse Jackson 1988 campaign.

This report chronicles the major developments in the Jesse Jackson 1988 Campaign and their consequences for the establishment of a national health program in the United States. It describes the characteristics of the Jackson 1988 Campaign, and the set of events that led to the rediscovery of the national health program by the Democratic Party of the United States.

Health Benefit Plans, Employee↗
PubMed1988

Free care: a quantitative analysis of health and cost effects of a national health program for the United States.

We estimate the health and cost effects of instituting a National Health Program (NHP) in the United States that would provide universal, comprehensive free care. Based on empiric studies of the relationship of health service use to cost and health outcomes, we estimate that an NHP would increase use of health services by 14.6 percent and save between 47,000 and 106,000 lives annually. Because the United States faces a growing surplus of hospital beds and physicians, additional services could be provided at low cost. Simplifying the health bureaucracy that currently enforces unequal access to care would also result in substantial savings. Consequently, an NHP would actually decrease costs 2.4 percent, $10.2 billion annually, since the $35.7 billion spent for additional services would be offset by $45.9 billion saved on bureaucracy.

Comprehensive Health Care↗
PubMed1988

Principles for a national health program: a framework for analysis and development.

Growing gaps in health insurance coverage have generated increased interest in enactment of major reforms. A framework for evaluating proposals embodying different approaches to a national health program is offered, highlighting seven dimensions: inclusiveness of coverage; comprehensiveness of benefits; financing methods; efficiency of resource utilization; extent of planning and market forces in resource allocation; accountability to beneficiaries; and political feasibility. Four health care reform bills in the Congress are shown either to emphasize political feasibility at the expense or universal coverage and comprehensive benefits, or to stress coverage, benefits, and system reform at the cost of such feasibility.

Financing, Organized↗
PubMed1989

The Jackson National Health Program.

In this position paper we outline the major problems that exist in the U.S. health care system and present a proposal for addressing them. This paper contains the major health proposal put forward by the Jesse Jackson 1988 Campaign, calling for the establishment in the United States of a universal and comprehensive National Health Program (NHP) that will be federally funded and administered and be equitably financed. We also discuss how the NHP will affect patients, unions, corporations and employers, practitioners and other health workers, hospitals, and the insurance industry. Specific proposals are made for the transition from the current system to the proposed NHP, with a discussion of the major differences between national health proposals put forward by the two major Democratic contenders for the U.S. Presidency. This position paper also includes a brief appendix sketching some of the major differences between the U.S. and the Canadian medical care systems.

Cost-Benefit Analysis↗