Health care reform - past and future

Article Abstract:

Efforts to pass federal health care reform legislation may require persistence on the part of politically savvy professionals to persuade middle-class Americans that health care reform will benefit them as well as the uninsured poor. Several reasons for the failure to pass health care reform legislation in Congress in 1994 includes political inexperience, Americans' lack of dissatisfaction with their health insurance, and the success of special-interest groups in turning Congress and important groups of Americans against health care reform. Medicare was the health care reform issue of the 1960s. It was opposed by the American Medical Association, but President Johnson and several other politically experienced leaders were successful in convincing Americans of the need for health insurance for the elderly. Political leaders may help to create a positive climate for health care reform by keeping the issue in the public spotlight, and by building partnerships with groups that support health care reform.

Column, Political aspects, Health care reform

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Ethical guidelines for physician compensation based on capitation

Article Abstract:

Compensation systems for physicians need to be designed with safeguards to minimize conflicts of interest. Most managed care systems pay physicians via a process called capitation. In a capitated payment system, physicians receive a specific amount of money per patient per month. This limits the amount of money the physician can spend on any particular patient. Many patients and physicians are concerned that physicians may limit care in order to operate within budget. Suggestions for an ethical capitation system are discussed.

Compensation and benefits, Physicians, Medical professions, Ethical aspects, Capitated payment systems (Medical care)

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Leaving gatekeeping behind -- effects of opening access to specialists for adults in a health maintenance organization

Article Abstract:

Eliminating gatekeeping in an HMO does not appear to increase the use of specialists by patients. Gatekeeping means the primary care physician would refer patients to a specialist when necessary. Gatekeeping was introduced to reduce the unnecessary use of specialists, which was thought to increase health care costs.

Research, Medicine, Human resource management, Medical referral, Health maintenance organizations, Medical specialties

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