States face rocky road to reform

Article Abstract:

State health care reform efforts may be aided by Medicaid waivers, although the Employee Retirement Income Security Act of 1974 (ERISA) may hamper the progress of reforms. Medicaid waivers allow states to test techniques to expand Medicaid coverage to the poor and uninsured, reduce costs, and provide services to enrollees. Under ERISA self-insured companies are exempted from state laws that regulate employee benefits. One estimate suggests that two-thirds of insured employees in the U.S. are covered by self-insured plans. ERISA prohibits states from enacting employer mandates, from collecting data from insurers on health care utilization and costs, and from implementing security measures such as mandatory health coverage for people with pre-existing conditions. The new Republican majority in Congress and the slim chance that ERISA will be amended are likely to stimulate heated political debate in 1995.

Management, Laws, regulations and rules, Political aspects, Medical policy, Health policy, Health care reform, Medicaid

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Creating a basis for good outcomes

Article Abstract:

Good outcomes can be better achieved if a basis for evaluating treatment results is established. Employers and insurance companies are holding health plans responsible for providing both cost-effective care and for superior outcomes. In turn, the plans are holding the medical groups accountable. Outcomes involve a clinical and patient satisfaction measure of health care services. Before good outcomes can be achieved, several factors should be considered. Adequate statistics need to be compiled. Outcomes, such as mortality, must be measured well. Case mix, including coexisting conditions, should be considered. Hypotheses must be developed before beginning a study. Socioeconomic status must be taken into account.

Evaluation, Measurement, Medical care, Outcome and process assessment (Health Care), Outcome and process assessment (Medical care)

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Studies suggest dog walking a good strategy for fostering fitness

Article Abstract:

Studies suggest that humans can lose weight and become more fit by walking their dogs. A research conducted among 351 adults at the University of Victoria, British Columbia suggested that dog obligation prompted the dog owners to walk an average of 300 minutes per week compared with 168 minutes per week for those who do not own a dog.

Health aspects, Methods, Physical fitness, Weight loss, Walking

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