Health care reform: blueprints for progress from the states

Article Abstract:

The Clinton administration can look to a number of states for examples to base the reformation of the US health care system. Hawaii is the most outstanding of all the states that have made health care greatly accessible to their citizens. Virtually every Hawaiian has health insurance and the life expectancy as well as infant mortality in the state are the best in the nation. This state has shown that affordable employer-based insurance is possible and effective. Along with Vermont which is committed to universal access, Hawaii can show the new administration the means to achieve universal health care.

Author: Dukakis, Michael S.
Health aspects, Management, Laws, regulations and rules, Medical care, Medical policy, Health policy, Hawaii

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TennCare: an experiment that created a monster

Article Abstract:

Tennessee's $3.1 billion TennCare health reform program is failing because of unrealistic assumptions. The program, which was supposed to reduce the growth of the state's health care spending and offer coverage to an additional 750,000 citizens, has failed to meet its promise. Part of the problem with TennCare was the program's policy of paying less for physician services than the state paid under Medicaid, which alienated many physicians. Additionally, the program's success was based on the assumption that managed care efficiencies would be sufficient to control cost growth.

Author: Chang, Cyril F.
Administration of Public Health Programs, Health Programs, Social policy, Public health, Tennessee

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Rationing: the health care reform rhino bullet?

Article Abstract:

The rationing of medical services is necessary to reduce health care costs and extend medical insurance coverage to the poor. However, politicians and the citizenry at large continue to oppose rationing. Instead, they continue to rely on medical practice guidelines to cut health care costs, even though such guidelines have been ineffective in stopping spiralling health care costs. A strategy that emphasizes improvements in the quality of life is the only way to stop rising health care costs.

Author: Burke, Gerald
Evaluation, Practice guidelines (Medicine)

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Subjects list: Analysis, Column, Health care reform
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