• 主题
高级搜索  >
历史搜索 清空历史
首页> 美国卫生研究院文献>California Medicine >Medicaid and the Mainstream: Reassessment in the Context of the Taxpayer Revolt
【2h】

Medicaid and the Mainstream: Reassessment in the Context of the Taxpayer Revolt

机译：医疗补助和主流：纳税人起义背景下的重新评估

代理获取
本网站仅为用户提供外文OA文献查询和代理获取服务，本网站没有原文。下单后我们将采用程序或人工为您竭诚获取高质量的原文，但由于OA文献来源多样且变更频繁，仍可能出现获取不到、文献不完整或与标题不符等情况，如果获取不到我们将提供退款服务。请知悉。
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

California's Medicaid program—Medi-Cal—attempted to implement the ideal of mainstream medical care for the poor by giving program beneficiaries a “credit card” for use in the private health care marketplace. This exposed the program to the perverse economic incentives of the fee-for-service, costplus health care system, and contributed to a high rate of increase in program costs. Attempts to control costs have been equally perverse, resulting in low payment rates, the second-guessing of physician professional judgments, the probing of medical and fiscal records, and the use of computerized surveillance systems.Attempts to shift to the use of more efficient delivery systems have had small success. Attempts to attain cost containment through restructuring the Medi-Cal program have been rejected in the name of the mainstream ideal. Costs have continued to escalate, with annual increases as high as 20 percent in some years. Medi-Cal now costs $4 billion per year, the largest single program in California state government.The taxpayer revolt in California is creating a fiscal crisis that will force rethinking of the premises of publicly funded health care for the poor, and a restructuring of strategies for reaching that objective. In the short run, it appears that the issue may not be whether the indigent will have access to mainstream medical care, but whether they will have access to any medical care. In the longer run, the crisis should represent an opportunity for building a system of health care that can serve the financially disadvantaged at a cost tolerable to our society.
机译：加利福尼亚州的Medicaid计划（Medi-Cal）通过向计划受益人提供在私人医疗保健市场中使用的“信用卡”，来尝试实现穷人主流医疗保健的理想。这使该计划遭受了有偿服务，费用加医疗制度的不正当经济诱因，并导致计划费用的高增长率。控制成本的尝试同样是错误的，导致支付率低，医生专业判断的第二次猜测，医疗和财务记录的探测以及计算机监控系统的使用。试图转向使用更高效的交付系统收效甚微。通过重组Medi-Cal计划来实现成本控制的尝试已被主流理想的名义拒绝了。成本持续上升，在某些年份每年的增长高达20％。 Medi-Cal现在每年花费40亿美元，是加利福尼亚州政府最大的单一计划。加利福尼亚州的纳税人起义正在造成一场财政危机，这将迫使人们重新考虑为穷人提供公共资助的医疗保健场所，并对战略进行重组为实现这一目标。从短期看，问题似乎可能不是穷人是否将获得主流医疗服务，而是他们是否将获得任何医疗服务。从长远来看，危机应为建立医疗保健系统提供机会，该系统可以为社会经济上可以承受的成本服务于经济困难的人。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
代理获取

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号