• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of health politics, policy and law >Waiting for Godot: wishes and worries in managed care.
【24h】

Waiting for Godot: wishes and worries in managed care.

机译：等待戈多：托管治疗中的愿望和担忧。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Managed care has done a better job at reducing expenditure growth than it has in improving quality. Although reduced expenditure growth is not appreciated by many, it has real benefits. For the majority of Americans who are privately insured, it results in greater disposable income for goods and services other than health care (although the illusion of employer-paid health insurance obscures this reality for many). For Medicaid programs, slower growth of expenditures facilitates efforts at expanding coverage. For low-income workers, slower expenditure growth results in larger numbers of people retaining insurance coverage than would have been the case if premiums rose more quickly. While there are some victories to which managed care organizations can point, we cannot credibly argue that overall levels of quality and health outcomes are improving as the health care system is massively disrupted by changes in health care finance and delivery. The disruptions create real hardships for some physicians and other health care workers, and worries for many consumers. These worries fuel the managed care backlash. The danger is that politicians will respond to these worries with policies that inhibit the development of high-quality delivery systems. The opportunity is for relatively modest public policy changes--external review organizations, better public-sector purchasing capabilities, public investment in producing and publicizing information on health plan and medical group performance, and establishment of a public ombudsperson--to respond to consumer worries and lead to improvements in health care quality and outcomes. Finally, I would be remiss without a reminder that the single most effective action politicians could take to improve health care quality and outcomes would be to change the rules of health care financing to assure that all Americans are covered by managed care. Even with all of its inadequacies, managed care is much superior to the patchwork care available to the 43 million Americans who are uninsured. The managed care backlash is concerned with protecting patients who are insured (and their providers). Far more valuable would be to protect those without insurance. Sadly, no politician has yet figured out how to do this. Still waiting.
机译：与提高质量相比，管理型医疗在减少支出增长方面做得更好。尽管减少的支出增长并未被许多人所接受，但它具有真正的好处。对于大多数有私人保险的美国人来说，这导致医疗保健以外的商品和服务的可支配收入增加（尽管许多人用雇主支付的健康保险的幻想掩盖了这一现实）。对于医疗补助计划，支出增长放缓有助于扩大覆盖范围。对于低收入工人，与保费增长较快的情况相比，支出增长放慢会导致更多人保留保险。尽管管理式医疗组织可以取得一些胜利，但是我们不能令人信服地争辩说，由于医疗保健系统的财务和交付方式的变化极大地破坏了医疗保健系统，因此总体质量和健康成果正在改善。中断给一些医生和其他医护人员带来了真正的困难，并给许多消费者带来了担忧。这些担忧加剧了管理式医疗的反弹。危险在于，政客将通过抑制高质量交付系统发展的政策来应对这些担忧。机会是相对温和的公共政策变更-外部审核组织，更好的公共部门购买能力，公共投资以生产和宣传有关健康计划和医疗团体绩效的信息以及建立公共监察员-以回应消费者的担忧并导致医疗质量和结果的改善。最后，我会在没有提醒的情况下退缩，政客们可以采取的最有效的行动来提高医疗保健质量和结果将是改变医疗保健筹资规则，以确保所有美国人都可以接受医疗管理。即使存在所有不足之处，管理式护理也比4300万没有保险的美国人所能得到的拼凑护理要好得多。管理式医疗的强烈反对是保护受保患者（及其提供者）。更有价值的是保护那些没有保险的人。可悲的是，还没有政治家想出如何做到这一点。还在等。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

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