Government Involvement In Health Care Research Articles

The politics of pooling risk: People want to help the vulnerable by involving the government in healthcare

AbstractMany people want the government involved in healthcare. Is this because citizens are concerned about their own vulnerability, the plight of vulnerable others, or both? To test for these concerns, we used representative surveys and experimental economic games. We found robust evidence for concern for others. In surveys, people who worried about vulnerable others wanted more government involvement in healthcare. In experiments, people with the opportunity to subsidize vulnerable others often helped. The evidence for personal concern was more mixed. In surveys, people who were personally vulnerable did not usually want more government involvement in healthcare. In experiments, however, vulnerable people often wanted more healthcare. Additional data suggests that concern for the vulnerable is motivated by social preferences, empathy, and compassion. We discuss how the logic of healthcare is different from other aspects of the welfare state and therefore needs to be studied separately.

ОТНОШЕНИЕ РОССИЯН К РОЛИ ГОСУДАРСТВА В СФЕРЕ ЗДРАВООХРАНЕНИЯ

The aim of the study was: 1) to consider the views of Russians on the state’s role in providing and financing health care services and the success of the government in this area; 2) to identify changes in these views over time; 3) to explore the relationship between the Russians’ opinions and their individual characteristics. The analysis of International Social Survey Programme (ISSP) data collected in 2006 and in 2016 shows that support for the government’s role in providing and financing health care has slightly declined over a ten-year period and a significant part of the respondents are dissatisfied with the government’s success in ensuring treatment to those in need of medical attention. However, despite this, most Russians still support government involvement in health care. Individual characteristics associated with the attitude to the role of the state in healthcare have also been identified.

Shared Responsibility: Massachusetts Legislators, Physicians, and An Act Relative to Substance Use Treatment, Education, and Prevention.

Recent passage of the Massachusetts law, An Act Relative to Substance Use, Treatment, Education, and Prevention, represents an admirable public health approach to substance use disorder (SUD), a stigmatized chronic disease that affects some of society's most vulnerable people. With its seven-day supply limit on first-time opioid prescriptions, this legislation takes an unusual approach to state government involvement in health care. By intervening in individual physicians' practices, state legislators have entered a space traditionally reserved for clinical teams. The seven-day supply limit and the process through which it was developed highlight competing priorities and dialogue between physicians and legislators, limits of physician self-regulation, and standards of evidence in policy making and health care. Addressing these issues requires both physicians and legislators to recognize and fulfill new responsibilities in order to better assist the populations they serve.

Decision-makers' acquaintance with the public's priorities in health services.

BackgroundDecision makers often assume they know the public’s standpoints and see themselves as capable of representing them.The aim of this study is to assess the level of acquaintance that senior decision-makers in the Israeli health system have concerning the priorities of the public in whose name they act.MethodsA phone survey was conducted with a representative population sample and face-to-face interviews were conducted with senior decision-makers.ResultsThe decision-makers did predict correctly the public’s desired level of government involvement in health care; but only some of them correctly predicted the public’s preferences on allocation of funds—to health versus other areas. They had difficulty foreseeing public priorities for allocating additional monies to health, and even greater difficulty ascertaining preferences of the public for their own health insurance.ConclusionsGovernment decision-making processes should include evidence about public preferences. The findings of this study indicate that decision makers need to be provided with reliable, systematic information on public preferences.

Reforming the past: the challenges faced by Obamacare

Reforming the past: the challenges faced by Obamacare

Transformation of the US Healthcare System: Why is change so difficult?

The United States spends considerably more on medical care than any country in the world but is the only resource-rich country where a substantial portion of its residents lack health insurance coverage. Moreover, the US continues to rank low on most measures of health outcome compared to other developed countries. Therefore, there was considerable incredulity by those unfamiliar with the US as to why a revamping of this obviously broken system was not widely embraced by the American public when in 2009 a popularly elected president made healthcare reform his top priority. This commentary examines this phenomenon and discusses why a meaningful transformation of the US healthcare system has proven so elusive. Among the factors discussed here are political institutions and economic forces, a powerful medical establishment, the dominant private insurance industry, an extensive liability system and a public that is highly suspicious of any government involvement in healthcare.

So Many Issues, So Little Time

So Many Issues, So Little Time

U.S. Health Reform

A new political climate in the United States has raised renewed hope for achieving much needed reform of the U.S. health care system. Opposition to reform raises old arguments, however, including warnings against "big government," currently focused on proposals to include a public plan option in health reform. But greater government involvement in health care is needed to achieve comprehensive reform. Further substantial delay in achieving reform is unthinkable; success will require continued and expanded support efforts. Although a strong public plan option would represent a significant step forward, continued advocacy by proponents of single-payer health care can help strengthen broader efforts to achieve public accountability. Supporters of meaningful health reform will need to continue their efforts long past the passage of reform legislation.

Health Care Reform in the 2008 US Presidential Election

As in Canada, the challenges of health care reform are a constant political refrain in electoral battles in the United States. Since the 1940s, in fact, successive presidential elections have been marked by the issues of health care access, cost, and coverage. The failure of Harry Truman's fair deal proposals and the success of Lyndon Johnson's great society project both had core visions for health reform, while the more recent challenges faced during Bill Clinton's first term in office underscore the persistent problems in addressing health care issues in the US.1The 2008 election year lived up to its promise of political spectacle, with a showdown between Hillary Clinton and Barack Obama for the Democratic nomination, and the fresh image of Sarah Palin recasting the Republican ticket with John McCain. In the vortex of the personality politics that dominated the campaign, it remained important not to lose perspective on the real political issues of the contest. The policy stakes between the parties were real and salient for voters and candidates alike. And although the economic crises of the fall 2008 would dominate headlines, health care reform remained a main ballot box issue in the November election.HEALTH CARE IN THE 2008 CAMPAIGNIn most US political contests, pocketbook issues tend to dominate voter concerns, particularly in worsening economic times. Members of the babyboom generation have become increasingly insecure about their health-care future as costs soar and even middle-income Americans remain worried about being able to afford health care.The stakes also are high for businesses grappling with how to insure workers in an economic downturn and how to compete with firms in other countries - including Canada - that don't have to shoulder that burden directly. Yet even though a good number of business leaders recognize the need for health reform, the business community remains divided on the nature of needed change and has been unable to sustain or support concerted legislative efforts.2Moreover, the persistent problem of the uninsured - 47 million at last count - haunts every political candidate.3 Why the US can spend so much on health care and yet have so many residents uninsured has led to a lively scholarly debate, but the question of the uninsured is of key practical concern as well .4 This is because access to health care in the US depends on insurance coverage, not citizenship, as is the case in practically every other industrialized country.In fact, in the United States today, in sharp contrast to Canada, access to care is not guaranteed. Instead, access to care depends on one's insurance coverage, which varies widely between individuals and is determined by state of residence, employment status, financial capacity, age, and disability. Most Americans (and their dependents) are covered through voluntary employment-based health insurance, in which they share in paying the costs of premiums with their employer. A small minority carry individual private insurance.So, while Canadians bemoan rising taxes and politicians fret about increases in health care budgets, our concerns are largely about the collective impact of rising health care costs. In the US, meanwhile, those costs are felt directly in people's wallets. As the economy tightens and the potential for unemployment rises, so too does the possibility of losing coverage. But financial squeezes also come into play for the employed, since many low-wage workers cannot afford to pay health insurance premiums, while most part-time workers are not offered those benefits at all.As in Canada, health care reform in the US is also about government programs, public spending, and fiscal federalism. This is because government involvement in health care is substantial, through major federal legislation instated in the 1960s, through tax subsidies for health insurance for employees and the self-employed, and through extensive regulations of insurers and health maintenance organizations. …

Historique de l’évolution des modes de financement des services de santé au Canada

The history of Canadian government involvement in health care financing from the earliest colonial times to the present day is briefly reviewed. Particular attention is paid to the institution of major health care insurance programs and the underlying reasons for their implementation. The current financing arrangements, as dictated by the Established Programs Financing Act of 1977, are reviewed in some detail with a discussion of the advantages and disadvantages of these arrangements.

Similar Pressures, Different Contexts: Public Attitudes toward Government Intervention for Health Care in 21 Nations

Health care systems worldwide are experiencing similar pressures such as rising cost, aging populations, and increased burden of disease. While policy makers in all countries face these challenges, their responses must consider local pressures, particularly the implicit social contract between the state, medicine, and insurers. We argue that public attitudes provide a window into the social context in which policy decisions are embedded. Using data from the International Social Survey Programme (ISSP), we compare public attitudes toward government involvement in health care in 21 countries, testing the associations between various national-level variables (e.g., health care expenditures, aging of population, health care traditions) and public opinions. Specifically, we posit four national-level hypotheses ("health care traditions," "expenditure crisis," "demographic crisis," "changing disease profile crisis"), one individual-level hypothesis ("individual vulnerability"), and two cross-level hypotheses ("cultural socialization" and "health care need"). Our findings indicate that public attitudes cluster around the historical organization of health care, but also relate to current economic and demographic realities. Individuals in countries adopting the "National Health Service Model" (the state directly provides health care but complete state control is absent) or the "Centralized Model" (the state directly provides health care and has much control) are more supportive of government involvement in health care than those in the "Insurance Model" (the state is limited to maintenance of the system) countries. However citizens in countries currently spending more on health care and having a greater burden of chronic illness are less supportive. Our results cast doubt on arguments that increased cost will result in a questioning of the contract between the state and citizens in the social provision of health care. We end by discussing implications for recent work in political sociology that highlights the importance of public attitudes.

Health Care in the 2008 Presidential Primaries

In this report of voters' views, respondents listed health care as an important issue in the 2008 presidential primary election. Democratic voters reported dissatisfaction with the health care system and favored government efforts to expand coverage for the uninsured. Republican voters were less dissatisfied and were less likely to favor increased government involvement in health care.

Individual autonomy and state involvement in health care

This article examines the ethical basis for government involvement in health care. It first provides the case for individual autonomy, focusing on the justifications–particularly ethical ones–for allowing individuals to make...

Health for all: the impossible dream?

Health for all: the impossible dream?

Antigovernment sentiment and support for universal access to care: are they incompatible?

Attitudes toward universal access to medical care were examined to determine whether support for it among people opposed to government involvement in health care was modified by three proxy measures of self-interest: being uninsured, in poor health, or a high user of medical care. Data on support for universal access, attitudes toward government involvement in health care, and the indicators of self-interest were obtained from a representative sample of adult Oklahomans (n = 1547) surveyed between October 1992 and December 1994. Forced-order multiple regression with interaction terms was the data analysis technique. People opposed to government involvement in health care were found to be less likely to favor universal access to medical care, but poor health, lack of insurance, and high usage of medical care moderated this effect. The findings support the view that antigovernment sentiment need not foreclose the public option for health policymakers. Other considerations such as self-interest may modify the effect of unfavorable attitudes toward government.

Do the bishops have it right on health care reform?

The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitable and just system for providing health care. Natural law arguments in the tradition of Roman Catholic social teaching lead to the conclusion that a just and prosperous society has a moral obligation to provide health care even if there is no such right. Further, there are strong moral grounds for concluding that the bishops are correct in their claim that health care ought not to be considered a market commodity. It is argued that if health care ought not to be considered a commodity, then national health insurance is the best available alternative for fulfilling the social obligation to distribute health care resources justly and fairly at this time in American history. The bishops' case for government involvement can be made on the strength of the Catholic tradition in theological argumentation, independent of the claim that health care is a right.

High cost technology in health care: A benefit or a burden?

The influence of high cost technology goes beyond its consequences for the selected patient groups that benefit from its application. Past and future technological developments have a variety of social, economic and ethical implications which have to be taken into account when balancing its costs and benefits to society. Departing from an economic perspective we describe a number of mechanisms underlying the emergence of high cost technology which help us to understand some of the characteristics of high cost technology, such as its focus on quality enhancement rather than on economy. To assess the actual performance of high cost technology in terms of efficiency and equity is difficult as there may be debate about the perspective guiding such assessment and as there still is scarce information on high cost technology in terms of these economic indicators. The increasing technological opportunities have triggered a wider debate on the desired evolution of our health care systems. In some countries there is a tendency to diminish government involvement in health care and emphasize private (for profit) enterprise as a reaction to not being able to finance all new high cost technology. The risks of such strategies are discussed briefly. We conclude that the main actors in health care should adjust their behaviour in order to accomplish the introduction of more cost-effective technologies and to achieve a more socially efficient distribution of their benefits.

Social issues in medicine: a follow-up comparison of senior-year medical students' attitudes with contemporaries in non-medical faculties.

A comparison of first-year medical students' attitudes to social issues in medicine with attitudes of non-medical first-year students in 1983 found that the medical group was less conservative towards general social issues but more conservative in relation to those areas which closely affect the doctor's role, particularly the place of allied health professions and government intervention in health care. This paper reports a follow-up study of the same groups of students when they had reached senior years in their respective courses. While medical student conservatism on general social issues continues to be no greater than other student groups there is a marked increase in conservatism of attitudes towards government involvement in health care and regulation of costs. Attitudes to allied health professions and preventive care remain unchanged but senior medical students are significantly less likely to recognize social factors as determinants of illness than they were when they commenced the study of medicine. Specific curricular attention to social and behavioural medicine does not appear to counteract the predominantly biomedical perspective students experience in teaching hospitals, the major venue for their clinical education.

International perspectives on the health care crisis in the United States

The American health care system is confronting a crisis: one consisting of severe problems of cost and access, and the other consisting of significant qualitative changes in structure, systemic behavior and operation. Some of these factors may be understood better in comparison with how systems in other nations have responded to similar problems. The United States had adopted solutions which are significantly different from those of other countries, including more limited government involvement in health care and planning, and the development of corporatized medicine. These solutions pose significant ethical and operational problems.

Continuing dental education. Reasonable answers to unreasonable questions

Increasing government involvement in health care, interest in consumerism, and improved instructional technology have raised new challenges for continuing dental education. Arguments from educational research and evaluation theory are used to show the potential dangers involved in compulsory, mass-media continuing education with pre- and posttest measures of success.