Health Care for Older Americans: Insuring Against Catastrophic Loss : Hearings Before the Special Committee on Aging, United States Senate, Ninety-ninth Congress, Second Session : Part 1, Fort Smith, AR, August 27, 1986; Part 2, Little Rock, AR, August 28, 1986

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Page 71 - Efficient community services which provide social assistance in a coordinated manner and which are readily available when needed. (9) Immediate benefit from proven research knowledge which can sustain and improve health and happiness. (10) Freedom, independence, and the free exercise of individual initiative in planning and managing their own lives.
Page 68 - health care planning" in the 197os now talk about "health care marketing." Everywhere one sees the growth of a kind of marketing mentality in health care. And, indeed, business school graduates are displacing graduates of public health schools, hospital administrators, and even doctors in the top echelons of medical care organizations. The organizational culture of medicine used to be dominated by the ideals of professionalism and voluntarism, which softened the underlying acquisitive activity. The...
Page 74 - The Subcommittee on Aging of the Senate Committee on Labor and Human Resources...
Page 68 - The corporate health services industry will also represent a powerful new force resisting public accountability and participation. A corporate sector in health care is also likely to aggravate inequalities in access to health care. Profit-making enterprises are not interested in treating those who cannot pay. The voluntary' hospital may not treat the poor the same as the rich, but they do treat them and often treat them well. A system in which corporate enterprises play a larger part is likely to...
Page 70 - Obtaining and maintaining suitable housing, independently selected, designed and located with reference to special needs and available at costs which older citizens can afford. 4. Full restorative services for those who require institutional care, and a comprehensive array of community-based, long-term care services adequate to appropriately sustain older people in their communities and in their homes, including support to family members and other persons providing voluntary care to older individuals...
Page 76 - ... continue to be a shared responsibility of individuals, the private sector and State and Federal Government. The goals of public policy should be to encourage individuals to make provision for long-term care needs to the extent permitted by their income...
Page 65 - Long-term care represents a range of services that address the health, social, and personal care needs of individuals who, for one reason or another, have never developed or have lost the ability for self -care. Services may be continuous or intermittent, but it is generally presumed that they will be delivered in the "long-term)" that is, indefinitely, to individuals who have demonstrated need usually measured by some index of functional incapacity (113).
Page 80 - The financing of long-term care (including skilled nursing facility, intermediate care facility, home care, and custodial "nursing home" care) has been, and will continue to be, a shared responsibility of individuals, the private sector, and state and federal government. The goals of public policy should be: to encourage individuals to make provision for...
Page 67 - The rise of a corporate ethos in medical care is already one of the most significant consequences of the changing structure of medical care. It permeates voluntary hospitals, government agencies, and academic thought as well as profit-making medical care organizations. Those who talked about "health care planning" in the 1970s now talk about "health care marketing.
Page 68 - The failure to rationalize medical services under public control meant that sooner or later they would be rationalized under private control. Instead of public regulation, there will be private regulation, and instead of public planning, there will be corporate planning. Instead of public financing for prepaid plans that might be managed by the subscribers...

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