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 68 - Efficient community services, including access to low-cost transportation, which provide a choice in supported living arrangements and 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.
Page 69 - 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 65 - health care planning" in the 1970s 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 72 - The Subcommittee on Aging of the Senate Committee on Labor and Human Resources...
Page 66 - 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 64 - Hospice Respite care Geriatric day rehabilitation hospital Day care Sheltered workshop Congregate meals Community mental health Senior citizen center Geriatric medical services • dental service • podiatry service Legal services Protective services Visiting nurse Homemaker Home health aide Chore services...
Page 63 - 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 66 - 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...
Page 68 - 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 needing long-term care services.
Page 77 - ... beneficiaries the option of enrolling in qualified private health plans, which combine the financing and delivery of care and are paid on a capitation basis, also has potential as a means of providing catastrophic coverage at lower total costs to the program and beneficiaries. The expansion of these alternatives may be limited in the short term by the absence of actuarial ly sound methods of computing premiums or voucher amounts for individuals and small...

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