RESUMO
This paper focuses on the major health care initiatives and proposals that policymakers have enacted or considered since 1980 and describes what we can learn from these efforts to expand coverage. Most proposals have focused on incremental strategies, through expansion of public programs or tax incentives for the purchase of private coverage, although universal proposals have also emerged. Incremental approaches, which seem more politically feasible, still involve complex policy trade-offs. Efforts to improve take-up rates of public and private insurance could greatly expand coverage as well.
Assuntos
Reforma dos Serviços de Saúde/tendências , Política de Saúde/tendências , Cobertura Universal do Seguro de Saúde/tendências , Criança , Serviços de Saúde da Criança/economia , Reforma dos Serviços de Saúde/legislação & jurisprudência , Setor de Assistência à Saúde/legislação & jurisprudência , Política de Saúde/legislação & jurisprudência , Humanos , Competição em Planos de Saúde , Medicaid/tendências , Assistência Médica , Técnicas de Planejamento , Política , Planos Governamentais de Saúde , Estados Unidos , Cobertura Universal do Seguro de Saúde/legislação & jurisprudência , Cobertura Universal do Seguro de Saúde/organização & administraçãoRESUMO
This paper describes the conceptual structure underlying the microcomputer-based modeling system developed by Mathematica Policy Research, Inc. The modeling system was developed to assist communities in planning nonacute care services for symptomatic human immunodeficiency virus (HIV)-infected persons. The modeling system is based on the assumptions that (1) the characteristics of the HIV epidemic and the availability of nonacute care service vary across communities and (2) combinations of nonacute care services can be appropriately substituted for one another and for hospital-based nonacute care to meet the varying medical and social needs of symptomatic HIV-infected persons.
