RESUMO
Despite increasing demand and numerous problems associated with its delivery, long-term care has been largely ignored in the recent debates over health care reform. The gap between concept and reality is explored in detail, along with possible approaches to the creation of a system that is humane, fair, and equitable.
Assuntos
Assistência de Longa Duração , Responsabilidade Social , Criança , Reforma dos Serviços de Saúde , Humanos , Seguro de Assistência de Longo Prazo , Medicaid , Medicare , Qualidade da Assistência à Saúde , Estados UnidosAssuntos
Programas de Assistência Gerenciada/tendências , Reforma dos Serviços de Saúde/tendências , Sistemas Pré-Pagos de Saúde , Política de Saúde , Acessibilidade aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Competição em Planos de Saúde , Planos Governamentais de Saúde , Estados UnidosRESUMO
The need to control governmental health expenditures has led to experiments with mandated managed care for Medicaid recipients. Loss of freedom to choose care providers was considered a worthy sacrifice. The authors examine the historical and legislative background, including research and demonstration projects. Although they view some form of rationing as inevitable, they argue that Medicaid recipients should not be singled out to bear the main part of the burden.
Assuntos
Participação da Comunidade/legislação & jurisprudência , Programas de Assistência Gerenciada/estatística & dados numéricos , Medicaid/legislação & jurisprudência , Planos Governamentais de Saúde/legislação & jurisprudência , Serviço Hospitalar de Emergência/estatística & dados numéricos , Mau Uso de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Kentucky , Programas de Assistência Gerenciada/legislação & jurisprudência , Medicaid/organização & administração , Projetos Piloto , Estados Unidos , WisconsinRESUMO
Today's health care professionals must deal with problems of financial viability, competitiveness, quality control, and consumer focus. The major theme of this article is how appropriate is the education system that trains and prepares health care managers for these challenges. Because we are not in the health care business, but rather in the business of managing health care, the authors suggest that a new educational paradigm that incorporates indepth study of business disciplines be the health administration educational model for the 21st century. Whether or not the proposed model is alien to our basic traditional concepts of health care management, the viability of our institutions will be at stake if they do not implement a healthy business protocol to the services they provide.
