Biomaterial Database

The restructuring of U.S. health care. 1985

E Ginzberg

Despite highly publicized recognition in the 1970s that a health care financing crisis existed in the United States, the crisis has gone unabated. In this review of the recent health care experience, I discuss the federal and other initiatives that were taken in the 1970s to curb health care cost increases and why they failed. I then review transformations that are currently altering the health care delivery and payment system in this country. I conclude with a discussion of three possible scenarios for the U.S. health care system at the end of the century. In the absence of a grass-roots acceptance of the limitations of medical intervention, it seems likely that total outlays will continue to increase. That is, we are probably in for "more of the same."

UI	MeSH Term	Description	Entries
D008484	Medicaid	Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.	Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D010820	Physicians	Individuals licensed to practice medicine.	Physician
D003363	Cost Control	The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)	Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D003695	Delivery of Health Care	The concept concerned with all aspects of providing and distributing health services to a patient population.	Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D005102	Health Expenditures	The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.	Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket
D005381	Financing, Organized	All organized methods of funding.	Community Financing,Grants,Organized Financing,Financing, Community,Grant
D005544	Forecasting	The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.	Futurology,Projections and Predictions,Future,Predictions and Projections
D006278	Medicare	Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)	Health Insurance for Aged and Disabled, Title 18,Insurance, Health, for Aged and Disabled,Health Insurance for Aged, Disabled, Title 18,Health Insurance for Aged, Title 18
D006291	Health Policy	Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.	Health Care Policies,Health Policies,Healthcare Policy,National Health Policy,Care Policies, Health,Health Care Policy,Health Policy, National,Healthcare Policies,National Health Policies,Policies, Health,Policies, Health Care,Policies, Healthcare,Policy, Health,Policy, Health Care,Policy, Healthcare
D006301	Health Services Needs and Demand	Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.	Health Services Needs,Needs,Needs and Demand, Health Services,Target Population,Health Services Need,Need, Health Services,Needs, Health Services,Population, Target,Populations, Target,Target Populations