Word: public
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Dates: during 1970-1979
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...Medicaid, the source of more than half the hospital industry's revenues. Backed by blustering Joe Califano, secretary of HEW, Carter pushed the bill on a reluctant Congress in April 1977. Since then, committee after subcommittee responded to heavy pressure from the medical lobby and near-total silence from public interest groups, dismembering the original bill...
Ironically, in the ensuing decade-and-a-half, public insurance programs greatly exacerbated the upward spiral of health costs. By providing almost limitless funds for hospital services, Medicare and Medicaid fostered loose management, easy expansion and profits for related industries. Improvements in quality or access to care have generally been made at great cost. Hospitals compete for physicians with expensive new technology and abundant beds, and doctors stock the wards. Because insurance usually covers in hospital care, doctors tend to hospitalize a patient for procedures which could be done on an outpatient basis, to keep the patient in the hospital...
CARTER IS RIGHT when the points to escalating hospital costs as a major source of inflation, but his ceiling on revenues is at best a stop-gap measure. More fundamental changes are needed, but as usual the public seems solidly set in its apathetic ways. Everyone has a hospital horror story, but few maintain a running interest in the issues of hospital organization and economics. For most people, serious illnesses are rare, and when they do happen insurance cushions the blow. The average patient pays only 8 per cent of his hospital bill, though this fee can still seem catastrophic...
...Harvard's stands influence our whole society. Justice Lewis Powell's majority opinion in the Bakke case, for instance, hinged on Harvard's friend-of-the-court brief. The Cambridge-Washington shuttle, institutionalized during President Kennedy's administration, shapes public policy to aid in education, tax rules on charitable giving, and myriad other areas...
...decide is to decide. Not to boycott Nestle products is to support Nestle. Not to rename the Engelhard Library is to endorse Engelhard's example of "public service." Not to pressure corporations to withdraw from South Africa is to support apartheid...