Health affairs
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To explore the concerns of practicing physicians as a way to inform the health reform debate, the authors conducted a survey of physicians in the United States, Canada, and Germany. Survey results indicate that U. ⋯ German physicians did not cite access problems as frequently as Canadian physicians did; other measures of satisfaction were closer to U. S. levels, suggesting fewer trade-offs if the United States were to adopt aspects of the German health care system.
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The connection between firearms and violence has not received adequate research attention in the past. This paper proposes a research agenda that should explore (1) the effects of firearm use on the costs of violence; (2) the extent to which particular interventions can reduce the cost of violence by limiting use of firearms; and (3) the extent to which the benefits derived from firearm interventions are worth their public and private costs. The author identifies three priority research issues: the relationship between firearms and suicide; how to design interventions to reduce firearm use in violence; and how to evaluate the long-range costs and benefits of gun controls. Public health researchers can investigate many of the key issues in firearms and violence, but only if they expand their knowledge about guns and gun controls.
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A new data set from the Health Care Financing Administration gives estimates of state spending for hospital care, physician services, and retail purchases of prescription drugs, which together account for 70 percent of health expenditures nationwide. Analysis of these data, which are the first uniform state data to be produced for nearly ten years, shows considerable variation among states and among regions in health care spending. The New England and Mideast regions show the consistently highest spending levels for all three categories; the Southwest and Rocky Mountain regions spent the smallest amount (as much as 17 percent below the U. S. average).
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Comparative Study
Health spending, delivery, and outcomes in OECD countries.
Data comparing health expenditures in twenty-four industrialized nations show that the United States continues to lead the world in health spending as a percentage of gross domestic product. In 1991 the United States spent $2,868 per person on health care, compared with an average of $1,305 in Organization for Economic Cooperation and Development (OECD) countries. ⋯ S. figure exceeds spending in Canada, the next-highest spender, by 50 percent. Measures of health care use and health status do not provide convincing evidence that the United States has a superior health care system for its larger expenditure levels.
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Faced with the national epidemic of gun violence, legislators should be especially sensitive to their constituents' support for various policy options. This support is best evidenced by well-conducted public opinion polls. ⋯ Although the public support for a number of promising interventions targeting the design and manufacture of firearms has not been meaningfully investigated, strong support is evidenced for most other gun-control options. The public also believes, contrary to Supreme Court rulings, that the Second Amendment to the Constitution protects a broad individual right to bear arms.