Physician executive
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There is no question that the past few years have seen a tremendous surge in interest in what has come to be known as complementary and alternative medicine (CAM). Health plans contemplating adding CAM benefits face a daunting challenge. How should a plan define CAM benefits? How should a plan define appropriate CAM providers? How can these benefits be managed? Will the addition of CAM benefits undermine coverage policies for conventional biomedicine? The answer to these questions lies largely in uncharted waters, as even CAM advocates will agree that many alternative therapies (even those like Oriental medicine which has been in practice for some 5,000 years) have not yet undergone the type of rigorous, evidence-based analysis that is required to validate conventional biomedicine. This article explores options for CAM benefit design by considering two basic approaches-creating an uninsured benefit or insured benefit.
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The Department of Veterans Affairs' mission is "to care for him who are shall have borne the battle for his widow and orphan." The Veterans Health Administration comprises 172 hospitals that are the hub of the health care delivery system. It is the largest provider of graduate medical education, and one of the major research organizations in the United States. The medical care budget exceeds $17 billion annually. ⋯ There may also be exploitation of the Veterans Administration hospitals by university medical schools. The Veterans Health Administration is a very expensive way to deliver care to entitled service connected veterans. Therefore, it is suggested that privatization be considered as an alternative vehicle for delivering health care.
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Physician executive · Nov 1998
Complementary and alternative medicine. Considering the alternatives.
Therapies variously described as alternative, complementary, or unconventional because they lie outside the realm of scientific medicine practiced by graduates of orthodox U. S. medical schools are gaining mainstream respectability despite many questions about their efficacy and safety. ⋯ Establishment of an Office of Alternative Medicine in the National Institutes of Health in 1992 has heartened advocates of CAM, increased interest and government funding for research into unorthodox therapies, and lent credibility to CAM modalities. Embracing marginal therapies may represent an opportunity for physicians and health systems to reduce inappropriate consumption, offer a wider range of choices to patients, and profit from a lucrative market.
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Physician executive · Nov 1998
Resource allocation. The cost of care: two troublesome cases in health care ethics.
With the cost of health care rising rapidly, both physicians and administrators regularly face resource allocation decisions. Under these conditions of relative scarcity, the equitable and appropriate distribution of limited resources becomes an ethical as well as a financial issue. ⋯ Six criteria are frequently "weighted in the balance" by ethicists when analyzing whether justice is served in the distribution of a limited resource: need, equality, contribution, ability to pay, effort, and merit. The authors argue that, from an ethical standpoint, the best single criterion upon which one can base an allocation decision is that of merit, defined as the potential to benefit from the investment of additional resources.