The Milbank Memorial Fund quarterly. Health and society
-
Milbank Mem Fund Q Health Soc · Jan 1975
Equity in paying for health care services under a national insurance system.
The debate over the future of the health care delivery system evolves around the policy issue of what constitutes a fair distribution of the medical services which are considered essential to prolonging life, curing disease, and relieving pain. A case can be made that a socially equitable distribution implies that consumption of medical services is independent of the consumer's income and payment for them unrelated to utilization. The present paper examines to what extent the provisions for financing a national health insurance system are likely to advance or hinder the fair distribution of health care services. ⋯ To rectify such inequities, some NHI proposals specify separate insurance plans for the disadvantaged. Such programs, which require income-testing to determine eligibility, are likely to be plagued by administrative complications currently engulfing other means-tested social welfare programs. The present paper makes some recommendations for the purpose of avoiding these difficulties and fostering equity in health care.
-
Milbank Mem Fund Q Health Soc · Jan 1975
Historical ArticleEmergency medical services in crisis: an Italian case study.
This paper deals with the system of emergency medical services in Italy. More specifically, it is a case study of the organization and operation of this system in the region of Tuscany. ⋯ The effects of a long history of social and political cleavages on provision of these services at the regional level are presented and discussed. The paper concludes that prospects for rational reform of emergency care service are dim.