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Benefits in Medical Care Programs - Avedis Donabedian - Bog - Harvard University Press - Plusbog.dk

Benefits in Medical Care Programs - Avedis Donabedian - Bog - Harvard University Press - Plusbog.dk

"Every social mechanism appears to have a dual potential for good and evil. Prepayment for medical care is no exception. On the one hand, it provides assurance of necessary care as a safeguard to health, economic well-being, and peace of mind. On the other hand, it opens the way to wasteful and harmful care, to price inflation, and to concealed redistributions in socially undesirable directions. The problem is to devise a plan that allows us to reap the most advantages while we incur the fewest drawbacks." Benefits in Medical Care Programs is a comprehensive treatment of this problem. Dr. Donabedian begins with a clear and straight forward analysis of his own assumptions about the social mandate for medical care benefits, the objectives of medical care programs, and the magnitude and distribution of the unmet need that these programs are designed to alleviate. The problem of defining and measuring the need for care is considered within the con text of the data yielded by alternative definitions. The analysis then shifts to the impact of benefits on certain key features of the medical care system. Program benefits are weighed against program objectives, and policy implications are drawn from this comparison. We are shown what can and cannot be accomplished through medical care benefits and what goals are served by specific aspects of existing or proposed plans. Although Dr. Donabedian counsels a fairly thorough reform of existing systems, he remains skeptical about the possibility of designing a perfect system, and he does not hesitate to point out that increased access to care "increases exposure to both what is good and what is bad in our system of medical care. . . The machinery of medical care has a sinister potential for those who fall into it in the wrong place at the wrong time. Dr. Donabedian's previous book Aspects of Medical Care Administration has been called the "bible" of its field. Benefits in Medical Care Programs should prove equally invaluable.

DKK 554.00
1

The Atlantic City Gamble - George Sternlieb - Bog - Harvard University Press - Plusbog.dk

The Atlantic City Gamble - George Sternlieb - Bog - Harvard University Press - Plusbog.dk

In November 1976, the state of New Jersey embarked upon a bold experiment when the voters approved a referendum to authorize casino gambling in Atlantic City. Expectations were high: the gaming industry could rejuvenate a dying city core, employment would swell, the tax base would broaden and welfare rolls diminish, tourism might spread through the state, and the cruel spectacle of a poverty-stricken community would be eliminated. The Atlantic City Gamble reports the results of this experiment and evaluates casinos as a tool for economic revitalization, a painless source of revenue. The casinos are enormously profitable—but for whom? The city has paid a huge toll in human and economic hardship. There are 30,000 new jobs, but little spillover into non-casino employment. Crime rates have skyrocketed. Housing has been priced beyond the reach of minority groups and the elderly. In 1982, the casinos paid more than $117 million in state taxes, but much of the projected bonanza to Atlantic City has been swallowed by the industry’s need for expanded municipal services, such as police protection. Fears of the old connection between gambling and organized crime may be exaggerated, but few can deny that the gaming industry—with its immense daily cash flow—harbors a vast potential for corruption. The state promoted visions of a glorious rebirth, but it failed to provide a governing mechanism that could produce the promised rewards. Would better planning and research enable any government to cope with such instant large-scale business and the political clout it carries? Economic strangulation has motivated at least eight other states to think about letting in casinos. The decisions they make will have far-reaching social and economic consequences, and must be based on a set of facts as accurate and comprehensive as possible. In searching out the lessons of Atlantic City, the authors have provided a sobering glimpse into the intricacies of legalized gambling.

DKK 284.00
1