Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1982 Sep;72(9):1028–1033. doi: 10.2105/ajph.72.9.1028

What good is legislation--or planning--if we can't make it work? The need for a comprehensive approach to health and welfare.

A W Snoke
PMCID: PMC1650091  PMID: 7102852

Abstract

Health and welfare programs continue to be developed and implemented on a piecemeal basis in this country. There is difficulty in recognizing not only that health and social affairs are intimately related, but that the system must be dealt with as a whole of its interrelated problems are to be solved. Increasing costs for health and social programs are becoming of even greater concern, and cost containment (voluntary or regulatory) preoccupies both the payers and the recipients. Complicating the current situation is uncertainty of the role of financing and regulation on the part of the federal government and the states (the New Federalism), and the fragmentation and uncertainty of the private delivery sector and its third party reimbursement agencies. Questions are raised as to whether viable solutions can be obtained until all components (governmental and private) can work together in a partnership rather than an adversarial relationship in the development of an overall strategy with understandable objectives. Of basic importance is consideration of matters of organization, administration, and leadership at all levels so that whatever program may be developed or evolved can be successfully implemented. The subject is of such magnitude and is so complicated that it deserves a major coordinated effort of the federal government, the state governments, and the diverse private sector components to ensure a coordinated and systematic approach to any realistic solution.

Full text

PDF
1028

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Caper P. Sounding Boards. Competition and health care -- caveat emptor. N Engl J Med. 1981 May 21;304(21):1296–1299. doi: 10.1056/NEJM198105213042113. [DOI] [PubMed] [Google Scholar]
  2. Christianson J. B., McClure W. Competition in the delivery of medical care. N Engl J Med. 1979 Oct 11;301(15):812–818. doi: 10.1056/NEJM197910113011504. [DOI] [PubMed] [Google Scholar]
  3. Copper T. Shattuck Lecture--In the public interest. N Engl J Med. 1979 May 24;300(21):1185–1188. doi: 10.1056/NEJM197905243002104. [DOI] [PubMed] [Google Scholar]
  4. Edwards C. C. The federal involvement in health. A personal view of current problems and future needs. N Engl J Med. 1975 Mar 13;292(11):559–562. doi: 10.1056/NEJM197503132921104. [DOI] [PubMed] [Google Scholar]
  5. Ellwood P. M., Jr, Anderson N. N., Billings J. E., Carlson R. J., Hoagberg E. J., McClure W. Health maintenance strategy. Med Care. 1971 May-Jun;9(3):291–298. doi: 10.1097/00005650-197105000-00008. [DOI] [PubMed] [Google Scholar]
  6. Fein R. Effects of cost sharing in health insurance. A call for caution. N Engl J Med. 1981 Dec 17;305(25):1526–1528. doi: 10.1056/NEJM198112173052510. [DOI] [PubMed] [Google Scholar]
  7. Feldstein M. S. The medical economy. Sci Am. 1973 Sep;229(3):151–passim. doi: 10.1038/scientificamerican0973-151. [DOI] [PubMed] [Google Scholar]
  8. Foley H. A. Health planning--demise or reformation? N Engl J Med. 1981 Apr 16;304(16):969–972. doi: 10.1056/NEJM198104163041611. [DOI] [PubMed] [Google Scholar]
  9. MASUR J. Some challenges in hospital administration. J Med Educ. 1955 Oct;30(10):567–572. [PubMed] [Google Scholar]
  10. McCarthy C. M. New York study shows regulatory costs unreasonably high. Hospitals. 1979 Jan 16;53(2):89-90, 92, 94. [PubMed] [Google Scholar]
  11. Newhouse J. P., Manning W. G., Morris C. N., Orr L. L., Duan N., Keeler E. B., Leibowitz A., Marquis K. H., Marquis M. S., Phelps C. E. Some interim results from a controlled trial of cost sharing in health insurance. N Engl J Med. 1981 Dec 17;305(25):1501–1507. doi: 10.1056/NEJM198112173052504. [DOI] [PubMed] [Google Scholar]
  13. Relman A. S. The new medical-industrial complex. N Engl J Med. 1980 Oct 23;303(17):963–970. doi: 10.1056/NEJM198010233031703. [DOI] [PubMed] [Google Scholar]
  14. Roe B. B. Sounding boards. The UCR boondoggle: a death knell for private practice? N Engl J Med. 1981 Jul 2;305(1):41–45. doi: 10.1056/NEJM198107023050108. [DOI] [PubMed] [Google Scholar]
  15. Smits H. L. The PSRO in perspective. N Engl J Med. 1981 Jul 30;305(5):253–259. doi: 10.1056/NEJM198107303050504. [DOI] [PubMed] [Google Scholar]
  16. Snoke A. W., Snoke P. S. Linking private, public energies in health and welfare planning. Hospitals. 1976 Aug 16;50(16):53–58. [PubMed] [Google Scholar]
  17. Snoke A. W. The unsolved problem of the career professional in the establishment of national health policy. Am J Public Health Nations Health. 1969 Sep;59(9):1575–1588. doi: 10.2105/ajph.59.9.1575. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES