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Health planning in this paper is considered as a developmental process in which different types of planning appear at different times. These types are discussed and the place in the complex health care system developing in the United States is assessed. [ABSTRACT FROM AUTHOR]

Operations-research workers have not met with much success in being accepted as integral members of regional-health-planning teams, owing in part to a lack of understanding by health planners of the skills the operations researcher has to offer and in part the analyst's inability to demonstrate that he can close the gap between theoretical modeling and the implementation of his results. This paper explores the growth of regional health planning in the United States and highlights its important problem areas. The literature of operations-research applications to health planning is reviewed critically with respect to the feasibility of models and the appropriateness of assumptions. Specific problems with the types of studies currently in the literature are identified and recommendations are made for improved coordination between operations-research workers and health planners. [ABSTRACT FROM AUTHOR]

The article reports that the health policy issues become increasingly more salient to political scientists as a whole series of major decisions about future causes of action in health emerge before the U.S. President and Congress. State and local governments are also responding to the continued pressure of rising expenditures in health, especially for care of the poor and the medically indigent. On the current national legislative agenda are such items as a major expansion of national health insurance, restructuring of local and state health planning, continuing the commitment to health research and increasing health manpower training support.

Since June 1963 official groups in all fifty states, plus the District of Columbia, Puerto Rico, and the Virgin Islands, have been participants in the most exciting and comprehensive attacks on the problems of mental illness and mental health ever to be attempted in this nation on the state level. With the financial assistance of the federal government, each of these mental health planning projects will be engaged in the process of developing a comprehensive mental health plan. This nation ride effort has stimulated the attention of many citizen and professional groups. To social work, which still looks to the heritage of the settlement movement, there is a familiar ring to the concept of meeting the nation's mental health needs in the community. This paper reports the early stages of the effort in one state, Massachusetts. It is not intended to reflect directly the situation or experience of other states, but much of what is reported will sound familiar. Though the focus will be local rather than national, the Massachusetts Mental Health Planning Project can best be examined within its historical perspective.

ABSTRACT This paper is concerned with the differential impact of the Medicaid program on state incomes in 1967-68. Benefits and costs of the program are calculated for each state and the results are evaluated in terms of the perceived original intent of the program planners. It was found that although the program favors the poor in all states with Title XIX plans, it does so at the expense of extreme horizontal inequity. The conclusion is that federal incentives for the development of comprehensive state Medicaid programs are inadequate to insure an equitable system for the distribution of program benefits and costs. [ABSTRACT FROM AUTHOR]

The author of this paper argues that we need a national system for collection of health data which will meet the needs of planners, evaluators and investigators at local, state and federal levels and that national health insurance legislation should require the collection of these data as well as the facts needed for fiscal management. [ABSTRACT FROM AUTHOR]

The article offers information on the challenges faced by the American Public Health Association on the development of the association's Medical Care Section in the U.S. On November 10, 1948, the American Public Health Association's Governing Council voted to approve the petition requesting the establishment of a Medical Care Section. In 1972, the association expanded their health services because of the changes on their needs and demands. In 1920, the association created a committee to study the municipal health departments and determine the extent of variation on the health services and procedures offered in a specific community.

The article focuses on the development of neighborhood health center approach to health care delivery in the U.S. The neighborhood health centers have proliferated under a variety of federal grant-in-aid programs and private sources of support. It was mentioned that neighborhood health center approach demands an increasing emphasis on cost-effective management of neighborhood health centers and increased revenue generation activities. In addition, changes in federal health service funding policies have necessitated a reevaluation of sources of future support for neighborhood health centers.

The article presents a discussion on medical care policies. The detailed analysis of costs and the changing character of medical expenditures is very useful. The interpretation of the statistics is confined to those facts on which an economist can rightly pass judgment. Monopsonistic buying by government may eliminate some selling and advertising expense but the procurement experience of the United States government does not augur well for efficiency. The amount of the total cost to be allocated is of considerable importance in discussing methods of financing compulsory health insurance. The actual cost of compulsory health insurance would depend on several variables. These include: the efficiency with which the government operated its ventures in general, the number of people covered, the number and kinds of medical services and facilities made available, the extent to which people made use of the system, the number of governmental payrollers involved in addition to medical personnel, and the volume of abuses that developed.

The article reports on the final Hover Commission report, which focuses on the subject of government research and development in the U.S. According to sources, the report reversed its usual plea for reduction of federal spending by recommending increased support for research activities. Moreover, the report stressed the overriding importance of basic research, in which the safety, the increase in productivity, and the advance of health in the country must come from constantly increasing knowledge through fundamental research. Thus, five overall recommendations were made, including increased support for basic research, and establishment of assistant secretaryships in research and development in the Army.

The article examines the role of public health to promote family planning in the U.S. In 1965, the Office of Economic Opportunity have made domestic grants in family planning wherein the Children's Bureau were then given the authority after two years. By 1970, legislation have been implemented which made all components and methods of family planning available to the public to include abortion and sterilization. The possible costs of complete family planning services for the population was also taken into account.

The study assess the extent of utilization of preventive health care services by eligible residents of low income neighborhoods in the U.S. Previous studies have indicated that preventive health services are underutilized by poor Americans. In fact, this relative lack of preventive care seems to be one of the reasons why poverty and a minority status tend to correlate with higher morbidity and mortality rates. This study was undertaken based on the assumption that the new comprehensive clinics set up in Los Angeles in the late nineteen-sixties afforded new possibilities for preventive health care.

The article focuses on the occupational survey about the interest, attitudes and involvement of the forty-four dentists who are serving on a comprehensive health planning advisory committees in the U.S. The survey aims to help dentists in formulating ideas on planning, as well as background and guidelines on legislation and provide some of their experience in the planning process. The data gathered in the survey were used as base of the short-term training course offered by the Columbia University School of Public Health and Administrative Medicine. The training course covers a wide range of materials that pertains on the comprehensive health planning legislation, public health law, and regional medical program legislation.

Two articles are presented on the new federal provisions for health care for the aged. The first, by Melvin A. Glasser, contends that there are two systems of medical care--one for the rich and one for the poor--and offers some bold suggestions for using the new Title XIX of the Social Security Act to move toward a single system. The second article, by the U. S. Commissioner of Welfare, Ellen Winston, describes the provisions of the new legislation and the significance of some of the amendments for public welfare. [ABSTRACT FROM AUTHOR]

The article analyzes the development of prepaid drug plans sponsored by pharmacists in the U.S. In 1965-1966, pharmacists and their organizations in various states vocalized the demand of creating prepaid drug plans. Promotion of the prepaid scheme is at a peak because of some reasons: approximately 10-15 percent of written prescriptions are not filled; pharmacists acknowledge that they will be paid for prescriptions they fill; it is possible to shift the high cost of drugs from the consumer to a third party; first-dollar prepaid drug concept has attained momentum; and the enactment of Medicaid activated the druggists' reception of prepaid drug schemes. While protection against first-dollar drug costs opposes long-espoused insurance principle and consumer demand for the product is substantial and persistent, the coverage will be available.

A report is presented giving up-to-date information on State Boards of Health covering composition, functions, method of appointment, term of office, professional representation, consumer representation, recent changes, and a number of other topics. This is a useful review for all concerned with the health services. [ABSTRACT FROM AUTHOR]

The article focuses on the use of political platforms for health issues in the U.S. It is commonly found that public and private interests does not appropriately represent their constituencies when they fail to participate in the platform process. The platform process is divided into three closely related phases including preparation, participation, and propitiation. The first phase starts prior to the platform committee hearings when a platform is drafted by appointed writers. The health planks of the political parties are considered as the predictor instrument for the introduction of new health programs or policies. Since 1952, the chief parties of the U.S. have had good records when it came to transforming these programs into action legislation.

Three directions in health policy in the United States (health maintenance organizations, allied health personnel, social reform) are discussed in terms of strengths' weaknesses and implications. The author provides much food for thought. [ABSTRACT FROM AUTHOR]

Efforts to control communicable diseases must contend with various factors. These aspects are discussed and the conclusion is reached on the need for a long-term commitment to surveillance and control based more on potential danger than actual incidence and prevalence. Also existing mechanisms for creating and modifying federal policy in communicable disease control should be strengthened. [ABSTRACT FROM AUTHOR]

This report presents observations and conclusions on the free clinics operating in Chicago, and offers generalizations on the free clinic movement in the United States, as well as its relation, present and potential, to the changing health care delivery system. [ABSTRACT FROM AUTHOR]

This author argues that health care delivery should continue under voluntary nonprofit auspices as far as possible and that the health system should adopt appropriate modern managerial and organizational approaches to achieve greater economy and effectiveness. Decentralized planning with consumer participation is the preferred approach and must be kept viable. [ABSTRACT FROM AUTHOR]

Taking a critical view of national health insurance, the author asserts that it is not a popular movement but rather a means of providing public subsidies for financially shaky elements of the health power structure. An alternative plan is proposed. [ABSTRACT FROM AUTHOR]

The experience of health facilities planning councils is selectively evaluated for its relevance to the development and operation of comprehensive health planning councils. ‘Lessons’ have been chosen with regard to councils' creation, financing, staffing, structure, functions, and research and study activities. The article also includes an identification of some general problems in the evaluation of health planning councils. [ABSTRACT FROM AUTHOR]

Quite a few people in public health have been thinking what Dr. Freedman says, and are wondering where we are really going. The fragmentation and the attitudes to which he addresses himself must be seen in terms of the need for development of comprehensive health services for all Americans. [ABSTRACT FROM AUTHOR]

The article provides information on the efforts of the American Public Health Association (APHA) to establish sound local health services in the U.S. as well as the development of the Committee on Administrative Practice (CAP). CAP has been devoted to mass surveys which focus on the public health activities and this article discusses the development and results of each survey. A significant event in CAP's existence since 1915 until its termination in 1956 is provided, as well as the information about its members and staffs.

A section of the Partnership for Health Act (314d) consolidated nine categorical health programs in one block grant to states. The impact of this action with respect to decentralization, change of state health department policies, increased use of the block grant mechanism, and other aspects is analyzed and assessed. [ABSTRACT FROM AUTHOR]

The implications of federal legislation of health care services and of health maintenance organizations for planning are presented and discussed. The elements of a plan to anticipate coming changes are offered. [ABSTRACT FROM AUTHOR]

Immediate past and future principal problems and challenges confronting those involved in comprehensive health planning are identified and discussed. Prospects for survival of comprehensive health planning and its likely role in innovation are assessed. [ABSTRACT FROM AUTHOR]

A report is presented on a voluntary association of local governments established to encourage and enable regional planning for improvement of health, safety and general welfare. The role of this organization in health planning is presented and discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the economic issues related to the policy of compulsory health insurance in the United States. Voluntary health insurance plans are expanding at a rapid rate in areas where insurance or prepayment methods of meeting health expenses are needed and desired. This encompasses the areas of major illnesses, such as the large, unexpected, and non-recurring expenses for hospitalization and major surgery. Medical expenses fall into two categories: the small, expected, recurring expenses for doctors' visits, dentists' services, etc., and expenses for hospitalization, surgery, etc. It is for the latter category that insurance means of payment are needed. This is also the area in which voluntary insurance plans have been expanding at a rapid rate. Most people can afford to pay for the cost of medical care. It was found that if the policy of compulsory health insurance was adopted, the probability is that it would be so costly that the benefits derived from it would not justify the cost. The major difference between compulsory and voluntary health insurance lies in the element of compulsion.

The application of the culture-of -poverty concept to family planning is reviewed. Two approaches to program development are contrasted: accessibility versus cultural-motivational. Experience appears to support the accessibility approach, which seeks to create services where none exist or to remove obstacles which make services inaccessible (distance, crowding, eligibility and fee practices, scheduling, lack of information, and depersonalized delivery). Yet the cultural-motivational view dominates the thinking of many health and welfare professionals and is employed to rationalize slow progress. This anomaly is analyzed as an example of the resistance of institutions to change and in terms of its historical antecedents in upper-class biases about lower-class fertility. The implications for public policy are explored, particularly the potential use of the culture-of- poverty concept to justify selective compulsory fertility control if health and welfare agencies continue to lag in developing voluntary programs. [ABSTRACT FROM AUTHOR]

This article focuses on the role of the federal government of the U.S. in the financing of medical care. The objective of government financing of medical care is frequently expressed as either achieving equal access to care regardless of income or removing income as a barrier to the consumption of medical care or assuring everyone a minimum level of care. It is believed that achieving equal access to health care irrespective of income is not equivalent to assuring all individuals some minimum level of care. The efficient method of achieving the latter is to increase the consumption of those below the minimum. The efficient method of achieving the former is to simultaneously increase the consumption of those at the bottom and decrease the consumption of those at the top. While a nationalized free health service system would be an inefficient method of achieving the minimum provision objective, it could conceivably be the most efficient method of achieving equal access. But, a necessary condition for free provision to be a more efficient alternative than pure subsidization might be artificial restriction of supply.

The United States is confronted with the necessity of formulating and adopting national policies with reference to certain social aspects of medicine. These policies should not be projected without careful study of the experience of countries that have applied them over a period of years. It is desirable that the American people should discover and know the facts in regard to the conditions in the United States that will be affected by such policies. Thus, to make possible the social and medical research prerequisite to the intelligent construction of sound policies in social medicine and related fields, it is imperative that pertinent source materials be systematically collected and made accessible. In setting up a program for the provision of these vital materials, the medical and social science research worker and the librarian would do well to cooperate in the formulation of: (1) a definite statement of those categories of source materials relating to the social aspects of medicine which deserve more attention than they have hitherto received in the collecting activities of libraries; (2) a national plan for the systematic collection of these materials in strategic geographical and scholarly centers; (3) a program of social and medical research.

National health insurance and group practice will not of themselves solve the American health crisis. A basic defect in the delivery system must be dealt with, namely, to regulate the flow of patients into the system according to need. To do this, a regulatory health-testing system is described, and the need to create a new delivery system, to conserve health manpower is stressed. [ABSTRACT FROM AUTHOR]

In 1965, the U.S. Congress passed legislation by which nearly all persons 65 years of age and over in the U.S. became eligible for health insurance under the Medicare provisions of the Social Security Act. Prompt action by those eligible and desiring to participate in the program is essential, for enrollment periods are limited, and late enrollment increases cost to the individual and may also render him ineligible. With respect to Medicare as well as other programs it would be Ideal if information could be sent through the channels most likely to be used by those for whom particular programs are designed, so that the least effort and expense will be wasted and the largest returns gained. The identification of the social and demographic characteristics of the users of certain media would be a step in the direction of facilitating planning for the transmission of specific messages to particular public. This article reports the sources from which rural low-income women In the southeastern United States heard about Medicare.

This article presents an overview of the econometric model of the Medicare system in the U.S. Health care industry has become the largest public sector activities. The Medicaid program which was initiated in 1966, provided for federal, state, and local sharing of reimbursement for hospitals and physician services for that part of population identified to be medically indigent. Hospital care which accounts for 22.5 billion dollars is provided almost exclusively by the U.S. government and nonprofit organizations. The model presented explains the interstate variations in five key variables. By the end of the second fiscal year, 84 percent of all Medicare enrollees had purchased supplementary medical insurance, and the additional 11 percent had been bought by their state government.

What effect has Medicare had on the provision of health services by a number of community health resources? In answering this question, major attention is given to community general hospitals, although other providers are mentioned. A number of effects are noted but generally there has been a relative lack of coordination so far of the different resources. [ABSTRACT FROM AUTHOR]

The article discusses the increase of involuntary sterilization of poor especially the minority females in the U.S., according to the American Public Health Association (APHA). APHA cites an incident involving welfare mothers who are about to give birth and faced with the choice of consenting to sterilization as a condition of medical care. It has mentioned that the practices would violate not only legal concepts of due process but the most fundamental respect for human dignity and the basic rights of human beings.

The article reflects on the health care for the poor in the U.S. He states that the sensivity of the country can be measured through the extent of health care available for the poor. He implies that if one is serious about making health care available, a comprehensive system of national health insurance tied to reorganize the services under a clearly enunciated national policy is a remedy for such situation of health care problems.

The author reflects on the difference between Canada and the U.S. with regards to the payment and provision of health care to the public. He argues that the health care system of Canada offers a wide variety of health plans and services to people, regardless of their social status. On the other hand, the U.S. offers health care services and plans to people who are capable of paying such expenses. An overview of the health care systems of the two countries is offered.

The article reports updates related to environmental policies in the U.S. It mentions about the message of President Richard M. Nixon to Congress regarding oil pollution in which he outlined several legislative and executive actions to reduce the risks from the hazard. Meanwhile, the Council of the National Academy of Sciences (NAS) has recommended that the government should open ocean waters subject to the country's jurisdiction to scientific research by foreign nations. As part of the Clinical Laboratories Improvement Act of 1967, laboratories accepting or soliciting human specimens in interstate commerce for laboratory examination are required to obtain a license or a letter of exemption from Department of Health, Education and Welfare (HEW).