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The article focuses on franchising. A franchise is a continuing relationship between the franchisor and the franchisee in which the sum total of the franchisor's knowledge, image, successes, and manufacturing and marketing techniques are supplied to the franchisee for a consideration. As of today, the franchisor service-sponsors the franchisee, so that he can function in the manner prescribed by the franchisor. The consumer receives the same products and services as if he had bought from the franchisor direct. Franchising is now being used as a specialized marketing device to introduce new products and services to the public. And there are other developments. Medicare is bringing a sizable segment of activity to the field of franchising. Because of the great need of help by physicians and dentists for assistants in processing the patients in their offices, they are turning to schools specializing in this training. As of today, there are more than 340,000 franchised businesses in the United States; and franchising comprises nearly 10% of the gross national product.

The article focuses on a brief analysis of the War on Poverty, Medicare, and the Family Assistance Plan that shows that political factors influenced their design and their fate more than need or effectiveness. The author suggests that social workers have a role in promoting the wiser and wider use of research data for determining social policy. Interest has grown to the point of demand that social work practitioners and administrators give priority to evaluating their programs and methods of intervention leaders of the profession, social scientists, and key governmental officials have put forth compelling arguments on the importance of demonstrating the effectiveness of services and ways of work. Program evaluation seems to have relatively little to do with initiating, implementing, and modifying social programs. How much this failure reflects the capacity of social research to evaluate may be irrelevant. Sustained research in the three major social programs examined was neither demanded nor supported on a scale commensurate with the problems under consideration.

Presents letters to the editor published in the November 1970 issue of the journal "Public Administration Review." Participation of Visiting Nurse and Public Health Society Inc. in a Medicare program; Discussion on planning, programming and budgeting system; Criticism of an article related to regional planning, published in an earlier issue of the journal.

This article presents a proposal for reducing the subsidy effect of hospital insurance the U.S. Variable Cost Insurance (VCI) is applicable to private and government-sponsored hospital insurance. In particular, it is relevant to the present debate over the costs of the Medicare and Medicaid programs. Currently Medicare and Medicaid make hospital care free to persons covered by the program. The result is to cause overconsumption of hospital services, raising the costs of these programs. Their costs could be lowered with minimum loss of welfare to the recipients by providing insurance of the type suggested. Pauly has pointed out that insurance acts as a subsidy and, if there is any price elasticity of demand for the commodity being insured, can lead to a misallocation or resources. Although price elasticity for the quantity of units of hospital care consumed may be low, price elasticity for a number of product characteristics which we call quality may be much higher. Hence, even though price elasticity of demand in the usual sense is low, insurance may result in the production of an inefficient bundle of goods. By making insurance payments independent of the hospital used, VCI would avoid a distortion of consumer choice of hospital quality at the margin.

Focuses on the special plans developed by health insurance organizations that will supplement Medicare in the United States. Amount of health protection afforded by a negotiated health and insurance plan; Adjustment of all private plan benefits for retirees to avoid duplication of Medicare coverage.

Focuses on the adjustment of existing private health insurance plans to the operation of Medicare. Methods used to adapt group health plans to Medicare; Retention of benefit patterns; Issues in adjusting to Medicare; Nature of benefits changes resulting from adjustment to Medicare.

Explores the manpower dimensions of community health facilities and services in the United States. Shortage of doctors; Argument raised by the advocates of expansion of Medicare and Medicaid; Influences behind the demand for health services; Factors which contribute to doctor shortage.

The article focuses on the social security systems, Medicare and Medicaid in the U.S. It gives a brief look at the U.S. Social Security Act. The Act included a wide range of programs. The. largest is Old Age, Survivors and Disability Insurance (OASDI). This is a federally-operated program administered by the Social Security Administration. It provides protection for workers and their families against loss of earnings resulting from retirement in old age, disability and death. Also included in the provisions of the Act are grants to the states for public assistance programs for the aged, the disabled, dependant children and the blind.

This study endeavored to identify the extent to which home health services are provided to consumers, the cost of such services, and the projected cost of these services were delivered to the entire population at risk. The study is placed in the context of the development of home health services and the need for development of current services. [ABSTRACT FROM AUTHOR]

A review of national health indicators shows that much remains to be done before a national health accounting system can be established as a basis for planned social change. One question concerns the readiness of health policy-makers to accept such a challenge to use a new set of norms, or their likelihood to deal with piecemeal adjustments. [ABSTRACT FROM AUTHOR]

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]

The accounting requirements of Medicare are more rigorous than appears obvious on the surface. Many of the providers, particularly in the nursing home sector, lack adequate accounting systems in the present circumstances--without the added requirements of Medicare. Many of these institutions will find it necessary to convert from their present cash method of accounting to an accrual basis that includes a costing, standard costing, and periodic reporting capability. The resources of the individual institutions, monetarily and technically, are insufficient to cope with the changes that are needed. The intermediaries recognized in Public Law 89-97 will be able to provide some of the assistance these institutions need to meet their new accounting requirements. But there is also an opportunity for the accounting profession to make a valuable contribution to sound accounting practice in this field of interest by sponsoring institutes, offering courses in institutional accounting, and establishing and maintaining the necessary accounting systems through consultation and the audit function. [ABSTRACT FROM AUTHOR]

Provides information on the progress in medical research in the U.S. as of September 1967. Implication of the passage of Medicare; Discussion on what produced the change in the thinking of physicians and patients on medical research; Economic effects of penicillin; Reason for the objection of scientists to the proposition that the mere act of discovery implicates them in its social application.

Group insurance, which has grown to play a major role in the national economy in its short 50-year history, now faces serious challenges. Medicare and other Federal and state social welfare programs are causing group insurance underwriters to accept new concepts in the providing of medical expense insurance and to accelerate exploration of new market areas hitherto untouched. This article discusses some of the critical problems and some of the new opportunities confronting the group insurance industry at this pivotal point in its development. [ABSTRACT FROM AUTHOR]

This article reviews a few new developments in coverages and environment that appear to affect the future of group insurance. The factors affecting the environment include taxation of group term life insurance, the adoption of Medicare, and the Disclosure Act. The new developments include employees' pay-all permanent life insurance and accident insurance and long term disability insurance. The article also reviews changes in marketing methods of doing business. [ABSTRACT FROM AUTHOR]

The coverage of extended-care facilities (ECFs) under Medicare was intended as a means of shortening patient stays in short-term hospitals and reducing the overall costs of the program. Regression analysis of state data on the average hospital stay for Medicare patients in 1967 and 1968 shows that the use of ECFs has, in fact, contributed to shorter stays. Further, the savings in hospital reimbursements, estimated from the regressions, more than outweighed the costs of ECF care in both years. [ABSTRACT FROM AUTHOR]

Comments on an article written by Herbert E. Klarman concerning economics-based policy recommendations for limiting hospital facility benefits in the U.S. Importance of the recommendations to providers and holders of hospital insurance; Theory of the demand for hospital care; Number of hospital insurance members in the form of Medicare and other private health insurance.

The effects of health insurance are to help equalize the financial burdens of illness, facilitate payment to the providers of service, and increase the use of services. Prepayment per se need have no consequences for reimbursement. Health insurance in this country was superimposed on certain distinctive institutional arrangements for delivering hospital service. Owing to the complexity and diversity of the product, hospital service cannot be bought as a standard product at a uniform price. With admission to a hospital arranged by physicians with staff appointments in that hospital, relative price cannot play a significant part in influencing the patient's choice of a hospital. Medicare was added to the existing structure of financing. Its most prominent sequel is a large rise in hospital milt cost. The huge increase in the number of patient days reimbursed at cost--75 percent or more--may be an important factor in this development. Thought must be given to devising effective ways to combine fair reimbursement for a given quality of care, with rewards for efficient operation and penalities for inefficiency. [ABSTRACT FROM AUTHOR]

This paper deals first with the differences in the financing bases of social insurance and private insurance. Then, it discusses the underlying financing principles of the Social Security program (cash benefits and Medicare) as they have developed over the years. Finally. the paper takes up various proposals and possibilities of changing the present financing basis of the Social Security program. Among the several possibilities for changing the financing basis of the program, the principal proposals are centered around introducing contributions from general revenues. Several different approaches and rationales can be taken, and these are discussed in some detail, with indication being given of the pros and cons of each approach. Attention is also directed to the existing limited experience as to contributions to the program from general revenues. Perhaps there will be changes in the time-tested methods of financing the program that have underlaid its sound development over the past three decades. However, any changes in this fundamental aspect should be made only after thorough consideration and not merely for the sake of change. [ABSTRACT FROM AUTHOR]

The article comments on the article "What Would Medicare Cost?," by Barkev S. Sanders previously published in the journal. The 180-day option deductible initially is 92.50 dollars or less if the hospital average is less is erroneous because the if less proviso is not based on the particulars average per diem cost of the hospital. Deductibles are apt to encourage overuse instead of discouraging that is contrary to the belief of experts. The Forand Bill includes surgical benefits and could be believe as radically different from the King-Anderson Medicare Bill. The failure to study the actuarial reports because of failure to recognize the basic assumption in the cost estimates of Actuarial Study Number 57. Another failure is the consideration of all factors and comparing of similar things in the British National Health Service.

The article presents information on the cost of Medicare for the aged people in the United States. The argument for providing health services to the aged is based on the assertion that these people cannot get the needed services. The recent estimates of hospital utilization by OASDI beneficiaries aged 65 and over are based on a survey made in the winter of 1957 among OASDI beneficiaries. The article indicates that the estimators of Medicare costs believe that hospital care received by the aged may be sufficient now, or that at most, utilization would be increased by 24 per cent under the proposed program. Removal of financial barriers to obtain hospital care would very sharply increase hospital utilization. With the world polarized between totalitarian rule and aspirations for democratic principles, aged should not be deceived as to what they can expect from Medicare, nor the public deluded as to the costs of an effective health program consistent with free enterprise for health services.

The article presents a reply to comments made on an article related to the econometric model of the U.S. Medicare programs. The designers of Medicare understood that, by covering a broad range of services, they would reduce the bias in favor of hospital inpatient care that is inherent in many insurance programs. The important aspect of this difference is that the average cost per day among Medicare patients is an increasing function of their use of extended care facilities. A well-established fact about hospital cost per day is that it is a decreasing function of the duration of the hospital episode. Shortening the average duration of hospital episodes therefore increases the average cost per day. Since a greater use of extended care facilities shortens the average stay of Medicare patients, it increases their average daily cost. It is clear that the estimated elasticity with respect to extended care admissions is almost completely unaffected by the different period and definition of hospital admissions. When average cost per patient day is replaced by the average cost for Medicare patients, the elasticity with respect to extended care use is no longer significant. The evidence therefore strongly supports the conclusion that the total cost of the Medicare program is increased by the coverage of services in extended care facilities. If such coverage is justified, it is not because it saves money but because it contributes to the health of the population or to the welfare of the Medicare patients and their families.

The article presents comments on the econometric model of the U.S. Medicare system. Under the Medicare program, the extended-care facility (ECF) is defined as a substitute for hospital care, a place for the patient who still needs skilled nursing care but is beyond the acute phase of his hospital episode. The best of the regressions is used to estimate savings in hospital reimbursements due to ECF use by a method that avoids many of the approximations necessary to Feldstein's method. The independent variables are hospital cost per day to deflate the dependent variable so that it yields an approximation of mean stay and a set of variables, described below, to explain mean stay. Nevertheless, if the result is significantly positive, as it is in Feldstein's results, it can reasonably be interpreted as showing that Medicare costs are increased by ECF use, either because the shorter hospital stays are not sufficient to offset the costs of ECF care or because ECF use acts preversely to lengthen hospital stays. Extended-care facilities were intended to serve as substitutes for short-term hospital care. Medicare reimbursement per patient day in short-term hospitals replaces cost per patient day and admissions per enrollee and ECF admissions per hospital admission both refer to short-term hospital admissions.

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.

This article presents a reprint of a lecture that was given at the Internationalen Sozialmedizinischen Kongreß der Deutschen Gesellschaft für Sozialmedizin in West Berlin, West Germany. The author discusses the Medicare Bill that United States President Lyndon Johnson signed into law in July 1965. The author examines the confusion and criticism of the idea of social medicine, which is often erroneously referred to as socialized medicine. The economic and political changes that led up to the signing of the Medicare bill are discussed.