Abstract
There is no U.S. “health services system”, in the formal sense of the term, and very little formal coordination between the many fragments, public or private, of this huge and vital industry, which now accounts for nearly 10 percent of the Gross National Product (GNP) and is estimated to cost about $275 billion in 1982.1/ In some important respects, there is even less coordination today — under the antigovernment, pro-competition policies advanced by the Reagan Administration — than there was five years ago. However, this does not mean that the multitudinous programs, agencies, instititions, and individual practitioners are totally lacking in cooperative arrangements, coordination, or other “meaningful relationships”. On the contrary, there is widespread, albeit inconsistent, evidence of increasing coordination, consolidation, and even mergers between and among various institutions and programs.
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References
W.K. Stevens, “High Medical Costs Under Attack as Drain on the Nation’s Economy”, New York Times, March 28, 1982.
Health U.S. 1981, U.S. Department of Health and Human Services, DHSS Publ. No. (PHS) 82–1232, Hyattsville, MD, December 1981.
R.M. Gibson and D.R. Waldo, “National Health Expenditures, 1980,” Health Care Financing Review, vol. 3, September 1981, pp. 1–54.
A.R. Somers and D.R. Fabian, Eds., The Geriatric Imperative: An Introduction to Gerontology and Clinical Geriatrics, New York City: Appleton-Century-Crofts, 1981.
C.C. Havighurst, Ed., Regulating Health Facilities Construction, Proceedings of a Conference on Health Planning, Certificates of Need, and Market Entry, Washington, DC: American Enterprise Institute, 1974.
D.S. Salkever and T.W. Bice, “Certificate of Need Legislation and Hospital Costs”, in M.Zubkoff, I.E. Raskin, and R.S. Hanft, Hospital Cost Containment: Selected Notes for Future Policy, New York: Prodist for Milbank Memorial Fund, 1978, pp. 429–460.
National Academy of Sciences — Institute of Medicine, Committee on Health Planning Goals and Standards, R. Fein, Ch., Health Planning in the U.S.: Selected Policy Issues, Vol. I and II, 1981.
E.Ginzberg, Ed., Regionalization and Health Policy, U.S. Department of Health, Education, and Welfare, DHEW Publ. No. (HRA) 77–623, 1977.
W. Greenberg, Ed., Competition in the Health Care Sector: Past, Present and Future, Proceedings of a Conference Sponsored by the Bureau of Economics, Federal Trade Commission, Washington, DC, 1978.
A.R. Somers, Ed., The Kaiser-Permanente Medical Care Program: A Symposium, Oakland, CA: Kaiser Foundation Health Plan, Inc., 1971 (rev. 1979).
Multiple Hospital Units under Single Management. Report of the 1965 National Forum on Hospital and Health Affairs, Durham, NC: Graduate Program in Hospital Administration,1965.
B.J. Jaeger, Ed., A Decade of Implementation: The Multiple Hospital management Concept Revisited. Report of the 1975 National Forum on Hospital and Health Affairs, Durham, NC: Department of Health Administration, Duke University, 1975.
J.P. Cooney and T.L. Alexander, Multi-hospital Systems: An Evaluation. Chicago: Hospital Research and Educational Trust and Northwestern University, 1975.
Hospital Corporation of America, Department of Corporate Communications, Nashville, TN, telephone communication, May 7, 1982.
B.J. Jaeger, Ed., Vertically Linked Health Organizations. Report of the 1978 National Forum on Hospital and Health Affairs, Durham, NC: Department of Health Administration, Duke University, 1978.
H.S. Zuckerman and L.E. Weeks, Multi-Institutional Hospital Systems. Chicago: Hospital Research and Educational Trust, 1979.
Lorna Lafko, Assistant to the President, Sisters of Mercy Hospitals, Inc., Farmington Hills, MI, telephone communica-tion, May 8, 1982.
Hospitals, Journal of the American Hospital Association, vol. 56, April 1, 1982, p. 23
A.R. Somers, “Rationalization of Community Health Services and the Role of the Hospital,” in A.R. Somers, Health Care in Transition: Directions for the Future, Chicago: Hospital Research and Educational Trust, 1971, Chap. 7.
President’s Biomedical Research Panel, Report Submitted to the President and the Congress of the U.S., U.S. Department of Health, Education, and Welfare, DHEW Publ, No. (OS) 76–500, Washington, DC, 1976.
L.B. Russell, Technology in Hospitals: Medical Advances and Their Diffusion, Washington, DC: Brookings, 1979.
S.H. Altman and R. Blendon, Eds., Medical Technology: The Culprit Behind Health Care Costs?Proceedings of the 1977 Sun Valley Forum in National Health, U.S. Department of Health, Education, and Welfare, DHEW Publ. No. (PHS) 79–3216, Washington, DC,: 1979.
A.D. Spiegel, D. Rubin, and S. Frost, Medical Technology, Health Care and the Consumer, New York: Human Sciences Press, 1981
Congress of U.S., Office of Technology Assessment, Assessing the Efficacy and Safety of Medical Technologies, Washington, DC, 1978.
G.S. Omenn and R.P. Nathan, “What’s Behind those Block Grants in Health?” New England Journal of Medicine, vol. 306, April 29, 1982, pp. 1057–60.
M.S. Carroll and R.H. Arnett, “Private Health Insurance Plans in 1978 and 1979: A Review of Coverage, Enrollment, and Financial Experience, ” Health Care Financing Review, vol. 3, September 1981, pp. 55–87.
J.K. Iglehart, “Health Care and American Business,” New England Journal of Medicine, vol. 306, January 14, 1982, pp. 120–125.
Hospital Statistics, 1981 Edition, Chicago: American Hospital Association, 1981, Table 12A, pp. 190–197.
C.M. Bidese and D.G.Danais, Physician Characteristics and Distribution in the U.S. 1981, Chicago: AMA, Division of Survey and Data Resources, 1982 (in press).
August Swanson, Director of Academic Affairs, Association of American Medical Colleges, Washington, DC, telephone communication, May 7, 1982.
H.B. Curry, et.al., Twenty Years of Community Medicine: A Hunterdon Medical Center Symposium, Frenchtown, NJ: Columbia, Publ. Co., 1974
L.B. Wescott, “Hunterdon: The Rise and Fall of a Medical Camelot,” New England Journal of Medicine, vol. 300, April 26, 1979, pp. 952–56
J.T. Dunlop, Coordinator, Lamont University Professor, Littauer Center, Harvard University, Cambridge, MA, Press Release, January 1982.
Director of Research, Association of University Programs in Hospital Administration, Washington, DC, telephone communication, May 5, 1982.
A.R. Somers, “Health Care Technology and the Political System: The Sorcerer’s Apprentice Revisited,” in A.R. Somers and H.M. Somers, Health and Health Care: Policies in Perspective, Germantown, MD: Aspen Systems Corp., 1977, pp. 479–490.
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Somers, A.R. (1984). Health Services in the United States: Groping Toward a “System”?. In: Pannenborg, C.O., van der Werff, A., Hirsch, G.B., Barnard, K. (eds) Reorienting Health Services. Nato Conference Series, vol 15. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2685-4_16
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DOI: https://doi.org/10.1007/978-1-4613-2685-4_16
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