AIDS, risk adjustment, and health care financing in New York State

Article Abstract:

Risk pool systems are a necessary element in health care reform, although they are complex and may be difficult to implement. Risk pooling spreads health care costs among large groups of people. Each group must have similar numbers of sick people and the insurance premiums must remain low so that risk is spread broadly and coverage is available to all. In New York State, Blue Cross and Blue Shield Insurance Companies used risk pooling to offer high quality health insurance policies to small groups and individuals, without regard to risk status. Eventually, Blue Cross and Blue Shield covered larger proportions of sick people compared to other insurers. As a result, Blue Cross and Blue Shield insurance premiums rose rapidly and many people could no longer afford coverage. In 1992, New York legislators passed a law requiring all commercial insurers to share the burden of insuring high-risk people.

Management, Finance, New York, Health insurance, Insurance, Risk (Insurance)

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Welcoming presentation to the Henry J. Kaiser Family Foundation Forum on AIDS and Managed Care

Article Abstract:

Health care reform is occurring in the 1990s and must center on efforts to achieve quality. Market forces, the AIDS epidemic, and the needs of the aging population are driving these reforms. Managed care plans are growing and consolidating to create an integrated health care system. New challenges result from technological breakthroughs that improve the lives of people with chronic illness and create a need for multifaceted care. Financing HIV care in an era of shrinking funds requires resource pooling to spread the risk across the population. Outcome studies are needed to facilitate optimal patient care and medical providers must be involved in implementing the results. Investments in research and development, information infrastructures, and disease prevention are worthwhile. Rewarding organizational efforts aimed at continuous quality improvement can achieve lower costs.

Models, Medical care, Quality management, Medical care quality, Health care reform

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Vitamin A deficiency in non-vitamin-supplemented patients with AIDS: a cross-sectional study

Article Abstract:

AIDS patients may develop vitamin A deficiency even though their diet contains sufficient amounts of vitamin A. Vitamin A deficiency in HIV infection is often associated with more rapid progression of the disease. Researchers measured vitamin A concentrations in blood samples from 35 AIDS patients who were not taking vitamin A supplements and asked the patients to fill out a dietary questionnaire. Eight of the patients had vitamin A deficiency. Seven were eating diets that provided more than the recommended dietary intake of vitamin A. Patients with chronic diarrhea and Pneumocystis carinii pneumonia had lower blood levels of vitamin A. The prevalence of vitamin A deficiency in these patients was substantially higher than in the general population.

Demographic aspects, Food and nutrition, HIV patients, Vitamin A deficiency

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