Specialty distribution of U.S. physicians - the invisible driver of health care costs

Article Abstract:

The high percentage of specialists among physicians in the US contributes to the skyrocketing cost of medical care and inadequate access to basic health care. Generalists make up 50% to 70% of the physicians in other countries but only 30% in the US, and this percentage continues to drop. Two factors encourage medical students to become specialists: specialists make considerably more money than generalists and medical school policies encourage specialization. In a study that used an analytical model to simulate physicians' incomes according the 1992 Medicare fee schedule, specialists make more money than generalists and were over-compensated for their actual practice costs while generalists were undercompensated. Jefferson Medical College's program to increase the number of family physicians practicing in rural and underserved areas demonstrates that medical school policies can influence the composition of the physician work force. However, curbing the trend toward specialization will require reform at the national level.

Social aspects, Editorial, Medicine, Supply and demand, Medical care, Cost of, Health care costs, Physicians (General practice), General practitioners, Medical specialties

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The medically uninsured - will they always be with us?

Article Abstract:

There are at least 40 million poor Americans without access to health care or health care insurance. About 29 millions are not adequately insured for the event of catastrophic illness, a national trend that is likely to grow. The most typical responses to this malaise range from dismissive to cautious to finger pointing. Although other developed countries have managed to provide health care coverage via employment or government subsidies, the US continues to lag behind. An individual's right to choose and a mistrust of government further complicates such a sweeping policy reform and its attendant cost. Voters are reluctant to embrace the increased cost of health reforms, while politicians avoid advocating serious change. Media coverage is most inadequate. Since industry profits are a main priority, radical change is unlikely unless the gradual expansion of health care coverage by state proves successful.

Economic aspects, Column, Political aspects, Medically uninsured persons, Health care reform, National health insurance, Civil rights

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Class-the ignored determinant of the nation's health

Article Abstract:

It is found that the American people in upper class, having good education, high-paying jobs, and living comfortably, live longer and healthier lives than those in lower classes, many of whom are African Americans or members of ethnic minorities. The U.S. should enable the people in lower economic classes to attend the social and environmental factors encouraging healthy behavior, and attention should be given to social policies that address the class differences that underlie illness and premature death.

United States, Health aspects, Influence, Demographic aspects, Americans, Social classes, Social class

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