Health reform debate understandably focuses on large system design. We should not omit attention to the “last mile” problem of physician payment theory. Achieving fundamental goals of integrative, patient-centered primary care depends on thoughtful financial support. This commentary describes the nature and importance of innovative primary care payment programs.

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

The enigmatic sixteenth-century Swiss physician and natural philosopher Philippus Aureolus Theophrastus Bombastus von Hohenheim, called Paracelsus, is known for the almost superhuman energy with which he produced his innumerable writings, for his remarkable achievements in the development of science, and for his reputation as a visionary and alchemist. Little is known of his biography beyond his legendary achievements, and the details of his life have been filled in over the centuries by his admirers. This richly illustrated anthology presents in modernized (...) language a selection of the moral thought of a man who was not only a self-willed genius charged with the dynamism of an impetuous and turbulent age but also in many ways a humble seeker after truth, who deeply influenced C. G. Jung and his followers. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

These are indeed dangerous times. In the name of “cost-effectiveness,” we cut back health benefits to the poor, who are more likely to be sick than the nonpoor. We miss our chance to heal. In the setting, we’re told, of “scarce resources,” we imperil the health care safety net. In the name of expedience, we miss our chance to be humane and compassionate.’Medicaid is again - still - the subject of reform discussions in Washington and in state capitals. The program (...) has been subject to varying, sometimes conflicting pressures since its inception. Its primary purpose has been serving the health care needs of the poor and disabled. It was structured, however, to appeal to private health care providers. In addition, its mix of state and federal funding and control was intended to draw in the states as partners. (shrink)

These are indeed dangerous times. In the name of “cost-effectiveness,” we cut back health benefits to the poor, who are more likely to be sick than the nonpoor. We miss our chance to heal. In the setting, we’re told, of “scarce resources,” we imperil the health care safety net. In the name of expedience, we miss our chance to be humane and compassionate.’Medicaid is again - still - the subject of reform discussions in Washington and in state capitals. The program (...) has been subject to varying, sometimes conflicting pressures since its inception. Its primary purpose has been serving the health care needs of the poor and disabled. It was structured, however, to appeal to private health care providers. In addition, its mix of state and federal funding and control was intended to draw in the states as partners. (shrink)

Was ist der Mensch? Das ist die Kernfrage dieses Buches, die aus philosophischer Sicht bearbeitet wird. Es wird dafür argumentiert, dass der Mensch mehr ist als eine sehr komplexe Ansammlung materieller Elementarteilchen, die einfach nach den normalen Gesetzen der Physik miteinander zusammenwirken. Stattdessen muss man Menschen zusätzlich spezifisch menschliche Eigenschaften zuschreiben, die nicht vollständig aus den körperlichen Eigenschaften heraus erklärbar sind. Sie verfügen über Bewusstsein und können in einem gewissen Umfang frei handeln. Das sind psycho-physische Phänomene, die mit den Gesetzen (...) der Physik nicht vollständig erfasst werden können. Deswegen ist der Materialismus wahrscheinlich falsch, wenngleich er nicht definitiv widerlegbar ist. Die beste Antwort auf das uralte Leib-Seele-Problem ist der Polare Dualismus, ein Eigenschaftsdualismus, der die Welt als grundsätzlich psycho-physisch auffasst. Psycho-physische Zusammenhänge sind keine nachträgliche Verbindung zweier eigenständiger Seinsbereiche, sondern stehen in einem polaren Verhältnis zueinander. Keiner der Bereiche ist ohne den anderen denkbar, aber es kann auch keiner auf den jeweils anderen zurückgeführt werden. (shrink)

The Affordable Care Act1 promises to improve access to coverage and care for two vulnerable groups: low-income persons who are excluded by a lack of resources and chronically ill and disabled people who are excluded by the dysfunction of our existing insurance and care delivery systems. ACA’s sprawling provisions raise a wealth of implementation challenges that are exacerbated by the compromises required to move reform through Congress. In particular, the compromise between regulatory/public program advocates and advocates for private, market-driven programs (...) requires thoughtful regulatory coordination between public and private health systems. (shrink)

The Affordable Care Act1 promises to improve access to coverage and care for two vulnerable groups: low-income persons who are excluded by a lack of resources and chronically ill and disabled people who are excluded by the dysfunction of our existing insurance and care delivery systems. ACA’s sprawling provisions raise a wealth of implementation challenges that are exacerbated by the compromises required to move reform through Congress. In particular, the compromise between regulatory/public program advocates and advocates for private, market-driven programs (...) requires thoughtful regulatory coordination between public and private health systems. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1969. Routledge is an imprint of Taylor & Francis, an informa company.

The Institute of Medicine has returned the problem of medical error to the top of the health-care agenda. Its report that 44,000 to 98,000 patients die each year as a result of medical errors in American hospitals has renewed scholarly interest in health system quality control. In To Err Is Human, the IOM provides a vivid picture of a health-care system riven with serious quality problems. It calls for systems-based error-reduction methods borrowed from other high-risk industries and forcefully argues against (...) the traditional tendency to assign accountability primarily to individual physicians. Most errors, the IOM argues, can be successfully addressed by engineering systemic fail-safe protections against the inevitable failings of human actors. (shrink)

The Institute of Medicine has returned the problem of medical error to the top of the health-care agenda. Its report that 44,000 to 98,000 patients die each year as a result of medical errors in American hospitals has renewed scholarly interest in health system quality control. In To Err Is Human, the IOM provides a vivid picture of a health-care system riven with serious quality problems. It calls for systems-based error-reduction methods borrowed from other high-risk industries and forcefully argues against (...) the traditional tendency to assign accountability primarily to individual physicians. Most errors, the IOM argues, can be successfully addressed by engineering systemic fail-safe protections against the inevitable failings of human actors. (shrink)