Suchergebnisse

This descriptive study assesses the access to care provided by five model and diverse safety net programs that enroll uninsured adults in a coordinated system offering primary care, hospital care, prescription drugs, and most specialist services. Physician use by safety net program members was similar to insured groups. However, there was less use of hospitals in the two programs that relied on uncompensated charity care. Considering access measures commonly used in population-based surveys, the uninsured in these five communities fared no better than uninsured elsewhere. However, respondents may consider enrollment in a well-structured safety net program to be equivalent to insurance. If so, population surveys may be least accurate in identifying uninsured people in the very communities that have the best safety net programs. On balance the five safety net systems profiled here meet the needs of low-income uninsured residents at a level that is roughly similar to that for people with insurance.

The growth in statutory provisions in the UK requiring employers to inform and consult employee representatives has been driven primarily by EU law rather than domestic policy. The 2002 EU information and consultation Directive was widely seen as having far-reaching implications for UK law and employment relations practice, but the 'reflexive' design of the UK regulations transposing the Directive has limited its impact to date. An assessment of the available evidence suggests that the regulations have prompted considerable voluntary activity in terms of reviewing, modifying and introducing information and consultation arrangements but that this has been largely employer-led. The article argues that the reform of key aspects of the UK regulations is necessary to overcome trade union ambivalence towards the legislation and the low uptake of its provisions by employees.

Many measures to reform health insurance markets include various types of government-sponsored reinsurance. This article explains the purposes and types of private and public reinsurance, and reviews available evidence about their performance. The author concludes that government-sponsored reinsurance inherently cannot reduce total costs, but it can shift costs from the private to the public sector. Also, reinsurance can help transition to a new government program or market structure that creates uncertain risks. Whether reinsurance is the best way to accomplish these goals depends greatly on the details.