Value-Based Coverage Policy in the United States and the United Kingdom: Different Paths to a Common Goal

This background paper traces the development within American health care of two interrelated trends and activities: an evidence-based approach to medical practice and the critical evaluation of new technologies with respect to their costs and effectiveness. Over the past 35 years each of these developments has increasingly shaped the coverage decisions of public and private health insurers, and their importance for coverage policy is certain to grow. The paper also contrasts the different approaches to such “evidence-” or “value-based” coverage policy in the mixed public and private U.S. health care enterprise with the approach taken in Great Britain’s single-payer National Health Service

Covering the uninsured: What is it worth?

One out of six Americans under age sixty-five lacks health insurance, a situation that imposes sizable hidden costs upon society. The poorer health and shorter lives of those without coverage account for most of these costs. Other impacts are manifested by Medicare and disability support payments, demands on the public health infrastructure, and losses of local health service capacity. We conclude that the estimated value of health forgone each year because of uninsurance ($65?$130 billion) constitutes a lower-bound estimate of economic losses resulting from the present level of uninsurance nationally

Citizen-centered health promotion: Building collaboration to facilitate healthy living

Unhealthy behaviors, notably tobacco use; unhealthy diets; and inadequate physical activity are major contributors to chronic disease in the U.S. and are more prevalent among socioeconomically disadvantaged groups. Differences in the prevalence of unhealthy behaviors among communities with different physical, social, and economic resources suggest that contextual environmental factors play an important causal role. Yet health promotion interventions often are undertaken in isolation and with inadequate attention to these holistic social and economic influences on lifestyle. For example, clinicians\u27 advice to patients to stop smoking or lose weight can help motivate people to change behaviors, but their ability to take subsequent action can benefit from coordination with community-based and public health programs that offer intensive counseling services, and from modified environmental conditions to facilitate behavior change where people live, work, learn, and play. Reshaping these environmental conditions to support healthier living is the subject of six recommendations from the Robert Wood Johnson Foundation Commission to Build a Healthier America. Changing the conditions of daily life to make them conducive to healthy behaviors--what is here called citizen-centered health promotion--requires a concerted effort by clinical, educational, business, civic and governmental partners within communities. Linkages among clinical practices and community-based programs have been demonstrated to be effective, but moving from demonstration projects to sustainable community collaborations nationwide will require a proactive effort to establish the necessary infrastructure and financing

The Lantern Vol. 34, No. 1, December 1967

• il se fait tard • il pleut • For GM • A Fragile Fragment • Epic in Stereo • Kisskraft • The Critical Marquis • Sea Flame • Belladonna • Haiku • Symphony • Ziegfortenblat • It\u27s One of Those Nights • Contentment • Short-sighted and Mildly Unbelievable • Society\u27s Children • Crowded Mirrors • Child in Bright Colors • The Long-range Accident • The Ultimate Machine • They Live in a Crowded Area • Beastiary • Nocturne • I am Like a Candle • Two A.M. and After • Question Times Ten • College Blues • Poem at Midnight • Love Chaos-Style • Once Knew a Homespun Nanny • He Who Argues • Dying by the Water • Is This Prose • The Subintellectual • Untitled Series • Sunset Skirmish • Lyrics of the Field • That Day When I See • Haiku • When the Shadows Stopped • Luz-Maria • Prayerhttps://digitalcommons.ursinus.edu/lantern/1092/thumbnail.jp

The Lantern Vol. 34, No. 2, May 1968

• The Man Without a System • A Medal for Malcolm • On Hearing That Tonya Will Be Married • The Black Sea • Odyssey \u2767 • Second Poem to Chris • Singularity • Period 5-A Began • Long and Aching Ride • Souvenirs • My Eschatological Epitaph • Discotheque • Some Borrowed Words • False Breakthrough • Shore Morning • The Beholder • Thursday Childless • A Most Prominent Role • It Ran Out • Shades of the Living • The Dark Night of the Mind II • One Step Beyond the Doors • A Note of Thanks to My Parents and Teachers • To a Dead Hippie • A Scrap • Love • Haiku No. 30 • Rachel • There Is No Present • Winter Woods • One Hundred Per Cent Genuine • Heaven • Silence Is Like God • I Soaked Up Silence • Opened Letter From Whistler Homer, Insaned Assailant • Sol Clutch Rides Tonight • I Have Seen Destruction • Upon That Night • That\u27s Weird • Alone • Kathy\u27s Tune • On Walking Home • The Wheel • Some Excuse, at Least • Freedom to Flap • Awareness • Okay, You Guys • You Say You Dream • Bacci Miahttps://digitalcommons.ursinus.edu/lantern/1093/thumbnail.jp

The significance of using US-valued EQ-5D health states for comparative effectiveness and cost-effectiveness studies in U.S. popualtions

Two articles published, one by Nan Luo, and the other by Katia Noyes, substantially advance our understanding of the relative performance of US- and UK-based EQ-5D preference scores

The consequences of uninsurance for individuals, families, communities, and the nation

Discusses the consequences of uninsurance for individuals, families and communities in the U.S. Background of the Institute of Medicine; Impact of uninsurance on adults and children\u27s access to health care; Effects of uninsurance to the economic conditions of the nation

Reducing racial, ethnic, and socioeconomic disparities in health care: Opportunities in national health reform

Policy often focuses on reducing health care disparities through interventions at the patient and provider level. While unquestionably important, system-wide reforms to reduce uninsurance, improve geographic availability of services, increase workforce diversity, and promote clinical best practices are essential for progress in reducing disparities