Herman M. Somers

The Malpractice Controversy and the Quality of Patient Care

The widespread doctor strikes of 1975 stimulated belated attention to a crisis in malpractice insurance. Most state legislatures responded only to a shadow crisis in insurance as they rallied to the defense of health care providers. The smouldering substantive crisis--the reality of malpractice--is now galvanizing institutions and professions into aggressive activities for quality assurance and renewal of trust between patient and doctor. New procedural experiments offer prospects for preserving economy and equity by containing the causes of malpractice suits within the health care system itself.

Financing of Medical Care in the United States

THE well publicized revolution in medical care is widely understood to be a product of the explosive changes in science and technology. The more cautious revolution in financing, which has accompan...

The paradox of medical progress.

BAFFLEMENT, if not distress, must be a widespread predicament of those besieged by apparently contradictory reports on medical care. On the one hand, attention is continuously called to increasing ...

The Federal Bureaucracy and the Change of Administration.

The period starting November 5, 1952 has been called “The Time of the Jitters” for the middle and upper levels of the federal bureaucracy. Political change is usually disruptive and always accompanied by uncertainty and insecurity. Intellectual acceptance of this truism does not insulate one from the effects any more than death and taxes, for all their recognized inevitability, cease to be sources of distress. There were many reasons to anticipate that the 1952 election might result in a greater than usual degree of change, or at least of uncertainty. In many ways there were no real American precedents for the situation. The period of executive control by the outgoing party had been characterized by the unusual duration of 20 years, by highly controversial political policy, and by profound social change. This was the first change of administration under conditions of modern Big Government—the first since the American government found itself with accepted broad welfare and economic responsibility on the domestic scene and with major power responsibilities in a divided and warring world. Since the last full change, the size of the federal civil service had increased over 400 per cent, governmental expenditures over 16 fold. This was also to be the first full change of administration to show the effects of the 20th Amendment.

Coverage, Costs, and Controls in Voluntary Health Insurance

T WO overriding problems confront voluntary health insurance today: Can group benefit coverage be expanded far enough, fast enough, and at a feasible price to meet, for the majority of employed workers and their families, the rising tide of demand? For those who cannot generally qualify for group insurance, notably the aged, and for whom government is already paying a substantial portion of total medical costs, what will be the future relation between public financing and private medical care programs? Although these problems are obviously interrelated, this paper discusses the first one only. The central issue of group insurance-which

Health insurance: Are cost and quality controls necessary?

As this note is being written, a proposal to provide health insurance to retired workers under Social Security--the Forand bill--is being vigorously debated. Although health care for such workers involves some special considerations, the arguments of the proponents of this bill and the massive support being marshalled for its passage are symptomatic of general concern over voluntary health insurance. The dilemma threatening the survival of many of these voluntary programs is that costs tend to outstrip their ability to provide the quantity and quality of health care demanded by the groups they serve. In this discussion, the authors attempt to identify the major problems currently at issue in voluntary health insurance and to describe and appraise some administrative innovations that have been made in a few instances to control costs and improve the quality of medical and hospital care. (Authors abstract courtesy EBSCO.)

The President as Administrator

... they say, what has been common knowledge for twenty years, that the President cannot adequately handle his responsibilities, that he is overworked; that it is humanly impossible, under the system which we have, for him fully to carry out his Constitutional duty as Chief Executive, because he is overwhelmed with minor details and needless contacts arising directly from the bad organization and equipment of the Government. I can testify to this. With my predecessors who have said the