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Medicaid and the Costs of Federalism, 1984-1992 by Jean Gilman,

Medicaid and the Costs of Federalism, 1984-1992 by Jean Gilman,
While assistance programs for the poor have never been as popular as those for the elderly, one such program, Medicaid, became a favorite target for expansion by state and national policymakers during the fiscally conservative 1980s and early 1990s. As a result, Medicaid's expenditures began to grow at rates double that of Medicare which serves the elderly. The author explores the complex political and institutional factors, as well as the contribution of one exceptionally motivated individual, Henry Waxman, in promoting this unusual situation. Why was Medicaid singled out as virtually the only health care program expanded by Congress during these years? The answer is in the nature of the policy itself -- Medicaid's shared financing mechanism -- in which program costs are paid for jointly by the federal and state governments. Such an arrangement diffuses responsibility, increasing opportunities for shifting costs, blame, and/or credit between levels of government. This study presents numerous examples in which the federal government and states expanded the Medicaid program to serve their own interests, while shifting part or all of the cost to the other level of government. The end result was a dramatic increase in Medicaid expenditures, while those of Medicare program, funded by a single level of government, leveled off.



Veterans and Agent Orange
Veterans and Agent Orange
The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care--not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (the elderly), Medicaid (low income patients), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm--as well as to new readers interested in the federal government's role in health care.



Ohio Credit Union System - The Ohio Credit Union System is an Ohio-based American free trade association for credit unions. The Ohio Credit Union System is composed of four components: The Ohio Credit Union League (trade association), The Ohio Credit Foundation (non-profit organization provide support for credit unions in need), OCULPac, and OCUL Services Corp.

Tru Choice Federal Credit Union - The Tru Choice Federal Credit Union was called the Medical Federal Credit Union but due to a change it is now called Tru Choice. It is a federal credit union located on park avenue right across the street from Hadlock Field in Portland, Maine.

Navy Federal Credit Union - Navy Federal Credit Union is a credit union chartered and regulated under the authority of the National Credit Union Administration (NCUA). Like all credit unions, Navy Federal is governed by a Board of volunteers.

Taunton Federal Credit Union - The Taunton Federal Credit Union (TFCU) is a federal credit union based out of the city of Taunton (MA). TFCU provides an wide array of financial services to homeowners and etc.



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