A National Cost-Containment Strategy for Long-Term Care
本文提出了一项结合长期护理服务系统与激励性保险计划的国家战略，旨在控制长期医疗成本，对政策制定者和公共管理研究者有参考价值。
Inflationary pressures which have accelerated, unrestrained by government, in the 1970s have shaken the economic order and brought about a crisis in confidence of the American people in their government. Public concern over high taxes and uncontrolled spending for essential services has fostered a conservative mood at the dawn of the new decade. There is surprising agreement among citizens today that the government is unable to curb inflation; moreover, there is a growing suspicion that government is responsible for its continued upward spiral. Whether the federal, state, and local governments can restore the public faith will depend on the ability of government officials to formulate cost-effective solutions to our social, economic, and political problems. The essay presented here used a cost-containment approach in the development of a national strategy for dealing with one such problem: long-term health care. The strategy was devised by a team of graduate students in public administration at the State University of New York at Brockport. The concept combines a proposed delivery system for long-term health care with an insurance plan which provides incentives for cost savings. The authors are indebted to Gerald Eggert, director of Access, a delivery system model for long-term health care in Rochester, New York, and also to Christine E. Bishop' for her insurance plan outlined in a Brandeis University discussion paper. The authors of this essay drew on the efforts of these two people in adapting and combining ideas and concepts to create a comprehensive national strategy for cost control of long-term health care. A compendium of interim strategies developed to alleviate problems identified in long-term health care is included in the essay. Compiled from an extensive search of the literature, these proposals are aimed at eradicating some of the basic causes of problems identified with reimbursement for long-term care. Further research is needed, not only to refine the proposal and develop legislation that embodies the concepts presented in the essay but to explore other governmental service areas where the cost-containment approach may also be applied. Introduction