Уральский рабочий. 1942. № 197

Theorists and activists favor empowering government agencies to regulate technology; but an examination of such regulation by the US government exposes the inadequacy of any such regimen. Vested interests routinely interfere, e.g., keeping administration of polio vaccine in the hands of physicians, political infighting with regard to cancer research funding, advantages gained from noncompliance with military technology-constraining treaties. Public/private salary differences limit availability of the best talents for government positions, nor are truly appropriate regulatory policies easily arrived at in the absence of meaningful funding. Solutions such as a Science Court are unreliable given the influences that would undermine neutrality as well as competence

Targeting Interventions and Populations

The delivery of health care is undergoing dramatic changes. Important drivers for these changes include the increasing complexity of modern medicine, advancements in health information technology, and the shift in the delivery of care from the hospital to other care settings. As a result, physicians are now more specialized in the services that they provide and are more likely to focus their efforts either in a hospital, outpatient, or long-term care setting. At the same time, an increasing number of eligible older adults and an escalating average cost per beneficiary will make Medicare financially unsustainable. State Medicaid programs are also undergoing rapid changes. Many face potential increases in their financial obligations under the Patient Protection and Affordability Care Act (ACA) and an increasing population of indigent older adults in need of long-term care services. Complex geriatric care is needed to address these healthcare system changes. We will describe the most prevalent and important care models for complex patients. Additionally we will detail efforts to target these interventions to appropriate populations. Finally we will review what is currently known about the quality metrics and outcome measures that have been applied to these models