Consciousness-Based Education - Maharishi University of ...

consciousness-based education and governmentAccording to two reports by the Office of Technology Assessment(1989, 1990), Medicare does not pay for most preventive interventionsin the elderly because there is no evidence to justify these programsas being effective and affordable. These reports add that the failure toproduce strong evidence is usually related to research design problemsthat foil the accurate measurement of potential expenditure savings.The problem is not necessarily a lack of potential results, but the lackof well-designed and properly implemented research. Unfortunately, inAmerica prevention research has been a low priority; it has been overriddenby more popular projects such as AIDS and genetic research.Finally, interventions must also succeed in changing the potentialpatient’s perception of his or her own health status, in addition toimproving physical health. The reason for this is that health improvementalone is unlikely to reduce utilization. A study by Buczko (1986) indicatesthat the key determinant of physician utilization for the general populationis perceived health status. Buczko (1986) explained the results of hisregression analysis on various possible predictors of physician utilization:As in prior studies, health status variables were the strongest predictorsof both physician visit utilization and expenditures. Perceived healthstatus was the best predictor of number of physician visits and physicianvisit expenditures, and it was also a significant predictor of the probabilityof a physician visit. (p. 25)Thus to decrease medical utilization and expenditures, a healthpromotionintervention must improve both physical health and psychologicalstatus, because both of these factors affect medical careexpenses.The High-Cost Case Phenomenon: A Way to LeverageMedical Expenditure Savings Through PreventionThe term high-cost cases is applied to that fraction of a populationthat consistently incurs high medical expenses over a long time period(Alexandre, 1988). Numerous researchers have found that high-costcases, who compose only a small percentage of the population of anation, incur the majority of its medical expenditures. For example, inthe United States, Garfinkel, Riley and Iannacchione (1988) reported,“Based on data from the National Medical Care Utilization and368