Class of 2009 Abstract / OBJECTIVES: The purpose of this study was to determine the perceptions of the general public in Arizona regarding random drug screening and obtaining and maintaining health care benefits. METHODS: Individuals entering and leaving a grocery store in Chandler, Arizona on one day were invited to voluntarily participate in the study by reviewing a subject disclosure form and completing an 11 item questionnaire. The Likert scale varied from 1 = Strongly Disagree to 6 = Strongly Agree. Individuals were eligible to participate if they were adults and living in Arizona. RESULTS: One hundred adults participated in the study. The results of the study showed general agreement for passing a drug test for illegal substances before being hired (5.0 ± 1.5, mean ± SD), and if testing positive for illegal drugs, being allowed to enroll in a drug treatment program to keep their health care benefits (4.8 ±1.6). Respondents agreed that employers should require random drug testing to maintain employment (4.4 ± 1.8). However, respondents neither agreed or disagreed that people should be required to pass a drug test to be eligible to receive health care benefits (3.9 ± 2.0) or that they should be required to pass a periodic drug test to maintain their health care benefits (3.7 ± 2.0). CONSLUSIONS: Respondents agreed with drug testing to obtain and maintain employment; however, respondents neither agreed or disagreed with the concept of obtaining or maintaining health care benefits with passing a drug test for illegal substances.

The development of hemodialysis clinics in Taiwan has been rapid for about 17 years. In early days, many patients with no health insurance had to get hemodialysis at their own expense. Therefore, they often suffered pulmonary edema caused by breathing difficulties, and quickly rushed into medical centers and then stayed almost all night in the emergency of dialysis. Dialysis clinics were not very popular in communities at that time. Dialysis payment firstly was paid by civil servant insurance then Labor Insurance came second; followed by Agricultural Insurance, and eventually developed into the National Health Insurance. Among them, those dialysis patients are actually the primary beneficiaries. The National Health Insurance gives rise to a large number of community-based dialysis clinics to set up massively. The free competition creates a high-quality dialysis environment. The Japanese people are impressed by both the hardware and software of dialysis clinics. Japan dialysis payment is about 3.75 times of Taiwan. In recent years, the financial deterioration of health care benefits caused a decline in the value of pay- points! And the discussion about health insurance rates is not rationally debated by our society .As a result, the survival of dialysis clinics is really becoming a serious issue. The Taiwanese hemodialysis clinics are still able to provide high-quality dialysis services to the community. Such a successful experience in the Chinese region will surely set a practical example for China, which is in its rapid economic development and has a gradual increase in health insurance coverage now. Besides, the difficulty that faces China is the long serious shortage of basic dialysis medical supplies! So we hope to bring our experience in Taiwan to China dialysis clinics for the future planning in primary health care in the operation and management of dialysis. This research has done the literature review, expert interviews, and service pathway system. According to the three key elements, we analyze and find that Taiwan's experience in China is based on the critical success factors from expert opinions and clinics operation core. This study summarizes and organizes in the paper the following points: 1.service pathway system 2. hemodialysis clinics in communities 3. hemodialysis clinics resource management 4. safety planning and implementation in health care 5. education and training for the medical care personnel 6.cooperate communicate and develop with other organizations to improve management pattern continuously 7. The support from China government health organs

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In any given week glance through the nation's leading newspapers and popular magazines and chances are you will find an article on the nation's medically uninsured. In chiding a country that allows 16% of its citizens to suffer the risks associated with that lack of insurance, reference is frequently given to the exemplary coverage provided to federal government employees by the Federal Employees Health Benefits Program. What of the benefits provided to state government employees? How good is the coverage, and, of particular interest, are there significant variations across states and what factors might contribute to those differences? This study assesses the level of health care benefits afforded to state government employees in all fifty states and considers the potential impact of political ideology, political culture, economic conditions and public employee union membership in influencing variations in those benefits across the states. The state paid portion of a family’s health care premium was adjusted to allow for differences in health care costs across the states resulting in a range of the level of benefits from $318 per month in Mississippi to $1834 per month in New Hampshire. A state’s economic condition, the level of public union membership, and a moralistic political culture were all shown to have a positive association with the level of benefits. Political ideology, defined as the degree of liberalism, was, however, not shown to have a statistical association. Understanding health care benefit differences between states and the factors that drive those differences has the potential of improving lives and the functioning of state governments. Scant information on those differences exist in the current literature; this study has developed a baseline of information and an assessment of driving influences that will, hopefully, stimulate additional approaches and research efforts. Benefits, in general, have been shown in the literature to impact the ability of state governments to attract and maintain employees of merit. Advocates of increased benefits can utilize these study results to place their requests in a broader context.