Healthcare In The United States: Chapter Analysis

1. The chapter summarizes the emergence of medicine and how it grew into what it is today.
The development if healthcare in the U.S was based on social and political precedents. Early on the practice on medicine was not a profession. According to the book anyone could be a physician and there was little evidence based practice when treating patients.
People believed that to rid disease from the body, you had to be bled out. This practice caused a lot of infections in patients. Hospitals were not developed until the early 1900’s, although they lacked sanitation, and often people who came to hospitals became more ill. According to the book, mental illness was thought of as the government’s responsibility. Asylums were built by states to house
the mentally ill. The AMA was also discussed, founded in 1847 their interest were in bettering physicians professions. The process of getting medical care was also discussed. Fee for services is when you are billed for each service you receive, because this was expensive the use of physicians by families was only done when the patient was very ill.
The 1920’s is when physicians started making a lot more money, and actual medical education was required. The book discusses cultural authority, this is when a community accepts and relys on the judgement of members of a profession. This reliance on doctors knowledge grew as their profession grew. In 1896 26 stats has licensing laws for physicians. In 1893 Hopkins created graduate training for doctors. The National Institute of Mental Health formed in 1949 and helped form the idea of community mental health. Public health concentrated on population health, but overtime they also helped with family planning and health care screening. The book also describes voluntary health insurance, which is a private insurance. In 1911 insurance companies offered Early blanket policies, which covered large populations for illnesses. In 1929 modern health insurance was established. Blue cross was formed around this time and covered people for not only sudden illness but also general care. National health insurance was never really liked by the majority especially the AMA. In 1965 Medicare was formed to provide coverage for the elderly. In 1957 nursing home care was included as a part of SSI. Medicare part A and B were formed. Medicare allows balance billing, this allows the physician
to bill the remainder of what medicare won’t pay to the patient. The book also discusses Group plans these enroll populations in health care, and they receive services for a cap. The HIP plan of New York provided services with family physicians. The HMO act of 1973 was created and the insurance community thought this would create competition among plans. The information revolution first developed in the 1950’s they involve the use of computers in medicine. The Oregon health plan was discussed, which wanted to give insurance to the uninsured. The plan wanted to expand Medicaid and create a insurance pool to offer coverage to people with preexisting conditions.
2.
I believe that history helps us with our future, if we actually see what we did wrong in the past. Learning about how medicine started and peoples views on it can help me as a public health professional when decided what new plans I want to develop and how I want to help communities. Learning about different medical organizations and what their views are on public health is also beneficial to my career. I learned about how insurance started and what people’s views were on it, I think this is important to know when trying to implement changes in our insurance
system.