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30 Cards in this Set

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  • Back
The Shepard Towner Act
• 1921 the act is signed into law. It is established the first federal grant in aid program for local child health clinics.
• It was used to reduce child and maternal mortality. In 1928 it was terminated.
Prevalence
• the total number of cases of a given disease in a specified population at a specified time and/or
• The ratio of the number of cases of a disease present in a statistical population at a specified time and the number of individuals in the population at that specified time.
Incidence
is defined as the number of new cases of disease occurring in a population during a defined time interval.is useful for talking about diseases like chickenpox, which have a lifetime risk of almost one; since it is measured per unit time so can tell us when infections are likely to occur.
Rep Pete Stark (D-CA)
• “ My colleges listen to the folks from home and that’s the AMA’s strength”
• Chair of the health subcommittee of the house Ways and Means Committee.
• AMPAC spent a lot of money to unseat the rep in 1986
Harry Truman
• “Trying to persuade people to do things they ought to have enough sense to do without my persuading them…That’s all the powers of the president amounts to”
• “A representative of the 200 million or so Americans who are not directly represented by lobbies of some sort” On what the role of the president is.
• Truman tried after World War II, but he was thwarted by a potent combination of political forces, including the vehement opposition of the American Medical Assn., which was determined to defend doctors' incomes against the threat of "socialized" medicine.
5 Attempts to pass national health insurance in 20th century
1. Teddy Roosevelt and the Bull Moose Party (1910-1915)
2. New Deal (1935-1937)
3. Harry Truman Post World War II
4. Great Society (circa 1965)
5. Clinton Health Care Plan 1993-1994
US Murder Rate by guns Compared to European Rate
• US 44.6 % Europe 16.2%
• Most European countries have strict national gun control laws. US gun control has caused a lot of controversy.
10 top accomplishments of public health in the United States
1. Vaccination
2. Motor-vehicle safety
3. Safer workplaces
4. Control of infectious diseases
5. Decline in deaths from coronary heart disease and stroke
6. Safer and healthier foods
7. Healthier mothers and babies
8. Family planning
9. Fluoridation of drinking water
10. Recognition of tobacco use as a health hazard
Average Increase in American Life Expectancy during the 20th century
• Life expectancy at birth in the United States in 1901 was 49 years.
• At the end of the century it was 77 years, an increase of 57%.
Dr Herman Biggs
• The head of Health Department of NY city at the end of WWI, proposed building a network of health centers as a way to meet the needs of the rural areas for hospitals, outpatient clinics, and laboratories, among others.
• These centers would offer private practitioners and their patient’s services like x-rays, clinical consultations, and diagnostic tests.
Current Congress
• 1994 104th congress
• 110th 2007 congress
Private Medicine-
Has more to do with caring for more individual it is more profit driven service.
Public health
it is more preventative care it is in the community and a non profit status. PH is concerned with threats to the overall health of a community based on population health analysis.
Federal Share of Total Health Care Spending
73% in 2006
Federal share of public spending for health (2006):
27%
Health expenditures as a percentage of GDP (US):
15% or 1/7th of the economy
Diagnostic Related Groups
a. Created by the Reagan administration
b. This was a financial regulation applied to the health industry. The use of accounting practices to re-allocate money.
% of public health care dollars spent for public health
Nobody really knows for sure, definition not uniform, about 1-7% of healthcare budget
Leading causes of death (2004, US)–
1. Heart disease: 654,092
2. Cancer: 550,270
3. Stroke (cerebrovascular diseases): 150,147
4. Chronic lower respiratory diseases: 123,884
Medicaid expenditures for nursing home care (%)
about 1/5th of total Medicaid expenditures ~18%, elderly account for ~25%.
Employer Mandate
If employers are unable to provide their workers with healthcare they are required to give to a fund to help pay for healthcare
Authorization
Is part of the legislative process that establishes or continues an agency or program and describes its operations
Appropriations
This provides the funding for the agencies or programs.
Entitlements
a. They are guaranteed services to be provided to all recipients who meet the specified requirements for the program.
b. They are funded automatically without appropriations.
c. They make budget control difficult, since there is no overall limit on spending.
d. Largest entitlement programs are Social Security, Medicare, Medicaid, Food Stamps.
e. Escalation of spending can be attributed in part to demographic factors: an aging nation, cost of living adjustments
f. Cutting entitlement programs is extremely difficult. They are popular programs, especially among recipients. Elderly people are very organized.
Block Grants
a. Large categories of Federal money for state spending. Few rules involved, broad parameters. Very popular during the Reagan administration.
b. Oftentimes, states will use a substitution, instead of using state money for the program.
Categorical Grants:
Money that is appropriated to the state, but comes with very strict requirements on how it is spent.
Dr. Everett Koop
a. Surgeon General under the Reagan Administration
b. An individual highly regarded for this conservative agenda. He openly denounced abortion, gay rights and women’s liberation.
c. Highly controversial due to his strong beliefs, and he was opposed by many interest groups.
d. He issued strong statements against smoking and the tobacco industry
e. He issued his famous report on AIDS. He advocated for condoms, against quarantining AIDS patients, for sex education at the lowest level.
f. He was able to separate the findings of science and health from his personal morality views.
g. He changed the nation’s view of the Surgeon General from a figure head to a leader of gov’t.
Dr. Jocelyn Elders
a. Surgeon General under the first Clinton Administration
b. Very liberal in her policies, former director of the AK Department of Health, advance pre-natal care and treatment for HIV/AIDS
c. Very outspoken in discussing sexual policies, supported medical marijuana, abortion pill, and masturbation.
d. She was eventually fired from the position.
Dr. Harold Varmus
A Noble-Prize winning biologist that served at director of the NIH for 6 years. He
was well received overall by both the political and scientific sides. He served from 1993-1999.
Dr. David Kessler:
a. Served as commissioner of the FDA from 1991-1996.
b. He made significant changes during his time spent as commissioner. He removed silicone implants and expanded funding for AIDS research.
c. He helped pass the Prescription Drug User Fee Act in 1992, requiring drug companies to pay user fees and allowing the FDA to use the revenue generated from such user fees to hire more reviewers and support other agencies.
d. Well known for his crusade against the tobacco industry and cigarettes, brought to national attention all of the problems with smoking.