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24 Cards in this Set
- Front
- Back
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key point of history of policy
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-never been a broad commitment for health care access to all, rather incremental approaches
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what are four main historical periods?
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1.Era prior to the buildup of health care resources-prior to 1930
2. Era of Federal buildup of health care resources: WWII-1970s 3. Federalization of the health care system and cost containment era-1970s+ 4. The emergence of the competitive health care market (payer driven market), the defederalization of the health care system era, movement towards a consumer driven market, discussion of health reform. |
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what is the era prior to the buildup of federal resources?
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turn of the century - 1920s
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what are general trends of health care?
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-people took care of themselves
-they paid for HC services themselves, or had charity -physicians and pharmacists were the primary recognized HC fields |
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what was the trend of access to HC in history?
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access was more of a privilege for those who could pay than a right for everyone
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what were hospitals like in history?
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-many were sponsored by not-for profit corporations formed by concerned citizens and wealthy benefactors
-some were sponsored by local governments or small for-profit corporations (often by private physician |
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what was HC like for the indigent (poor)
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-social reform was a local responsibility
-local public health departments/local government provided for needy |
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nursing homes
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-rare
-financing non-governmental |
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maturation of public health services
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(1870-1910)
-enforcement of sanitary regulations and control of communicable diseases |
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what was the role of federal government prior to the 1930s
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-limited role, only minimally involved with public health services
-federal role strongly opposed by the AMA |
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what was the beginnings of public policy and the insurance industry:
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1798 US Merchant Marine Hospital: Department of Human Services, Center for Disease Control and Prevention.
1847 First private health insurance company- 1911 First state Workers compensation law |
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what is the smith/fess act?
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Occupational therapy was defined under medical authorities. (The vocational rehabilitation law 1918 "Smith-Fess Act"/Federal Board of Vocational Education, 1920)
**we were NOT part of this –we were babies. |
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Smith Fess Act
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Provided federal funds for people disabled in industrial settings and serviced only those with physical disabilities (Personal communication, Dunn, 2000: Reed, 1996).
Instituted founding of OT Limited impact on OT practice as defined OT as a medical, not educational service, and therefore would not reimburse for services titled "occupational therapy" (Reed, 1996). Did not include mental health rehabilitation in the scope of covered services (Personal communication, Dunn, 2000). 1943 (The Barden-LaFollette, Act) OT was reimbursed. |
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history until WWII
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era prior to the buildup of federal resources (1920s and 1930s)
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history until WWII
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Advances in technology and the discovery of antibiotics
1920s hospitals expanded services 1930's Depression: spending on health care dropped 33%. |
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when was blue cross system established
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1930
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what was the foundation for employment based insurance?
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blue cross system
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social security act
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1935
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national cancer institute founded-
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1937
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national institute of health
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1930s
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what established the 1st permanent continuous authorization of funds for vocational rehab training programs for civilians, unemployment, old-age pensions
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social security act
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what is considered to be the starting point for federalization?
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social security act
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why was HC federalized?
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system wasn't meeting needs of the nation
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what were some public policy key acts of the 1940s?
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1946 Blue Cross Association: National commission of the blue-cross plans is created.
1946 Hill-Barton Act or Hospital Survey and Construction Act-Grants 1946 National Mental Health Act- 1943 Vocational Rehabilitation Act and amendments 1947 OT received military status: |
