Assignment: Child Health Assistance
The Social Security Act of 1935 put the federal government in the health business. It gave grant-in-aid to states to provide Maternal and Child Health Assistance and Assistance to Crippled Children. It has led now to more than 1,000 specialized programs.
• 1940—The start of third party reimbursement—basically so that hospitals and doctors would be assured of being paid.
• 1943—The start of Health Manpower training, with grants to educational institutions to prepare manpower. • 1946—Hill–Burton construction grants were initiated and to date have totalled more than 4 billion dollars. • 1959—Government employees were given health insurance. • 1960—Medical schools were having difficulty surviving so that the government provided support through man- power funds, thus increasing revenue to the schools.
• 1965—Medicare and Medicaid provided help to the poor and elderly to obtain health service. As expenditures for health care increased so did the government’s concern, and eventually its involve-
ment shifted from purely contributory to regulatory. The major controls placed on the health industry today are: • The Occupational Safety and Health Act (OSHA) enacted in 1970 was designed to protect the worker in the work environment. It has provided some protection, but it has also increased costs.
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1980 Eleanor Clarke Slagle Lecture
• The Professional Standards Review Organization (PSRO) initiated in 1972 also had a humanistic goal—to assure that appropriate care was given to individuals by qualified professionals. This program has had a major impact on delivery of services by imposing control, restricting access to care, and increasing costs.
• In 1974, the National Health Planning Resource Act (HSA) presented in law the concept that health care is a “right.” Its impact has been on the control of capital expenditures, and the creation of a political football game with providers and consumers on opposing teams. The government serves as referee, and occasionally can be accused of making poor calls on the plays. The transition from public health promotion and disease prevention to a high technological mode has been
influenced by the federal government in the following ways: • The sponsorship of high technology biomedical research • The sponsorship of programs to produce specialization • Money for training nearly 200 health professionals • The construction of facilities.
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