The debate over health care reform in the United States centers on questions about whether there is a fundamental right to health care, on who should have access to health care and under what circumstances, on the quality achieved for the high sums spent, and on the sustainability of expenditures that have been rising faster than the level of general inflation and the growth in the economy. Health care policy in U.S. is a leading independent policy of health and social care services.
Health care policy
Health care
Health depends on a number of factors, including biological factors, environmental factors, nutrition, and the standard of living. In other words, health can be seen as a function of welfare. Few of the issues which cause ill health are dealt with directly by 'health services'; they are, rather, issues in the 'welfare state' as a whole. Health services' are better described as medical services (Crippen, 2008).
Health care in United States
Medical care in the nineteenth century was principally private or voluntary. However, sickness was a primary cause of pauperism, and the Poor Law authorities began to develop infirmaries for sick people. The number of infirmaries grew very rapidly after the foundation of the Local Government Board, because of the influence centrally of doctors (Cohen, 2009).
The demand for the infirmaries was at first resisted by a deliberate emphasis on the stigma of pauperism, of which the main legal consequence was the loss of the vote. In 1885, the law requiring people to be paupers before using the infirmaries was abolished.
Prior to 1948, health services were mainly based on three sources:
Charity and the voluntary sector.
Private health care. Hospitals were fee paying or voluntary; primary care was mainly fee-paying or insurance-based.
The Poor Law and local government. Poor Law hospitals were transferred to local government by the 1930 Poor Law Act.
These were unified when the national health services were implemented in 1948.
Public health services in United State
Public health medicine has a long history in the United States. Its origins can be traced back to the middle of the nineteenth century when the main Acts of Parliament concerning public health issues were passed (Carter, 2008). A total of 17 pieces of legislation were passed between 1848 and 1890, of which six affected the delivery of public health services through administrative and structural changes. It was, however, the Public Health Act of 1875 which represented landmark legislation. This consolidated previous legislation, giving a clear account of the powers and responsibilities of local sanitary authorities. It laid the foundations for modern public health (no changes were made for more than 60 years). Many successes were achieved by the turn of the century including improvements to water supply and sewerage, street cleaning, working and living environments and personal hygiene. The strong legislative framework combined with the growing power and effectiveness of local Medical Officers of Health made a crucial contribution to these improvements (Calsada, 2001). Having played a significant role in the organization of health ...