1. The Impact of Government on Healthcare

2. Hill Burton Act  Passed by Congress in 1946  Improvement/Construction of hospitals  Cities  renovated existing buildings  Established ICU unit, trauma centers, outpatient services  Rural areas  created regional health centers

3. Hill Burton Act (cont’)  Professional administration began to manage hospitals  Private clinics emerged to care for specific diseases  Research exploded

4. Dept of Health and Human Services  Formerly known as the Department of Health, Education and Welfare  In 1953, the U.S. Government gave Legislation to:  Public Health Services  Food and Drug Administration

5. National Institutes of Health (NIH)  Created by congress after the success of the National Cancer Institute (1937) and the old Hygenic Lab of the Public Health Services  Clusters of research institutes that focus on certain diseases

6. Medicare/Medicaid  In 1965, the government wanted to establish an effective and comprehensive federal health care program in the form of national health insurance  Medicare  Aged  Medicaid  Poor  Currently, the issue is how to control the massive costs

7. Medicare/Medicaid

8. Impact of Consumers on Health Care

9. Group Involvement  1960s – Critics of mainstream medicine became organized  Organized efforts to stop:  Vaccination Programs  Fluoridation of water  Animal research

11. Group Involvement (cont’)  Subtle criticism against:  Unnecessary surgery  Excessive use to prescription drugs  Over-medicalization of childbirth  Painful procedures  Heroic measures for prolonging life  Lack of confidence in the medical community  alternative health therapies

12. Group Involvement  Medical schools began addressing the issues of philosophy, social concerns, ethics  Began incorporating these classes into their curriculum

13. Group Involvement  Optometry, Chiropractic medicine, Christian Science, Faith Healing all gained popularity

14. Individual Changes  Renewed interest in herbal medicine and folk remedies  Contacts made in Asia by military exposed Americans to Asian medical and health concepts  Zen, yoga, martial arts, acupuncture all gained popularity  Influenced by President Nixon’s visit to China

15. Individual Changes  Promotion of physical activity and sports  Popular activities:  Body building  Aerobics  Running  Gyms/Health clubs  Vegetarianism became common

16. Individual Changes  Relationship between food, heart disease, diabetes, stroke are beginning to be studied  STI Management/Prevention, birth control, abortion

17. Organization and Legislation Affecting Healthcare  National Institutes of Health (NIH)  World Health Organization (WHO)  Medicaid  Medicare  Uniform Anatomical Gift Act  Occupational Safety and Health Administration (OSHA)  Controlled Substance Act  Health Insurance Portability and Accountability Act (HIPAA)  Medicare D

18. National Institutes of Health  Began in 1887 as a lab researching cholera and tuberculosis  In 1930, was established under the Department of Health and Human Services  Over 13 research institutes (National Cancer Institute)  Improve health, provide info to health care professionals

19. World Health Organization (WHO)  1948  Agency of United Nations  control and eradicate disease worldwide  Share information and technology  Deliver drugs and medical supplies where needed

20. Medicaid  1965  Title under the Social Security Amendments – provides government funding to states  Helps pay for medical care of the poor  States establish criteria for qualification

21. Medicare  1966  National health insurance for people over 65 or those who are blind or disabled  Administered by the Centers for Medicare and Medicaid Services (CMS) through the DHHS  Part A – Hospitalization  Part B – physicians and other medical providers

22. Medicare Part D  Everyone who receives Medicare is eligible  Prescription drug plan to assist in payment of medication costs

23. Uniform Anatomical Gift Act  1968  Allows living people to donate their body or organs to be gifted to research, transplant or a tissue/organ bank at time of death

24. Occupational Safety and Health Administration (OSHA)  1970, Originally an act to decrease injury, illness and deaths in the workplace  During the 1980s, focus was preventing HIV/AIDS in the health care setting  Guidelines to protect workers from:  Bloodborne organisms  Body fluids  Needles  Sharps  Spills  PPE

25. Controlled Substance Act  1970  The DEA works with the U.S. Department of Justice to address the serious use and abuse of drugs  Physicians must apply for registration and receive a DEA number in order to dispense narcotics

26. Health Insurance Portability and Accountability Act (HIPAA)  Limit health administration costs, provide patient privacy, prevent fraud and abuse  Electronic transmission of data  Release of personal information  Security of records  Establishing individuals as HIPPA officers