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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Carl W. Nelson, PhD, Northeastern University, 319 Hayden, 365 Huntington Avenue, Boston, MA 02115 and John D. Sullivan, PhD, Boston University, 808 Commonwealth Avenue, Boston, MA 02215, 617-353-3018, ca.nelson@neu.edu.
We examine the major accomplishments and issues associated with the federal government as the “single payer” responsible for the health care of special segments of the U.S. population. Our historical focus is directed to four areas where federal jurisdiction of health care services and benefits have prevailed: military medicine, veteran’s health, government employee health benefits, and Medicare’s end stage renal dialysis program. Our analysis shows that major clinical and health accomplishments are attainable for populations facing potentially great needs and great risks; or even low intensity medicine and public health services. We also find that these accomplishments can be made possible at reasonable costs in programs that encompass a major national service and civil service model as well as congressional management and oversight. The later is particularly crucial when criticism and crisis require change. We conclude with neutrality regarding the provision of health and medical services through market mechanisms or mixed models, as long as a representative and effective government can enlarge its role as the dominant purchaser of health services for those people unable to afford quality care themselves. There is ample evidence throughout our nation’s history that this is both feasible and desirable.
Learning Objectives:
Keywords: Universal Health Care, Management
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Department of Defense,
Veteran's Administration,
HCFA,
Fresenius
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.