George Wagoner, Anna Rappaport, Brian Fuller, and Frank Yeager
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780199204656
- eISBN:
- 9780191603822
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0199204659.003.0008
- Subject:
- Economics and Finance, Financial Economics
The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects ...
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The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects for retiree health insurance, focusing on traditional approaches to retiree health benefits where the employer assumes most risk, and on defined contribution approaches where significant risk is shifted to the retiree. It also examines government benefits for retirees, including new Medicare prescription drug benefits. It models future retiree health care costs and opportunities to save before retiring, highlighting public policy obstacles and issues for employer-provided retiree health benefits.Less
The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects for retiree health insurance, focusing on traditional approaches to retiree health benefits where the employer assumes most risk, and on defined contribution approaches where significant risk is shifted to the retiree. It also examines government benefits for retirees, including new Medicare prescription drug benefits. It models future retiree health care costs and opportunities to save before retiring, highlighting public policy obstacles and issues for employer-provided retiree health benefits.
Amy Gutmann
- Published in print:
- 1995
- Published Online:
- November 2003
- ISBN:
- 9780198280088
- eISBN:
- 9780191599927
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0198280084.003.0006
- Subject:
- Political Science, Political Theory
Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts ...
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Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts between multiple meanings of goods, which require adjudication in accordance with moral considerations that cut across distributive spheres. Drawing on the several meanings of productive employment and medical care in contemporary USA, she concludes that justice is complex, but not specific to distinct spheres.Less
Amy Gutmann argues that a just society could not, pace Michael Walzer, distribute social goods in accordance with the standards of complex equality. To support this view, Gutmann points to conflicts between multiple meanings of goods, which require adjudication in accordance with moral considerations that cut across distributive spheres. Drawing on the several meanings of productive employment and medical care in contemporary USA, she concludes that justice is complex, but not specific to distinct spheres.
Mark Schlesinger
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195170665
- eISBN:
- 9780199850204
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195170665.003.0024
- Subject:
- Political Science, American Politics
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes ...
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This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.Less
This chapter examines the emergence of market ideology and how it has reshaped understanding of the nature and import of inequality within the American health-care system. It describes four changes that have dramatically altered the politics of inequality in medical care. First, the introduction of markets to medical care exacerbates unequal health outcomes. Long-standing differences in health-care utilization and health outcomes are likely to grow under market reforms. Second, market arrangements promoted the growth of large health-care corporations. Their political power may circumscribe government policy making that could limit health inequalities. Third, market frames are associated with different standards of fairness for assessing the performance of the health-care system. This changes the outcomes seen as inequitable, and hence suitable, for government intervention. Fourth, market schemas have transformed prevailing discourse around important perspectives on health policy, including the rights of citizens and the responsibilities of local communities.
Deborah Stone
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195170665
- eISBN:
- 9780199850204
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195170665.003.0022
- Subject:
- Political Science, American Politics
This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter ...
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This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter suggests that market ideology is the biggest obstacle to health-care equity. The U.S. health-care system is designed to produce disparities, since it allocates medical care primarily by market criteria rather than by medical need. Market principles generate racial and ethnic disparities, and allow racism to continue under cover of economic justifications. The chapter argues that the nation will not be able to ameliorate racial and ethnic disparities until political leaders are willing to face up to the consequences of their devotion to the pluralistic ideals in medicine.Less
This chapter focuses on racial disparities in health care. It shows how certain principles of political organization in culture in the United States perpetuate racial disparities. The chapter suggests that market ideology is the biggest obstacle to health-care equity. The U.S. health-care system is designed to produce disparities, since it allocates medical care primarily by market criteria rather than by medical need. Market principles generate racial and ethnic disparities, and allow racism to continue under cover of economic justifications. The chapter argues that the nation will not be able to ameliorate racial and ethnic disparities until political leaders are willing to face up to the consequences of their devotion to the pluralistic ideals in medicine.
Kenneth M. Ludmerer
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195181364
- eISBN:
- 9780199850167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195181364.003.0009
- Subject:
- History, American History: 20th Century
The expansion of clinical service in the two decades following World War II created strains within academic medical centers, largely because of the distractions that patient care inevitably placed on ...
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The expansion of clinical service in the two decades following World War II created strains within academic medical centers, largely because of the distractions that patient care inevitably placed on teaching and research. Nevertheless, few academic medical centers lost sight—at least for long—of their unique role as educators of future physicians, and as producers of new medical knowledge and technologies. They worked hard to preserve the learning environment of the teaching hospital, even as that environment came under pressure from changing social, economic, and demographic circumstances. After the war, the strength of American medicine continued to reside in its academic medical centers—the collaborations of medical schools and teaching hospitals that generated knowledge, produced doctors, served as the ultimate arbiters in complicated clinical cases, and defined the standards of excellence in patient care.Less
The expansion of clinical service in the two decades following World War II created strains within academic medical centers, largely because of the distractions that patient care inevitably placed on teaching and research. Nevertheless, few academic medical centers lost sight—at least for long—of their unique role as educators of future physicians, and as producers of new medical knowledge and technologies. They worked hard to preserve the learning environment of the teaching hospital, even as that environment came under pressure from changing social, economic, and demographic circumstances. After the war, the strength of American medicine continued to reside in its academic medical centers—the collaborations of medical schools and teaching hospitals that generated knowledge, produced doctors, served as the ultimate arbiters in complicated clinical cases, and defined the standards of excellence in patient care.
Kenneth M. Ludmerer
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195181364
- eISBN:
- 9780199850167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195181364.003.0002
- Subject:
- History, American History: 20th Century
Typically regarded as a quiet time in American medical education, the interwar period was in fact highly dynamic. Medical research advanced and medical schools grew in size, wealth, and complexity. ...
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Typically regarded as a quiet time in American medical education, the interwar period was in fact highly dynamic. Medical research advanced and medical schools grew in size, wealth, and complexity. The values associated with the Flexnerian revolution became generalized—particularly the commitment of medical schools to research. If American medical schools after World War II were to grow so large as to dwarf pre-World War II medical schools, that was because a solid institutional infrastructure was already in place that could effectively utilize the massive infusion of federal and private funds.Less
Typically regarded as a quiet time in American medical education, the interwar period was in fact highly dynamic. Medical research advanced and medical schools grew in size, wealth, and complexity. The values associated with the Flexnerian revolution became generalized—particularly the commitment of medical schools to research. If American medical schools after World War II were to grow so large as to dwarf pre-World War II medical schools, that was because a solid institutional infrastructure was already in place that could effectively utilize the massive infusion of federal and private funds.
Russell K. Portenoy and Eduardo Bruera
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195130652
- eISBN:
- 9780199999842
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195130652.003.0020
- Subject:
- Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
This chapter reviews the barriers and opportunities to changing end-of-life care within the medical school environment. The academic medical center represents the pinnacle of modern medical ...
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This chapter reviews the barriers and opportunities to changing end-of-life care within the medical school environment. The academic medical center represents the pinnacle of modern medical achievement over the past 100 years. Unfortunately, until very recently academic medical centers have ignored death as a life-cycle event and the attendant education and clinical care issues and opportunities. The discussion suggests that the time is at hand to make major reforms in how physicians view end-of-life care, a view that must begin within the academic center. In particular, promoting faculty development, new education and evaluation initiatives, interdisciplinary education, and basic and clinical research has the potential to greatly improve end-of-life care. These changes require commitment and vision on the part of medical center leaders, hospital administrators, and senior faculty.Less
This chapter reviews the barriers and opportunities to changing end-of-life care within the medical school environment. The academic medical center represents the pinnacle of modern medical achievement over the past 100 years. Unfortunately, until very recently academic medical centers have ignored death as a life-cycle event and the attendant education and clinical care issues and opportunities. The discussion suggests that the time is at hand to make major reforms in how physicians view end-of-life care, a view that must begin within the academic center. In particular, promoting faculty development, new education and evaluation initiatives, interdisciplinary education, and basic and clinical research has the potential to greatly improve end-of-life care. These changes require commitment and vision on the part of medical center leaders, hospital administrators, and senior faculty.
Noralou P. Roos, Marni Brownell, and Verena Menec
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195179200
- eISBN:
- 9780199864539
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195179200.003.0006
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter aims to answer the question: What role does medical care play in determining population health? The Canadian health care system, with its universal medical care coverage, provides an ...
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This chapter aims to answer the question: What role does medical care play in determining population health? The Canadian health care system, with its universal medical care coverage, provides an important opportunity for assessing the impact of medical care on health. This chapter presents the findings of research examining this question in the province of Manitoba in a study that spans ten years, and reviews existing evidence on the relation between socioeconomic disparities, health care use, and health. It concludes that while a universal health care system is definitely the right policy tool for delivering care to those in need, investments in health care should not be confused with policies whose primary intent is to improve population health or reduce inequalities in health.Less
This chapter aims to answer the question: What role does medical care play in determining population health? The Canadian health care system, with its universal medical care coverage, provides an important opportunity for assessing the impact of medical care on health. This chapter presents the findings of research examining this question in the province of Manitoba in a study that spans ten years, and reviews existing evidence on the relation between socioeconomic disparities, health care use, and health. It concludes that while a universal health care system is definitely the right policy tool for delivering care to those in need, investments in health care should not be confused with policies whose primary intent is to improve population health or reduce inequalities in health.
William A. Silverman
- Published in print:
- 1999
- Published Online:
- September 2009
- ISBN:
- 9780192630889
- eISBN:
- 9780191723568
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192630889.003.0018
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter presents a 1991 commentary on the costs of medical care. It addresses the question: Can we afford miracle medicine's full cost, given that it involves an enormous outlay of community ...
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This chapter presents a 1991 commentary on the costs of medical care. It addresses the question: Can we afford miracle medicine's full cost, given that it involves an enormous outlay of community resources and long-term social consequences? It uses the US as an example to illustrate the financial crisis with respect to medical care.Less
This chapter presents a 1991 commentary on the costs of medical care. It addresses the question: Can we afford miracle medicine's full cost, given that it involves an enormous outlay of community resources and long-term social consequences? It uses the US as an example to illustrate the financial crisis with respect to medical care.
Jerome P. Kassirer
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195300048
- eISBN:
- 9780199850518
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195300048.001.0001
- Subject:
- Economics and Finance, Economic Systems
We all know that doctors accept gifts from drug companies, ranging from pens and coffee mugs to free vacations at luxurious resorts. But as this book exposes, these innocuous-seeming gifts are just ...
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We all know that doctors accept gifts from drug companies, ranging from pens and coffee mugs to free vacations at luxurious resorts. But as this book exposes, these innocuous-seeming gifts are just the tip of an iceberg that is distorting the practice of medicine and jeopardizing the health of millions of Americans today. This book offers an unsettling look at the pervasive payoffs that physicians take from big drug companies and other medical suppliers, arguing that the billion-dollar onslaught of industry money has deflected many physicians' moral compasses and directly impacted the everyday care we receive from the doctors and institutions we trust most. Underscored by countless chilling untold stories, the book illuminates the financial connections between the wealthy companies that make drugs and the doctors who prescribe them. The book details the shocking extent of these financial enticements and explains how they encourage bias, promote dangerously misleading medical information, raise the cost of medical care, and breed distrust.Less
We all know that doctors accept gifts from drug companies, ranging from pens and coffee mugs to free vacations at luxurious resorts. But as this book exposes, these innocuous-seeming gifts are just the tip of an iceberg that is distorting the practice of medicine and jeopardizing the health of millions of Americans today. This book offers an unsettling look at the pervasive payoffs that physicians take from big drug companies and other medical suppliers, arguing that the billion-dollar onslaught of industry money has deflected many physicians' moral compasses and directly impacted the everyday care we receive from the doctors and institutions we trust most. Underscored by countless chilling untold stories, the book illuminates the financial connections between the wealthy companies that make drugs and the doctors who prescribe them. The book details the shocking extent of these financial enticements and explains how they encourage bias, promote dangerously misleading medical information, raise the cost of medical care, and breed distrust.
John Knight and Lina Song
- Published in print:
- 1999
- Published Online:
- October 2011
- ISBN:
- 9780198293309
- eISBN:
- 9780191684975
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198293309.003.0005
- Subject:
- Economics and Finance, South and East Asia, Development, Growth, and Environmental
This chapter states that the fulfilment of such basic needs such as freedom from illness, malnutrition, and premature death may well be correlated with income, but that this relationship is unlikely ...
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This chapter states that the fulfilment of such basic needs such as freedom from illness, malnutrition, and premature death may well be correlated with income, but that this relationship is unlikely to be close. It also states that the capability of people to live long and healthy lives is an important aspect of welfare, but that this is not measured by the income they receive. It is also stated in the chapter that many major health hazards in developing countries with rather high mortality rates now have inexpensive solutions. The chapter goes on to discuss the institutional divide of medical health care in China, as well as the health-care provision and access distribution between rural and urban China. It then discusses the health-care finances available and the health outcomes in the country.Less
This chapter states that the fulfilment of such basic needs such as freedom from illness, malnutrition, and premature death may well be correlated with income, but that this relationship is unlikely to be close. It also states that the capability of people to live long and healthy lives is an important aspect of welfare, but that this is not measured by the income they receive. It is also stated in the chapter that many major health hazards in developing countries with rather high mortality rates now have inexpensive solutions. The chapter goes on to discuss the institutional divide of medical health care in China, as well as the health-care provision and access distribution between rural and urban China. It then discusses the health-care finances available and the health outcomes in the country.
MARTIN L. BROWN and K. ROBIN YABROFF
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195149616
- eISBN:
- 9780199865062
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195149616.003.0012
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter discusses the economic impact of cancer in the United States. Three categories of cost domains are identified: direct costs, resulting from the use of resources for medical care; ...
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This chapter discusses the economic impact of cancer in the United States. Three categories of cost domains are identified: direct costs, resulting from the use of resources for medical care; indirect costs, resulting from the loss of economic resources and opportunities associated with disease and treatment; and psychosocial costs, such as pain and suffering. The measurement of health care costs, source of data on the costs of medical care, and approaches to estimating the economic burden of cancer are discussed.Less
This chapter discusses the economic impact of cancer in the United States. Three categories of cost domains are identified: direct costs, resulting from the use of resources for medical care; indirect costs, resulting from the loss of economic resources and opportunities associated with disease and treatment; and psychosocial costs, such as pain and suffering. The measurement of health care costs, source of data on the costs of medical care, and approaches to estimating the economic burden of cancer are discussed.
Jane Whittle and Elizabeth Griffiths
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199233533
- eISBN:
- 9780191739330
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199233533.003.0004
- Subject:
- History, British and Irish Early Modern History
Food and other household consumables such as cleaning products and fuel have been neglected in the history of consumption. The Le Strange accounts include kitchen accounts which record the food ...
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Food and other household consumables such as cleaning products and fuel have been neglected in the history of consumption. The Le Strange accounts include kitchen accounts which record the food acquired and consumed on a week-by-week basis. This chapter uses the kitchen accounts to reconstruct the normal diet of the household, before moving on to examine the meanings of food through seasonal variations, comparisons with cookery-book recipes, and the differences between the food eaten by the gentry and their servants. Medicines had much in common with food, falling within women’s sphere in the first instance. But medical care also relied on male specialists and printed literature. Finally the provision of lighting, fuel and cleaning products is examined.Less
Food and other household consumables such as cleaning products and fuel have been neglected in the history of consumption. The Le Strange accounts include kitchen accounts which record the food acquired and consumed on a week-by-week basis. This chapter uses the kitchen accounts to reconstruct the normal diet of the household, before moving on to examine the meanings of food through seasonal variations, comparisons with cookery-book recipes, and the differences between the food eaten by the gentry and their servants. Medicines had much in common with food, falling within women’s sphere in the first instance. But medical care also relied on male specialists and printed literature. Finally the provision of lighting, fuel and cleaning products is examined.
Eli Ginzberg
- Published in print:
- 2000
- Published Online:
- October 2013
- ISBN:
- 9780300082326
- eISBN:
- 9780300133011
- Item type:
- book
- Publisher:
- Yale University Press
- DOI:
- 10.12987/yale/9780300082326.001.0001
- Subject:
- Sociology, Social Stratification, Inequality, and Mobility
Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based ...
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Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based hospitals have largely ignored the medical care of their poor neighbors. Now one of the leading experts in American health policy and economics ponders whether current and proposed changes in the financing and delivery of medical care will result in a realignment between AHCs and the poor. Basing the discussion on an analysis of the nation's twenty-five leading research-oriented health centers, this book traces the history of AHCs in the twentieth century. It claims that AHCs are once again moving toward treating the poor because these hospitals need to admit more Medicaid patients to fill their empty beds, and their medical students need opportunities to practice in ambulatory sites. It also assesses some of the more important trends that may challenge the AHCs, including financial concerns, changing medical practice environments, and the likelihood of some form of universal health insurance.Less
Academic health centers (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based hospitals have largely ignored the medical care of their poor neighbors. Now one of the leading experts in American health policy and economics ponders whether current and proposed changes in the financing and delivery of medical care will result in a realignment between AHCs and the poor. Basing the discussion on an analysis of the nation's twenty-five leading research-oriented health centers, this book traces the history of AHCs in the twentieth century. It claims that AHCs are once again moving toward treating the poor because these hospitals need to admit more Medicaid patients to fill their empty beds, and their medical students need opportunities to practice in ambulatory sites. It also assesses some of the more important trends that may challenge the AHCs, including financial concerns, changing medical practice environments, and the likelihood of some form of universal health insurance.
Kenneth M. Ludmerer
- Published in print:
- 2005
- Published Online:
- October 2011
- ISBN:
- 9780195181364
- eISBN:
- 9780199850167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195181364.003.0007
- Subject:
- History, American History: 20th Century
Medical schools had long been responsible for the quality of care rendered civilians, but during World War II they took direct responsibility for the military's medical care as well. The proportion ...
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Medical schools had long been responsible for the quality of care rendered civilians, but during World War II they took direct responsibility for the military's medical care as well. The proportion of faculty that enlisted in the armed services was much higher than that of the general profession. At the country's 52 general hospital units and 20 evacuation hospital units, the medical personnel, which numbered about 2,500, came almost entirely from academic medical centers. At home, schools were extremely short-staffed, but they nonetheless increased the production of doctors to meet both military and civilian needs. In addition, they conducted an extraordinary amount of war-related medical research, which enabled a dramatic reduction in death and suffering among troops in combat.Less
Medical schools had long been responsible for the quality of care rendered civilians, but during World War II they took direct responsibility for the military's medical care as well. The proportion of faculty that enlisted in the armed services was much higher than that of the general profession. At the country's 52 general hospital units and 20 evacuation hospital units, the medical personnel, which numbered about 2,500, came almost entirely from academic medical centers. At home, schools were extremely short-staffed, but they nonetheless increased the production of doctors to meet both military and civilian needs. In addition, they conducted an extraordinary amount of war-related medical research, which enabled a dramatic reduction in death and suffering among troops in combat.
Samiksha Sehrawat
- Published in print:
- 2013
- Published Online:
- January 2014
- ISBN:
- 9780198096603
- eISBN:
- 9780199082773
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198096603.003.0002
- Subject:
- History, History of Science, Technology, and Medicine
This chapter charts the growth and expansion of public medical infrastructure between 1880 and 1920. The number of hospitals and dispensaries increased dramatically over the twentieth century as did ...
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This chapter charts the growth and expansion of public medical infrastructure between 1880 and 1920. The number of hospitals and dispensaries increased dramatically over the twentieth century as did their popularity with patients, raising questions about how to fund this expanding network. The bulk of funding for these institutions came from local taxation and government grants despite attempts to encourage voluntary subscriptions and hospital fees. In contrast to the increasing involvement of the British government in medical care during this period, the colonial state sought to limit medical expenditure by devolving it to provincial administrations and restricted its role to fostering the voluntary and private sectors, which were expected to provide medical care for the Indian population. Nationalist politicians criticized this policy, and argued for increased state investment in medical care by reducing expenditure on the military and railways.Less
This chapter charts the growth and expansion of public medical infrastructure between 1880 and 1920. The number of hospitals and dispensaries increased dramatically over the twentieth century as did their popularity with patients, raising questions about how to fund this expanding network. The bulk of funding for these institutions came from local taxation and government grants despite attempts to encourage voluntary subscriptions and hospital fees. In contrast to the increasing involvement of the British government in medical care during this period, the colonial state sought to limit medical expenditure by devolving it to provincial administrations and restricted its role to fostering the voluntary and private sectors, which were expected to provide medical care for the Indian population. Nationalist politicians criticized this policy, and argued for increased state investment in medical care by reducing expenditure on the military and railways.
Nancy Tomes
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9781469622774
- eISBN:
- 9781469622798
- Item type:
- chapter
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/northcarolina/9781469622774.003.0011
- Subject:
- Public Health and Epidemiology, Public Health
This chapter focuses on what New York Times reporter Milt Freudenheim called “shopping mall medicine,” dedicated to providing quick and convenient service to patients every day of the week. It traces ...
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This chapter focuses on what New York Times reporter Milt Freudenheim called “shopping mall medicine,” dedicated to providing quick and convenient service to patients every day of the week. It traces the emergence of for-profit health care companies such as Humana and the Hospital Corporation of America and examines how they transformed the economic dynamics of medical care, particularly as they affected physicians. It also considers the rise of a new medical-industrial complex, financed in part by postwar funding for both hospitals and physicians, and some of its most visible elements, including health maintenance organizations. Finally, it examines other factors that dealt a blow to the medical profession's sense of autonomy, such as the Supreme Court's 1982 ruling for the Federal Trade Commission in its lawsuit against the American Medical Association over the issue of physician advertising.Less
This chapter focuses on what New York Times reporter Milt Freudenheim called “shopping mall medicine,” dedicated to providing quick and convenient service to patients every day of the week. It traces the emergence of for-profit health care companies such as Humana and the Hospital Corporation of America and examines how they transformed the economic dynamics of medical care, particularly as they affected physicians. It also considers the rise of a new medical-industrial complex, financed in part by postwar funding for both hospitals and physicians, and some of its most visible elements, including health maintenance organizations. Finally, it examines other factors that dealt a blow to the medical profession's sense of autonomy, such as the Supreme Court's 1982 ruling for the Federal Trade Commission in its lawsuit against the American Medical Association over the issue of physician advertising.
Samiksha Sehrawat
- Published in print:
- 2013
- Published Online:
- January 2014
- ISBN:
- 9780198096603
- eISBN:
- 9780199082773
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198096603.003.0004
- Subject:
- History, History of Science, Technology, and Medicine
This chapter examines the role of gender in shaping medical care for women in India. Orientalist essentializations about native women were reiterated in the construction of the zenana patient, whose ...
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This chapter examines the role of gender in shaping medical care for women in India. Orientalist essentializations about native women were reiterated in the construction of the zenana patient, whose observance of female seclusion was believed to expose her to illness and suffering. The Dufferin Fund epitomized colonial ideals of medical philanthropy and provided zenana medical care by supplying female doctors for Indian women. The difficulties of subsuming all Indian women in the figure of the zenana patient were exposed when zenana medical care had to accommodate patients who did not practise purdah. As a quasi-governmental organization, the Fund was closely linked to the colonial state through vicereines acting as incorporated wives. The growing importance of female medical experts, represented by the Association of Medical Women in India, marked a shift from maternal imperialism to feminization of the empire, with demands for state involvement in providing medical care for Indian women.Less
This chapter examines the role of gender in shaping medical care for women in India. Orientalist essentializations about native women were reiterated in the construction of the zenana patient, whose observance of female seclusion was believed to expose her to illness and suffering. The Dufferin Fund epitomized colonial ideals of medical philanthropy and provided zenana medical care by supplying female doctors for Indian women. The difficulties of subsuming all Indian women in the figure of the zenana patient were exposed when zenana medical care had to accommodate patients who did not practise purdah. As a quasi-governmental organization, the Fund was closely linked to the colonial state through vicereines acting as incorporated wives. The growing importance of female medical experts, represented by the Association of Medical Women in India, marked a shift from maternal imperialism to feminization of the empire, with demands for state involvement in providing medical care for Indian women.
Samiksha Sehrawat
- Published in print:
- 2013
- Published Online:
- January 2014
- ISBN:
- 9780198096603
- eISBN:
- 9780199082773
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198096603.001.0001
- Subject:
- History, History of Science, Technology, and Medicine
This meticulously researched book traces the introduction of colonial medical care, and its rapid expansion between 1840 and 1920. By funding medical care, the colonial state forged a new ...
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This meticulously researched book traces the introduction of colonial medical care, and its rapid expansion between 1840 and 1920. By funding medical care, the colonial state forged a new relationship between health and governance that raised many questions. How was medical care to be funded? Was the state responsible for providing medical care? What role were the voluntary and private sectors to play? The colonial state sought to transplant British forms of medical philanthropy to India. Participation in voluntarism and a public associational culture associated with medical philanthropy were meant to improve Indian society. Over the twentieth century, as the British state moved towards acknowledging the importance of medical care in India, the colonial state used decentralization to limit medical expenditure. Government and municipal expenditure on public medical infrastructure led to increasing acceptance of Western medicine by Indian patients and popularity of surgical specializations, but neglected rural patients. This book—a first of its kind—examines how gender and ethnicity shaped colonial hospitals in north India. The characterization of Indian society as irrational and bound to custom shaped the construction of both male and female patients. The failure of the Dufferin Fund to raise sufficient funds for a Women’s Medical Service exposed the limitations of the government’s reliance on the voluntary sector for medical provision. Reform of army hospitals was also stalled by prioritizing economy over efficiency. The underfunding of colonial medical care left a legacy of poor medical provision, regional disparities, and over-reliance on the private and voluntary sectors.Less
This meticulously researched book traces the introduction of colonial medical care, and its rapid expansion between 1840 and 1920. By funding medical care, the colonial state forged a new relationship between health and governance that raised many questions. How was medical care to be funded? Was the state responsible for providing medical care? What role were the voluntary and private sectors to play? The colonial state sought to transplant British forms of medical philanthropy to India. Participation in voluntarism and a public associational culture associated with medical philanthropy were meant to improve Indian society. Over the twentieth century, as the British state moved towards acknowledging the importance of medical care in India, the colonial state used decentralization to limit medical expenditure. Government and municipal expenditure on public medical infrastructure led to increasing acceptance of Western medicine by Indian patients and popularity of surgical specializations, but neglected rural patients. This book—a first of its kind—examines how gender and ethnicity shaped colonial hospitals in north India. The characterization of Indian society as irrational and bound to custom shaped the construction of both male and female patients. The failure of the Dufferin Fund to raise sufficient funds for a Women’s Medical Service exposed the limitations of the government’s reliance on the voluntary sector for medical provision. Reform of army hospitals was also stalled by prioritizing economy over efficiency. The underfunding of colonial medical care left a legacy of poor medical provision, regional disparities, and over-reliance on the private and voluntary sectors.
Valorie A. Crooks, Jeremy Snyder, Leigh Turner, Krystyna Adams, Rory Johnston, and Victoria Casey
- Published in print:
- 2013
- Published Online:
- May 2013
- ISBN:
- 9780199917907
- eISBN:
- 9780199332878
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199917907.003.0003
- Subject:
- Law, Medical Law
This chapter provides a media content analysis of Canadian print media depictions of medical tourism. It describes how the lack of reliable information in these sources about the numbers and ...
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This chapter provides a media content analysis of Canadian print media depictions of medical tourism. It describes how the lack of reliable information in these sources about the numbers and motivations of Canadians traveling abroad for care, and about how the public-health and resource-allocation effects of this practice domestically and abroad, have hindered a balanced and informed public discussion of the ethical issues raised by medical tourism. Fifty-nine articles are included in this media analysis. The analysis shows that Canadian print news media articles identify various factors employed to explain why Canadian patients go abroad for private medical care. The Canadian news media accounts of medical tourism address ethical issues linked to the quality of care and patient safety at international health care facilities. Finally, the significances for future Canadian media coverage of medical tourism are reviewed.Less
This chapter provides a media content analysis of Canadian print media depictions of medical tourism. It describes how the lack of reliable information in these sources about the numbers and motivations of Canadians traveling abroad for care, and about how the public-health and resource-allocation effects of this practice domestically and abroad, have hindered a balanced and informed public discussion of the ethical issues raised by medical tourism. Fifty-nine articles are included in this media analysis. The analysis shows that Canadian print news media articles identify various factors employed to explain why Canadian patients go abroad for private medical care. The Canadian news media accounts of medical tourism address ethical issues linked to the quality of care and patient safety at international health care facilities. Finally, the significances for future Canadian media coverage of medical tourism are reviewed.
