Laura Porto-Roquett, Pharm, MPH
Ph.D. Student
Week 2 Healthcare
System. History and
more
History timeline
I M P O R TA N T D AT E S I N P U B L I C H E A LT H H I S T O RY
EARLIEST 18TH 19TH
CIVILIZATION CENTURY CENTURY
BEFORE 18 T H
1850 1854
CENTURY
Modern Era Father of the
of Public Modern
Health in the Epidemiolog
U.S. y
History timeline
I M P O R TA N T D AT E S I N P U B L I C H E A LT H H I S T O RY
1862 1856 1864 1872 1890 1891 1895
The 20th century
• Health resources development
• 1900-1920
• Pure Food and Drug Act (1906)
• Occupational disease (1910)
• Volunteer health agencies
• Nursing programs
• Public Health School
1920
• Prohibition
• Rural population with no health services
• Rise of the life expectancy (59.7 years)
The Great Depression and the World
The 20th War II
• Precarious health situation
century • President Franklin Roosevelt’s agencies and
programs
• Social Security Act
Postwar years
• National Hospital Survey and Construction
Act
• More vaccines and medicines
The 20th
century
• Period of Social Engineering
• Medical advances…
• Medicare and Medicaid bills
• Health Promotion (1974-present)
• Lalonde report in Canada A
New Perspective on the
Health of Canadians
• The Health Information and
Health Promotion Act. –
Office of Disease Prevention
and Health Promotion.
• Lifestyles or health
behaviors as an explanation
for almost 50% of the
premature death.
• Healthy People
The 21st
century
• Some current problems:
• Healthcare cost
• Environmental concerns
• Lifestyle diseases
• Communicable disease
• Substance abuse
• Disasters
Healthcare in the US
• Prior to 1870
• Medical Education?
• More a trade than a profession
• Home Delivered
• Hospitals
• Almshouses (poorhouses)
• Pesthouses
Healthcare in the US
• The Hospital Survey and Construction Act of 1946
• Improved procedures, equipment, and facilities +
increase in noncommunicable diseases…
• 1960 and insurance
• Third-party payment system
• 1965 Medicare and Medicaid
Healthcare in
the US
• Managed care
• Financing
• Insurance
• Delivery
• Payment
• State Children’s Health
Insurance Program (CHIP)
• Medicare Prescription
Drug
Healthcare in the
US
• CHIP Reauthorization Act
• Patient Protection and Affordable
Care Act
• Health Care and Education
Reconciliation Act.
• Expansion of public programs
• Health insurance marketplace
• Changes to private insurance.
• Employer responsibility
provision
Types of US health
Insurance
Public coverage
The
Affordable
Care Act
(2010)
Lack of coverage
Three in 10 uninsured adults in 2019 went without
needed medical care due to cost.
Uninsured people are less likely to receive preventive
care and services for major health conditions and
chronic diseases
Billions in charity care each year
Lower productivity, increased rates of communicable
diseases, and higher insurance premiums
