The impact of health economics on health policy in England, and the impact of health policy on health economics, 1972-1997

This paper contains a review of the impact of health economics on health policy in England during the past 25 years. Some health economists have expressed disappointment with the scale of the impact that health economics has had on policy but the record set out below suggests that there is modest cause for celebration. That is not to say that there is cause for complacency. There is still a long way to go before all important health policies are based on sound economics reasoning and evidence. The paper begins with some definitions and background; it covers nine areas of health policy, and health policy making, where past impacts of health economics have been postulated; it covers briefly the reciprocal impact of health policy on health economics; and it concludes with a discussion about the findings.

History of federal legislation in health professions educational assistance in dental public health, 1956-97

Health professions education assistance in dental public health has been congressionally authorized in one form or another during the last four decades. The US Department of Health and Human Services (and its predecessor, the Department of Health, Education, and Welfare) has been a focal point for managing these federal programs. This report tracks the history of relevant national legislation, beginning in the 1950s with the Health Amendment Acts of 1956 and continuing most recently with the Health Professions Education Extension Amendments of 1992. The number of dental public health professionals trained and available to provide expertise and leadership to improve community oral health status has been tied to the presence and intensity of federal programming in this area.

Funding Melbourne's hospitals: some historical moments

In 1993 the Victorian Government introduced casemix funding as part of its restructure of the public hospital system. Casemix funding provides a new basis for government funding according to outcomes. At the same time, restructure of hospitals allows for a reconsideration of who is eligible to use them. Historical research into the growth of the public hospital system in Melbourne shows that attempts to reform the hospital system are as old as the system itself. This paper argues that the views of hospitals in funding crises and the solutions that are recommended have more to do with the politics of the day than the economics of running hospitals.

From piety to platitudes to pork: the changing politics of health workforce policy

Policy to subsidize the education of health professionals in the United States has become contentious and uncertain. This article examines the politics of workforce policy in the twentieth century, emphasizing the years since World War II. From early in the century until the 1970s, most decision makers viewed policy to subsidize the education of health professionals as self-evidently correct. As consensus eroded, proponents insisted to increasingly skeptical audiences that these subsidies created benefits for the public. Recently, decision makers outside health care institutions have come to regard workforce policy as serving particular rather than general interests. Thus health workforce policy, like other policies outside of health affairs, may be said, perhaps oversimply but not inaccurately, to have gone through three stages: from piety to platitudes to pork.

A brief history of federal financing for child care in the United States

Over the past 60 years, the federal government has provided funding for child care and early education programs in fits and starts. Funding has fluctuated in amount and purpose, with the result that today's child care financing system is a confused collection of funding streams with no uniform goals, standards, or administrative structure. This article traces the history of federal funding for child care and early education programs in the United States and examines how the values of American society have shaped the federal funding of child care and early education services.

The development of the Hill-Burton legislation: interests, issues and compromises

The Hill-Burton Hospital Survey and Construction Act has its roots in the social health and welfare programs of the New Deal. This paper traces its development and the positions of three groups-the hospital industry, the U.S. Public Health Service, and the Senate Subcommittee on Wartime Health and Education-on four issues: the nature of federal funding to states, the use of public funds by private hospitals, the oversight powers of a Federal Hospital Council, and health services for the poor. The analysis involves two lines of thought: the political strategy of incrementalism and the roles of the three interest groups in reaching compromises to quickly pass an "unsponsored" bill. Relevance to the current effort to pass a single payer national health insurance is explored.

Commitment to a world without cancer

The author is a layperson, health educator, and political oncologist who is, in addition to her work at the cancer center at UCLA, a long-time volunteer with the American Cancer Society. She has served the National Cancer Institute as a member of the National Cancer Advisory Board and is currently a member of its Board of Scientific Counselors, Division of Cancer Control. In these various roles she was part of the lay leadership that influenced and cooperated with the Nixon administration in its efforts to pass the National Cancer Act of 1971. She has participated continually in the implementation of the National Cancer Program and Act since 1971. This essay reviews the history of our nation's support of cancer research, commencing with the founding of the American Cancer Society. It considers the factors that led to the passage of the National Cancer Act in 1971. It then comments on the interaction between universities, the National Cancer Institute, and the Cancer Act, which has produced the "cancer business" that has come of age since the Cancer Act was passed. This commentary does not review the advances made in research and clinical practice as a result of the passage of the National Cancer Act of 1971. Others, better qualified, will do that in this journal and in other publications as well. These views are concerned with the process, the systems, and ancillary activities that have developed as a consequence of the national will to conquer cancer. They are meant to highlight several portions of the whole. The "seeds" of cancer consciousness sown early by the American Cancer Society and those so firmly planted in research and in the creation of a national network of researchers, patient care institutions, and information systems by the National Cancer Institute and the National Cancer Program Plan and Act of 1971 have reaped a harvest of independent programs and even businesses that have given substance to the hopes of those seeking to achieve a world without cancer.

Federal legislative and regulatory impact on funding of nurse anesthesia education. Report of the National Commission on Nurse Anesthesia education

The history of the impact of federal legislation and regulations on funding for nurse anesthesia education is traced from 1965 to the present. Current funding restraints and a decline in nursing education programs suggest that it may be time to explore innovative ways of educating nurse anesthetists.

Church and society. developments during the Schwitalla years, 1928-1947

As CHA evolved and expanded in the 1930s, it became a more complex organization with wider responsibilities--and more intractable problems--than it had had before. The third article in the six-part Health Progress series on the history of CHA (April 1990) described the struggles of Rev. Alphonse M. Schwitalla, SJ, the association's second president, to develop effective CHA programs and policies on nursing education. CHA's relations with other national Catholic organizations, the growth and eventual autonomy of its Canadian member hospitals, and its role as an advocate of federal healthcare legislation during the Depression and World War II are covered in this article. Next month's installment will describe CHA's modernization and expansion under the leadership of Rev. John J. Flanagan, SJ.