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Terms in this set (147)

-Physicans' professional sovereignty
--Physician power and income increased
- Transformation of the practice of Medicine
--urbanization: physicians can see more patients, less dependent on family members for care
-- growth of science and technology: radiology/x-rays
--institutionalization
-- dependency
-- autonomy and organization: hospitals grew, physicians can do surgery in hospitals and hospitals benefited because they filled beds.
--licensing: AMA approved schools to be licensed
--educational reform: school became harder with increased tech and more knowledge on medical practices
-specialization of medicine
-- Less focus on primary care and general practitioner: increase in expenditures
-Mental Health reforms
-- Veterans were coming back from and showed the need for mental health -- PTSD
--National Institute of Mental Health (1949): create a better understanding of mental health diseases
- Deinstitutionalization and community mental health in the 1960s
- Mental Health parity Laws (1996, 2008): equality in coverage between physical and mental illness, established insurance pays for mental illness
- Cures Act(2016)
-- improved mental health parity laws
-Focus on public health
-- urbanization and sanitation issues: Led to inadequate methods for waste disposal
-- Outbreaks of diseases such as cholera
-- developed separately from private health because it grew from the resistance that providers had from government regulation
-Provision of care for the veterans
-- establishment of hospitals, clinics, and nursing homes
Baylor plan- the birth of Blue Cross
-single hospital plan (Baylor Hospital)
-1,250 public school teachers enrolled
- Premium: $0.50/month for 21 days of care in hospital for hospital services (not physicians services)
All hospital plans
- rapid increase in all-hospital plans soon after Baylor started its insurance plan
-A plan including all community hospitals in Sacramento in 1932: benefit=choice
AHA Committee on Hospital Service in 1933
- Became AHA hospital service plan commission in 1936
-Became AHA blue cross commission in 1946
The first medical service plan (Blue Shield) was established in 1939- The California Physician's Service
-Free choice of physicians
- indemnity plan: choice of which physician to go to
-AMA began approving Blue Shield plans in 1939
Commercial Health Insurance
- joined later than Blue Cross because there was no actuarial success at the time
- in 1934, hospital indemnity coverage
-In 1938 surgical indemnity coverage
-By 1946, 14.3 million had commercial coverage, and 24.2 million had Blue Cross Coverage
Prepaid group practice
-Roos-Loos Clinic (1929), LA
- 2,000 workers and families of the LA Department of Water & Power
- Contracted with the clinic to provide comprehensive care
-Founders of Ross-Loos Clinic expelled from county medical society- denied hospital access
1933- Kaiser Foundation Health Plan established by Dr. Sidney Garfield
-License suspended for unprofessional conduct
- Was seen as commercialization in practice so AMA opposed it
- Early prepaid plans were then forced to build and use their own hospitals
The expansion of employer-sponsored insurance
- World war 2- wage/price controls; to decrease inflation employers, employers couldn't raise wages of workers but they could give people more benefits but not higher wages
-Taft-Hartley Act (1947)-health insurance subject to collective bargaining
- 1943 and 1954 tax rules- employer-sponsored health insurance not subject to federal income tax