Transcript The Role of the Medical Profession in Making Public Policy

The Role of the
Medical Profession
in Making Public
Policy
By Joseph R. Marbach, Ph.D.
Dean, College of Arts and Sciences
Seton Hall University
Introduction
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Historical overview of public policy
making in the United States
Public Health and Safety
Political Culture
American Political Culture
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Broad based participation by many
groups
Checks and Balances
Limited Government
“The government that governs
best, governs least.”
• Thomas Jefferson
Influence of the Medical
Profession on policy
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Limited due to nature of society
Expands due to
 Industrialization
 Urbanization
 Overpopulation
The Medical Profession
as Intetest Group
Medical Association – 1847
 New York Academy of Medicine – 1847
 American Pharmacists Association – 1852
 American Dental Association – 1859
 American Nursing Association – 1896
 American Hospital Association - 1898
 American
Role of Federalism
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States respond to domestic
problems
Response rate uneven
Laboratories of Democracy
Police Powers of Government
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New York City Metropolitan Board
of Health - 1866
New York State Department of
Health – 1901
U.S. Food and Drug Act – 1906
New York City Zoning Laws - 1916
Professionalization of
Health Care
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State regulation of Occupations
Delegation of occupational
standards to profession
Variations in standards by
individual states
New Jersey
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Opticians = Eye Glasses, No Contact Lenses
Optometrists = Eye Glasses + Contact Lenses
Ophthalmologists = Eye Glasses + Contact
Lenses + Surgery
Does this System Work Today?
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No
1770s – Minimimal Public Health
Concerns – Agraian Lifestyle
2000s – Globalization = Global
Public Health Concerns –
International Travel and Urban
Lifestyles
U.S. System
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2007 - $2 Trillion Spent on Health Care
$6,830/person
16% of GDP
2015 - $4 Trillion
$12,000/person
20% of GDP
U.S System
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46 Million Americans are uninsured
Since 2002 – 266,000 employers have
cut health coverage
US ranked 37th in mortality
(24th among Industtrial nations)
Solutions
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Reduce costs
Universal coverage