Community Health History Essay

Over the past couple of decades, the public health system has gained shape into what it portrays today. Over 150 years ago, the public health system has benefitted from scientific invention concerning knowledge of sources and the containment of diseases. In earlier, centuries, the society regarded illnesses with certain amounts of resignation and little was done regarding public action against the diseases (Shi & Singh, D. A., 2014). Later in the years, knowledge about the sources of contagions became available and diseases could now be controlled, leading to development of more effective interventions against threats to health.

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Apart from the discovery through scientific knowledge, the growth of public acceptance of disease control has also become a significant influence on the growth of public health systems. In the latter years, after discoveries made in health science, the society got the motivation to form public organizations and agencies, which would go ahead and employ newly discovered interventions against health threats (Shi & Singh, D. A., 2014). With the growth of scientific knowledge, came an expansion of the public organizations into performing new tasks, such as immunization, sanitization, and health education among others.

In the wake of the nineteenth century, came one of the most significant advancements in public health, in the form of the great sanitary awakening. In this period, filth was identified as a cause of disease as well as an agent of transmission. As a result, it was discovered that observance of cleanliness acted as a means of staying at bay from disease-causing agents (Shi & Singh, D. A., 2014). Sanitation, therefore, changed the thoughts of society on health and was embraced as a path to both physical and moral health.

As presented to the American people, the Affordable health care Act was supposed to be as a legitimate exercise of the power of Congress to regulate interstate commerce. However, as rewritten by Chief Justice John Roberts, the Act turned out to be as a tax (Amato, P. A., 2015). The federal government argued that the commerce clause, the tax clause and the necessary and proper clause authorized the health care mandate and citizens were supposed to buy insurance policies (Amato, P. A., 2015). Others, however, argued that failure to purchase insurance neither fell under commerce nor an interstate activity, but rather as an absence of commerce (Amato, P. A., 2015). The arguments were that the decision to do one thing relates to a decision not to do another thing altogether and, therefore, Congress ought not to be allowed to use the clause to regulate mere failure to buy insurance because such inaction has an economic effect.

Despite Medicare spending over $40,000 per decedent in the final year of life, the decedents represent only a small fraction of all Medicare beneficiaries. There are four different spending trajectories among decedents, with approximately 48% having high persistent spending, 29% moderate persistent expenditure, 10% having progressive spending and 12% having late rise spending. The high expenditure through the full final year before death is attributed to multiple chronic conditions developed by a high percentage of the decedents (Osborne, N. H., Nicholas, L. H., Ryan, A. M., Thumma, J. R., & Dimick, J. B. 2015).

Using 2016 data, it turns out that other OECD countries spend averagely just over half as much per person on health than the amount that the US spends. By 2016 US had the highest expenditure per capita, slightly above $10,000, while the UK had the least expenditure, only slightly above $4,000. On average, OECD countries spent just above $5,000 per capita on health (Polisena, J., Garritty, C., Kamel, C., Stevens, A., & Abou-Setta, A. M. 2015).

Conclusion

Advances in the health sector from the 1950s have reduced mortality, with post MI mortality reducing by close to 75%. However, with the advances, there is gradual but increasing cost in healthcare. Historically, there has been disparities between insured uninsured healthcare patients. Cost containment, where individuals are asked to for their own healthcare would lead to tiering of health care and thus increase the cost of healthcare services (Polisena, et al., 2015). With reducing death rates, and increasing life expectancy, there is possibility that the number of elderly individuals would increase further with time. Therefore, there would be a rapid increase in the funding for long-term care and development of alternative nursing homes. As a result, to cater for the long-term care, there would be a steady hike in the cost of health care as time passes by (Polisena, et al., 2015). Finally, continuous advancement in healthcare technology also affects the cost of healthcare. The health care system has to cater for research conducted to introduce new technologies that would improve the sector (Polisena, et al., 2015). Therefore, it is inevitable that the cost will increase, to provide extra funding for the innovations.

References

Amato, P. A. (2015). The Affordable Care Act: Impact on business. Northeastern University.

Osborne, N. H., Nicholas, L. H., Ryan, A. M., Thumma, J. R., & Dimick, J. B. (2015). Association of hospital participation in a quality reporting program with surgical outcomes and expenditures for Medicare beneficiaries. Jama, 313(5), 496-504.

Polisena, J., Garritty, C., Kamel, C., Stevens, A., & Abou-Setta, A. M. (2015). Rapid review programs to support health care and policy decision making: a descriptive analysis of processes and methods. Systematic reviews, 4(1), 26.

Shi, L., & Singh, D. A. (2014). Delivering health care in America. Jones & Bartlett Learning.