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Modern Colonization by Medical Intervention adds to our understanding of the political and economic transformations establishing colonial modernity in Puerto Rico. By focusing on influential physicians’ clinical work and their access to a remote and inaccessible rural population, this volume details how rural areas suffered the ravages of social dislocation, unemployment and hunger. The colonial administration’s hookworm campaign involved many Puerto Rican physicians in complex struggles with other elites, rural peasants and U.S. colonial administrators for political legitimacy. Puerto Rican physicians did not gain the professional autonomy their counterparts in the United States enjoyed. Instead, they became centrally implicated in the struggle between labor and capital enforcing the island’s subordination to a colonial modernity and the development of capitalism on the island.
The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms public and private, and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, regionalization in the 1970s, or defining civil rights and equity as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional public role of the largely private medical profession. Section V returns to the ambiguous public-priv
This timely volume illustrates how and why the fight against quackery in modern America has largely failed, laying the blame on an unlikely confluence of scientific advances, regulatory reforms, changes in the medical profession, and the politics of consumption. Throughout the 20th century, anti-quackery crusaders investigated, exposed, and attempted to regulate allegedly fraudulent therapeutic approaches to health and healing under the banner of consumer protection and a commitment to medical science. Quack Medicine: A History of Combating Health Fraud in Twentieth-Century America reveals how efforts to establish an exact border between quackery and legitimate therapeutic practices and medications have largely failed, and details the reasons for this failure. Digging beneath the surface, the book uncovers the history of allegedly fraudulent therapies including pain medications, obesity and asthma cures, gastrointestinal remedies, virility treatments, and panaceas for diseases such as arthritis, asthma, diabetes, and HIV/AIDS. It shows how efforts to combat alleged medical quackery have been connected to broader debates among medical professionals, scientists, legislators, businesses, and consumers, and it exposes the competing professional, economic, and political priorities that have encouraged the drawing of arbitrary, vaguely defined boundaries between good medicine and "quack medicine."
The unique composition and configuration of doctors and hospitals in the US is leading to a crisis in primary care provision. There are significantly more specialists than generalists, and many community hospitals and outpatient facilities are concentrated in affluent areas with high rates of comprehensive insurance coverage. These particular features present difficult challenges to policymakers seeking to increase access to care. Carl F. Ameringer shows why the road to universal healthcare is not built on universal finance alone. Policymakers in other countries successfully align finance with delivery to achieve better access, lower costs, and improved population health. This book explains how the US healthcare system developed, and why efforts to expand insurance coverage in the absence of significant changes to delivery will fuel higher costs without achieving the desired results.
The American Disease is a classic study of the development of drug laws in the United States. Supporting the theory that Americans' attitudes toward drugs have followed a cyclic pattern of tolerance and restraint, author David F. Musto examines the relationz between public outcry and the creation of prohibitive drug laws from the end of the Civil War up to the present. Originally published in 1973, and then in an expanded edition in 1987, this third edition contains a new chapter and preface that both address the renewed debate on policy and drug legislation from the end of the Reagan administration to the current Clinton administration. Here, Musto thoroughly investigates how our nation has dealt with such issues as the controversies over prevention programs and mandatory minimum sentencing, the catastrophe of the crack epidemic, the fear of a heroin revival, and the continued debate over the legalization of marijuana.
Divided Legacy (Vols. I-IV) is a history of Western medical philosophy from the time of Hippocrates to the twentieth century, treating it as a unified system of thought rather than a series of fortuitous discovers. Dr. Coulter interprets the development of medical ideas as the product of a conflict between two opposed systems of thought, Empiricism and Rationalism. This third volume of Divided Legacy continues the account of the conflict between the Empirical and the Rationalist approaches to therapeutics but introduces a socio-economic dimension which had earlier been lacking. In the early nineteenth century, Samuel Hahnemann’s formulation of the Empirical therapeutic doctrine, which he called homeopathy. It flourished especially in the United States. This volume traces the history of the rise and decline of this formulation of Empirical therapeutics in the nineteenth century United States. It analyzes the interaction between the homeopathic doctrines and those of the orthodox school and attempts to illustrate the influence of socio-economic constraints on the movement of medical thought during this period.