J Adv Nurs. 1990 Apr;15(4):487-97. doi: 10.1111/j.1365-2648.1990.tb01844.x.

The politics of American health care.

Journal of advanced nursing

J P Smith

PMID: 2187917 DOI: 10.1111/j.1365-2648.1990.tb01844.x

Abstract

The developments leading to the present American health care organization are traced. It is clear that hospitals have dominated at the expense of primary health care programmes. Health care costs have soared dramatically. There are particular problems inherent in a system shared between federal and state governments and a private health care industry. Attempts to provide a fully (or partially) tax-funded health service in the USA have been bedevilled by a number of factors. These include opposition from labour unions, politicians, vested-interest groups and, in particular, the American Medical Association. As part of its opposition, the AMA politicized itself in 1950. But, in the political literature, American nurses are not portrayed as being very politically active. Reasons for this are explored. The introduction of Medicare and Medicaid programmes is discussed and the legal, social and political implications. Recent attempts in the USA to control costs are assessed and new trends and new problems identified.

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MeSH terms

• American Medical Association
• American Nurses' Association
• Capital Expenditures
• Cost Control
• Delivery of Health Care / economics
• Delivery of Health Care / legislation & jurisprudence
• Delivery of Health Care / standards
• Humans
• Labor Unions
• Lobbying
• Medicare
• National Health Insurance, United States
• Politics*
• Public Policy
• United States

Publication Types

• Journal Article

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