The Role of the Medical Profession in Making Public Policy

1
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

2
Introduction

• Historical overview of public policy making in
  the United States
• Public Health and Safety
• Political Culture

3
American Political Culture

• Broad based participation by many groups
• Checks and Balances
• Limited Government
• The government that governs best, governs
  least.
• Thomas Jefferson

4
Influence of the Medical Profession on policy

• Limited due to nature of society
• Expands due to
• Industrialization
• Urbanization
• Overpopulation

5
The Medical Profession as Intetest Group

• American 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

6
Role of Federalism

• States respond to domestic problems
• Response rate uneven
• Laboratories of Democracy

7
Police Powers of Government

• 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

8
Professionalization of Health Care

• State regulation of Occupations
• Delegation of occupational standards to
  profession
• Variations in standards by individual states

9
New Jersey

• Opticians Eye Glasses, No Contact Lenses
• Optometrists Eye Glasses Contact Lenses
• Ophthalmologists Eye Glasses Contact Lenses
  Surgery

10
Does this System Work Today?

• No
• 1770s Minimimal Public Health Concerns
  Agraian Lifestyle
• 2000s Globalization Global Public Health
  Concerns International Travel and Urban
  Lifestyles

11
U.S. System

• 2007 - 2 Trillion Spent on Health Care
• 6,830/person
• 16 of GDP
• 2015 - 4 Trillion
• 12,000/person
• 20 of GDP

12
U.S System

• 46 Million Americans are uninsured
• Since 2002 266,000 employers have cut health
  coverage
• US ranked 37th in mortality
• (24th among Industtrial nations)

13
Solutions

• Reduce costs
• Universal coverage