Sickness in slavery and freedom

Author(s):  
Shirley A. Hill

The health deficit of African Americans is explored in a historical context, starting with the abuse, poor treatment, and sub-standard medical care Blacks received during and after slavery. Segregation was the law of the land until the 1960s, and African Americans not only received marginal health care but faced significant barriers in access to medical schools. This chapter looks at the battle to end segregated medicine and the gradual acceptance of black people in medical schools and as members of the American Medical Association.

Author(s):  
Gunnar Almgren

This chapter provides a narrative of the complex origins of the American Exceptionalism in health care and the main impediments to the realization of health care as a social right afforded to all Americans. As the chapter discusses, at the heart of American Exceptionalism in health care is “The Great Unsustainable Compromise”, that is, a fragmented mixed-public and private system of health care finance and delivery that has been built around a subsidized employment-based insurance system with selective entitlements to health care for the poor and aged. After tracing the development of the Great Unsustainable Compromise from the demise of the Truman Plan in the late 1940's at the behest of the American Medical Association through the enactment of the Medicare and Medicaid entitlements in 1965, the chapter explains the seeds of its demise and its gradually unraveling over the final decades of the 20th century. In its concluding section, the chapter advances the arguments for the inevitability of the evolvement of the health care system to a publicly financed universal entitlement to comprehensive health care as a social right of citizenship.


1999 ◽  
Vol 27 (4) ◽  
pp. 366-379
Author(s):  
Melissa Ballengee

Ever since the U.S. Attorney General named health care fraud as the government's second highest priority after violent crime, the government has cracked down on health care fraud and abuse. Some of this crackdown has been needed. The General Accounting Office (GAO) estimates that as much as 10 percent of all government expenditures on health care are being siphoned out of the system because of fraud or abuse.The extreme measures taken to curb health care abuse have raised eyebrows, however. The American Medical Association and the American Hospital Association both have been vocal in their disapproval, describing the current enforcement initiative as “absolutely out of control.” The associations even went so far as to file suit to enjoin the government's actions.


2021 ◽  
Vol 35 (S1) ◽  
pp. 25-44 ◽  
Author(s):  
Claire D. Johnson ◽  
Bart N. Green

Objective This paper is the second in a series that explores the historical events surrounding the Wilk v American Medical Association (AMA) lawsuit in which the plaintiffs argued that the AMA, the American Hospital Association, and other medical specialty societies violated anti-trust law by restraining chiropractors' business practices. The purpose of this paper is to provide a brief review of the history of how the AMA rose to dominate health care in the United States, and within this social context, how the chiropractic profession fought to survive in the first half of the 20th century. Methods This historical research study used a phenomenological approach to qualitative inquiry into the conflict between regular medicine and chiropractic and the events before, during, and after a legal dispute at the time of modernization of the chiropractic profession. Our methods included obtaining primary and secondary data sources. The final narrative recount was developed into 8 papers following a successive timeline. This paper is the second of the series that explores the growth of medicine and the chiropractic profession. Results The AMA's code of ethics established in 1847 continued to direct organized medicine's actions to exclude other health professions. During the early 1900s, the AMA established itself as “regular medicine.” They labeled other types of medicine and health care professions, such as chiropractic, as “irregulars” claiming that they were cultists and quacks. In addition to the rise in power of the AMA, a report written by Abraham Flexner helped to solidify the AMA's control over health care. Chiropractic as a profession was emerging and developing in practice, education, and science. The few resources available to chiropractors were used to defend their profession against attacks from organized medicine and to secure legislation to legalize the practice of chiropractic. After years of struggle, the last state in the US legalized chiropractic 79 years after the birth of the profession. Conclusion In the first part of the 20th century, the AMA was amassing power as chiropractic was just emerging as a profession. Events such as publication of Flexner's report and development of the medical basic science laws helped to entrench the AMA's monopoly on health care. The health care environment shaped how chiropractic grew as a profession. Chiropractic practice, education, and science were challenged by trying to develop outside of the medical establishment. These events added to the tensions between the professions that ultimately resulted in the Wilk v AMA lawsuit.


2020 ◽  
Vol 25 (3) ◽  
pp. 3-11
Author(s):  
Christopher R. Brigham ◽  
Helene Fearon ◽  
Steven Feinberg ◽  
Barry Gelinas ◽  
David Langham ◽  
...  

Abstract Virtual independent medical evaluations (IMEs) have become and are likely to remain common even after the coronavirus disease 2019 (COVID-19) pandemic ends, but virtual health care and virtual examinations are not simply a matter of moving to a new platform—rather, they require a transformation that affects all stakeholders. Innovative solutions necessitated by virtual IMEs potentially can improve both quality and efficiency. The American Medical Association (AMA) defines telemedicine as health-related services that are synchronous and asynchronous and include a variety of tools and platforms that allow clinicians to connect with one another and patients (a box provides information about AMA's ongoing telehealth initiative). Physicians who plan to perform virtual evaluations must have the appropriate policies, procedures, and security in place; resources are available from the AMA Guides series of publications. Each component of the virtual IME, including each data element, should be assessed to determine best practices and how to use virtual technologies successfully. The credibility of virtual IMEs may hinge on the examiner's ability to explain both what was done and why it was as efficacious as an in-person alternative or perhaps as useful as any other alternative under the circumstances. One challenge is to master the tools used in virtual IMEs and another is to obtain stakeholders' acceptance of the virtual process, but this will come with time, experience, and effective physician performance.


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