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  • Author: Ronald Hamowy
  • Publication Date: 03-2010
  • Content Type: Policy Brief
  • Institution: Independent Institute
  • Abstract: Prior to World War I, the federal government effectively provided no hospital or medical care to veterans other than extending domiciliary care to a few veterans disabled while in service. With American entry into World War I, however, it was decided to extend the treatment accorded members of the armed forces who were receiving hospital care after they had been mustered out. As a consequence the Veterans Bureau was created in 1921. In 1930 a new agency, the Veterans Administration (VA), took over responsibility for all veterans\' affairs. Following World War II and the passage of a comprehensive GI Bill that included generous medical and hospital care for returning soldiers, the VA rapidly expanded to the point whereby it established itself as the largest supplier of health care in the nation. For most of the period since the end of World War II these medical facilities were plagued by waste, poor management, and negligence. While it is true that conditions at VA facilities have improved since the late 1980s, they still lag behind those that obtain at the nation\'s voluntary hospitals. The shift from inpatient to ambulatory care, an increase in chronic care needs in an aging population, and increases in the demand for medical services as a result of the most recent Middle Eastern conflicts clearly undermines the reason originally put forward to operate a direct health care system. However, given the pressures put upon Congress by the American Legion and other veterans groups, it is unlikely that the United States will follow the lead of the governments of Australia, Canada, and the United Kingdom and close or convert their hospitals to other uses and integrate the treatment of veterans into the general heath-care system.Prior to World War I, the federal government effectively provided no hospital or medical care to veterans other than extending domiciliary care to a few veterans disabled while in service. With American entry into World War I, however, it was decided to extend the treatment accorded members of the armed forces who were receiving hospital care after they had been mustered out. As a consequence the Veterans Bureau was created in 1921. In 1930 a new agency, the Veterans Administration (VA), took over responsibility for all veterans\' affairs. Following World War II and the passage of a comprehensive GI Bill that included generous medical and hospital care for returning soldiers, the VA rapidly expanded to the point whereby it established itself as the largest supplier of health care in the nation. For most of the period since the end of World War II these medical facilities were plagued by waste, poor management, and negligence. While it is true that conditions at VA facilities have improved since the late 1980s, they still lag behind those that obtain at the nation\'s voluntary hospitals. The shift from inpatient to ambulatory care, an increase in chronic care needs in an aging population, and increases in the demand for medical services as a result of the most recent Middle Eastern conflicts clearly undermines the reason originally put forward to operate a direct health care system. However, given the pressures put upon Congress by the American Legion and other veterans groups, it is unlikely that the United States will follow the lead of the governments of Australia, Canada, and the United Kingdom and close or convert their hospitals to other uses and integrate the treatment of veterans into the general heath-care system.
  • Topic: Government, Health
  • Political Geography: United States, United Kingdom, Canada, Arabia, Australia
  • Author: Ronald Hamowy
  • Publication Date: 02-2010
  • Content Type: Policy Brief
  • Institution: Independent Institute
  • Abstract: There is strong evidence that the spectacular growth in the size of the federal government is a result of its expansion following one crisis or another, either real or imagined. After the crisis it gains new powers that become the norm for the next stage of growth. The Food and Drug Administration provides a particularly apt example of this increase in powers as a response to a series of crises, each of which has increased the regulatory authority of the agency. The Food and Drug Administration, which did not even exist before the twentieth century, now possesses massive regulatory powers over products that account for no less than twenty-five cents of every dollar spent by the American consumer, totaling well over $1 trillion annually. Historical investigation shows that the agency has been able to take advantage of several perceived crises, the combined effect of which was to increase its authority to determine what Americans ingest to the point where today, at least in the case of drugs, it is the agency—and not the consumer—that determines when and what is available. A regulatory agency originally established to ensure that consumers would be provided with full and accurate information on the drugs available to them has become one that determines which drugs are available, when they might be administered, and who may ingest them. This essay traces this growth in terms of the legislative reaction to three crises, the diphtheria antitoxin crisis of 1901, the sulfanilamide crisis of 1937, and the thalidomide crisis of 1960.
  • Topic: Government, Health Care Policy
  • Political Geography: United States
  • Author: Martin Eling, Robert W. Klein, Joan T. Schmit
  • Publication Date: 11-2009
  • Content Type: Policy Brief
  • Institution: Independent Institute
  • Abstract: In this paper we compare insurance regulatory frameworks in the United States (US) and European Union (EU), focusing primarily on solvency, but also considering product and price regulation, as well as other elements of consumer protection. This comparison highlights the use of more fluid and principles-based approaches in the EU as it is developing under Solvency II, while the US continues to focus essentially on static, rules-based regulation. The discussion further notes evidence suggesting that the EU approach is more successful in promoting a financially solid insurance sector.
  • Topic: Government, Political Economy
  • Political Geography: United States, Europe