Public health services can be dated back to 1872 when APHA was founded by Stephen Smith. He was a physician and a commissioner in the New York health board. In 1893, the public health service focused on tuberculosis control, in 1895 standardisation of water and sewerage examination was established. In 1905, public health through the Walter reed report focused on yellow fever. Milk examination act was passed in 1906; public health services also established the death certificate standard in 1908. The examination of air and the APHA journal were established in the year 1908 and 1911 respectively.
APHA focused on communicable diseases and published a report in the year 1916; health educator’s standards and qualification were set in the year 1943. In 1950, the polio vaccination was established and by 1956, the medicine library was introduced. The national headquarters was established in 1999 in Washington. Further initiatives were implemented and most notably the get ready campaign for all hazards in the year 2006.
Analysis of the health services setting
1) Who are the primary customers?
Primary consumers of public health care services are the aged citizens who face various chronic illnesses.
2) Who are the primary owners?
The government is the primary owner of public health care and the government finances construction and pay public health care providers.
3) What are the common organizational structures?
A common organisational structure in the health care system is the functional organisational structure. This is a pyramid shaped hierarchy with defined functions and roles of each position. There are strict command chain lines, control and reporting in this functional structure (JBPUB, 2012, pp 22).
4) What is the primary source of financing?
The government and private insurers’ finances health care, private insurers dominate the financing of health care in the US. Individuals and businesses pay taxes to the government, which in turn finances health care; payroll taxes associated with health are also imposed to finance health care. They also pay insurance premiums that are then used to finance health care. The government on the other hand pays medical insurance for its employees, pay medical providers and uses subsidies to finance health care.
5) Who are the primary care givers and how is the care team structured?
The primary care givers include the patient caregivers who include physicians and nurses, the support services providers who include the environmental, engineering, food and planning.
6) How does this setting interface with other settings in the health care delivery system?
The human resources providers who include benefits, compensation and recruitment team. The other is the finance section providers, which include financial officers, patient accounts and marketing. These settings interface with other settings in the health care system by providing an environment that enable appropriate services provision.
Challenges and Opportunities
Some challenges in the public health care system include the fact that legal risks highly influence the behaviour of caregivers. Another challenge is that social justice and market justice conflict in the health care system. Another challenge is that the level of access to public health care services depends on insurance coverage of an individual (JB Learning, 2012, pp 9).
Policies implemented concentrate on the cost of care, quality of care and access to health care, one challenge is that most individuals contend access to quality care at lower cost. Those who access care feel that it is their right to quality care without the consideration of their social class or income (Shi, L. and Singh, D., 2011, pp 534). The other challenge is the number of health care providers is not sufficient across geographical areas, the distribution of the different types of providers is not sufficient and this has resulted into issues relating to access and quality of care provided. (Shi, L. and Singh, D., 2011, pp 534)
Medicare policies also face numerous challenges in that these policies are not formulated to manage chronic conditions. These policies do not cover prolonged nursing care. The other challenge is that minority groups face access challenges, this include the Asian Americans, Native Americans, Hispanics and African Americans. Policies should therefore be formulated in way that they enable provision of care to special needs of the minority groups (Shi, L. and Singh, D., 2011, pp 535).
There exist opportunities to reduce the costs of public health care in future without affecting the quality of healthcare by reducing the number of individuals without healthcare insurance. Another opportunity is the use of research to help in policy development, research should gather, catalogue and correlate data, and information collected can then be used in defining problems and appropriate policies to be implemented. (Shi, L. and Singh, D., 2011, pp 538).
Technological advancements in public health care is another opportunity, technology promotes self reliance and at the same time offers cost effectives ways of performing tasks therefore reducing the costs of accessing health care and increasing the quality of health care (Shi, L. and Singh, D., 2011, pp 546).
AMAS (2012). Overview of the US health care system. Retrieved on 11th August, from http://www.amsa.org/AMSA/Libraries/Committee_Docs/HealthCareSystemOverview.sflb.ashx
JB Learning (2012). Characteristics of the US healthcare system. Retrieved on 11th August, from http://www.jblearning.com/samples/0763763802/63800_CH01_Final.pdf
JBPUB (2012). Understanding healthcare management. Retrieved on 11th August, from http://samples.jbpub.com/9780763759643/59643_CH02_5289.pdf
JBPUB (2011). Milestones of public Heath. Retrieved on 11th August, from http://samples.jbpub.com/9781449615192/69840_CH01_Niles.pdf
Shi, L. and Singh, D., (2011). Delivering Health Care in America. A Systems Approach. New York: Jones and Bartlett Publishers.