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'Hill Burton' Hospital Principle
The rebuilding effort can best be done in the spirit of the 1946 "Hospital Survey and Construction Act," which, for 25 years, built up the hospital and health-care system to high standards and accessibility. The nine-page law, often called the "Hill-Burton Act," after the bipartisan co-sponsors of the Act, Sens. Lister Hill (D-Ala.), and Harold Burton (R-Ohio), mandated Federal and local cooperation and funding, to see that the goal would be achieved of having a community hospital in every county, to guarantee hospital care to citizens: in rural counties at a ratio of 5.5 beds per 1,000 (sparsely settled regions require redundancy); and in urban areas, 4.5 beds per 1,000.
The Hill-Burton concept sees the community hospital as the hub of regional networks of health services, involving education, public health, sanitation, defense against epidemics and disasters, and research.
At the same time that the Hill-Burton hospital construction boom proceeded?providing many of the 3,089 U.S. counties with their first hospital ever?public-health programs and applied medical R&D all but eliminated polio, tuberculosis, and other diseases. Pertussis (whooping cough) declined from a peak of 156,000 cases in 1947 to 14,800 in 1960; diphtheria declined from 18,700 cases in 1945, to 900 in 1960. Mosquito control programs?including the use of the insecticide DDT, begun in 1940?were on the way to eliminating malaria and other mosquito-borne diseases.
By the mid-1970s, the Hill-Burton goal of 4.5 beds per 1,000 was nearly reached as the national average. Intervening laws furthered the approach: Amendments to the Hill-Burton Act in 1954 authorized funds for chronic-care facilities; in 1965, the Medicare and Medicaid health insurance programs were begun.
Then came the downshift, in line with the 1970s policy turn towards deregulation, privatization, and globalization. On Dec. 29, 1973, President Richard Nixon signed into law, with bipartisan support, the "Health Maintenance Organization and Resources Development Act," which, along with follow-up laws, ushered in the era of deregulation of health-care delivery, to the point where today, over 2,000 hospitals have shut down. Likewise, core public-health functions have been drastically reduced; hundreds of counties now have next to no programs at all. One of the most dramatic examples comes from the nation's capital.
In Fall 2001, the Washington, D.C. metro region could barely cope with the anthrax attack, given that its leading community hospital, the 150-year old D.C. General?a 500-bed, full-service facility with a pathology laboratory and isolation wing?had been shut down only months before, by direct action of Congress.
Hospital Systems Decline
The number of community hospitals in the U.S. fell from nearly 7,000 in the mid-1970s, down to barely 5,000 in 1999, and today, stands at 4,897. The ratio of licensed hospital beds per 1,000 citizens has dropped from 4.5 in the 1970s, down to 3 today.
The false "alternative" to full-service hospitals, has been presented in the form of clinics. The Obama Administration's "American Recovery and Reinvestment Act" is letting out $155 millions for 126 clinics. These are useful in themselves, but no substitute for hospitals and hospital networks. Even worse, there are those proposing that "doc-in-the-box" operations should supplant hospital systems, in order to offer cut-rate care as a pretense for real health insurance.
Look at the emergency situation on the state level. In New Jersey, in 2007, three acute-care hospitals closed, and five more filed for bankruptcy. On Feb. 18, the New Jersey Hospital Association released the results of a survey over the past two months, reporting that of the 37 of the state's 74 acute-care hospitals that responded to the survey, 27% had a drop in cash reserves, and were making drastic cuts in staff and services. Clinics associated with the hospitals were also cut. This is the nationwide pattern.
In March, in Dallas, Texas, the 95-bed Renaissance Hospital shut; the parent company declared Chapter 11 bankruptcy in 2008. In New York City, two hospitals closed on March 1: Mary Immaculate, and St. Johns Queens, after Caritas Health Care, Inc. filed for bankruptcy in February. In Pennsylvania, on March 5, the 40-bed Brownsville Tri-County Hospital closed, after 93 years. It is 30 miles southeast of Pittsburgh.
The Veterans Administration nationwide hospital system?in the forefront of many medical advances, from prosthetic therapies, to electronic records, to successfully battling MRSA?is being downsized to far below what is required to meet the needs of former servicemen, and their extended community.
http://www.larouchepac.com/node/10238