The Sickening Division Between Public Health and Private Medicine

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Bada Ba Baba

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The division between private medicine and public medicine is sickening, to say the least. If you look at the history between the two, especially during the twentieth century, the blame is to be put on the American Medical Association as the driving force of this division!

The AMA (probably still to this day) was driven by self-interest and economic gain, which ultimately resulted in the eradication of the public health framework. What is so interesting, is at one point in time, these two disciplines were indeed integrated amongst each other . In fact, public health was solely considered a secondary degree for doctors to obtain, and not at all a primary degree in which a undergraduate student can obtain. The division, is clear.

During the twentieth century, this division which was perpetuated by the AMA, was caused by several factors:

Dispensaries:
Dispensaries served as medical centers that provided outpatient care to poor citizens who were most susceptible to living in unsanitary conditions in the US, were eradicated by the economic interests of private medical practitioners. The AMA argued that the poor people who sought out treatment in these facilities were liars, stating that they were "fully capable of paying for private health care insurance". They also found reason to believe that dispensaries were servicing as "charity cases" for the "unworthy poor". Due to the great presence of the AMA in politics, dispensaries faded out, and an increase in private hospitals around the country replaced the dispensaries. For the dispensaries that did not die out, they served as outpatient facilities for the already established private hospitals. This is EVILNESS!

Compulsory Health Insurance and The Sheppard-Towner Act:
At one point in time, the AMA strongly supported the idea of compulsory health insurance, but during the twentieth century, their position no longer remained the same. They consistently lobbied and argued that "physicians may not get paid". They also had considerable influence on numerous failed passages of socialized medicine programs such as Medicaid and Medicare. They argued and cried out against The Sheppard-Towner Act, a bill that was meant to lower infant mortality and increase the health of women in the US, by arguing that the data from the studies in which the bill was supported under were false; The AMA talked down upon the bill as "state medicine" and that infant mortality rates were not higher in the US than other developed countries. Even more interesting, the AMA passed a bill called the Hill-Burton Act, which increased the dollars spent on technology improvements in medical education and technology. This is not a coincidence, but a selfish interest.The AMA is so disgusting to solely push their agenda without recognizing the importance of public health practice.

*Educational Reform
The medical education today was not what it once was. It was indeed a mess, and after the Flexner Report, many medical institutions closed down, and for those that remained opened, they heavily reformed their standards of medical education. The Rocker fellers got involved, putting in money towards research topics of pharmacology, physiology, anatomy, etc. and completely disregarded public health practice until years later. Only then, the concern for public health in medicine was addressed and the formation of separate public health programs in education were put into place.

At one point in time, public health in medicine were combined, and today they are slowly coming back together (but some argue they are not). Regardless, I find it hard to see myself getting into medicine anymore. When you look at the grand hospitals around the country and truly understand how it all came about, you recognize that the devil is in the details! The AMA is no longer as powerful as it once was, but what it did--separating public health from private medicine for economic gain--is disheartening! No wonder our medical education is so disconnected from the social determinants of health, no wonder we are spending the most on health care yet have some of the worst health outcomes compared to other developed countries. It sprouted from the selfish, and self-economical interests of the AMA.

When you apply to medical school, please recognize how your education has come to be what it is today and remain educated. Do not fall victim to blindness. Live a lifestyle with open eyes, and recognize the evil of the beautiful institutions that run our health systems today!

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