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进嘉)6/28总结与回顾(负责老师:陈美霞)
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BookReview(Milio,Nancy,Publichealthinthemarket:facingmanagedcare,leangovernment,andhealthdisparities,AnnArbor:UniversityofMichiganPress,2000)
ThisisareviewthatwaswrittenbyDr.DonaldLightinthejournalSocialScienceandMedicine,volume55(2002)2073-2079.
NancyMilioisanAmericanauthorityonmunityhealth,andherfield-basedexperienceesthroughinthepagesofthisarticulatebook.Thoughalwaystactfulandhelpful,shecannothelpbutdescribetheshamblestowhichpublichealthhasbeenreducedbythedecisionofemployersandgovernmenttoturnhealthcareovertofor-protcorporations.Whenstockholdersaretheprimeconstituency,``itcanconfusetheaimsofmunitypreventionwiththoseofpublicrelationsandmarketing,andimpairaccuracyofandaccesstodatathatarevitaltopublichealthassessmenty''(p.267).Decisionsonhowgoods,servicesandinformationareallocated``placeAmericans'interestsandopportunitiesasconsumersabovetheirrights,responsibilitiesandactionsascitizens''(p.272).Thesituationissofragmentedandprimitive(thoughshewouldneverbesoblunt)thatshehastoremendthat``publichealthcouncilscouldmoreeffectivelyguidepublichealthagenciesthanthemanyhundredsoftinyboardsofhealth,eachwithitsownlimitedcapacitytocarryoutevenafewoftheessentialpublichealthservices''(p.280),andshehastoremindherAmericanreadersthat``Healthymunitiesarersthealthyplaces''(p.276).HowembarrassingtohavereadersinScotland,orCostaRicaorIndialearnhowfarbehindpublichealthanizationisintherichestnationthatisreadytospendbillionsonupgradingitsmilitary.
PublicHealthintheMarketisdividedintofourpartsandfourteenchapters.Part1providesawell-researchedoverviewofthenewworldwhichmarket-basedpolicieshavecreated,inwhichpublicmoniesareprivatized.Part2assessestheconsequentpolicies.Part3laysoutMilio'stemplateforpolicypracticethatinformsthewholebookandherwork,andPart4providestwoin-depthanalyses,basedonoriginalresearch,oftwocontrastingstates,aswellastheconcludingchapters.
Milio'stemplateormodelcentersononeofthosefigureswith15-20factors,bi
公共卫生方面有关论文范文素材
ThecasestudiesofArizonaandWestVirginiaareeye-openers.Welearnthattherichestfifthearnabout13timesmorethanthepoorestfifth,anamazingdegreeofrelativepoverty,andthataboutone-quarterofthechildrenlivebelowthepovertyline,aninesetlowasanemergencyhouseholdbudget.WelearnthatduringWorldWarI,publichealthofficialsinArizonahadtogofromtowntotown,tryingtopersuaderesidentsthattheyneededtopayforsewerconnections.Somerefused.Bythe1960s,Milioreports,theArizonaStateDepartmentofHealthhadreachedabudgetof12centspercapita.Ironically,thecredoofindividualrightsandunfetteredgrowthhaveresultedinhighratesofviolentcrime,poverty,unemployment,overcrowdedclassroomsandmunitiesthatareunhealthyplaces-afistfulofpublichealthproblemsthatcannotbesolvedwithprivatemedicalcare.Eveninthe1990s,thestatestilllackedtheabilityeven``toestimateits investmentinthetenessentialpublichealthservices''(p.180).Thispairofchaptersisfullofplexdetailabouteffortstodeveloppublichealthprogramsinthetwostates.
这篇论文来源 http://www.sxsky.net/xie/070789191.html
Milioseesclearlyanddocumentswelltheeffectsofpetitionpolicyandmarketsonpublichealthandhealthcare.Costcontainmentprogramshaveactuallyworsenedaccessofvulnerablegroupstohealthcare.Managedcareanizationshavenoresponsibilityfororinterestinupstreampublichealthcausesofpatientproblems.Anygivenmunityisdividedintoeachpany'smarketshare,thuscarvingupanyresponsibilityforthewhole.Vitalinformationforpublichealthprograms,oncegatheredroutinely,beesproprietary.Theservicesandpatientsthataremoreprofitablegetsiphonedoff,leavingpublichealthcentersandprogramsinbudgetarycrisis.Large-scalefraudandbankruptcyarenotunmonandthrowcareintoturmoil,especiallyforthousandswithseriousproblems.
Inanymarket,thereareafewwinnersandmanylosers.Overall,thisbookprovidestellingdetailandtimehonoredinsightsintoatragedyofourtimes,enhancedbyawonderfulcollectionofquotationsthatframetheissuesinhistoricalperspective.Thebookiswelledited,indexedandprintedbythePress.
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