Gareth+-Memo+7+Historicizing+a+Project


 * __ Memo 7: Historicizing a Project __**

1918: Chamberlain-Kahn Act establishes Federal intervention in State Public health, and initiates systematic National Interest in population Health in the US, funding public health initiatives. Largely in response to past Flu epidemics.

1920’s: Blue Cross and Blue Shield form as Hospital and Physician ‘funding pools’ (respectively), Kaiser and other managed care coops are founded for profit.

1935: Social security Act, and New Deal expand to form basis of population entitlements in US Law.

1950’s: Waves of immigration from India and Philippines in post war years cement these groups in catchment communities in US with strong ties to homelands. Community formations link internationally and receipt of medical care during trips home is relatively common. Informal transnational healthcare economy forms.

1965: President Johnson Signs the Medicare/Medicaid laws.

1973: Nixon Signs HMO act, deemed liberal at the time, this begins argument over the role of individual choice and posits the HMO (managed care) vs. MSA (medical Savings accounts) as contradictory positions based on their allowance of individual choice.

1980: Founding of Bumrungrad private hospital in Bangkok Thailand

1980’s: Dramatic reversal of federal position on healthcare, ’81 OBRA, Budget act cuts funds, ’82 TEFRA, tax laws place burden on gov to reimburse hospitals and insurance, ’83 Social Security Amendments, medicare funding shifts, and Reagan’s pro-competativness initiative continues though bills fail to pass. ’84 DEFRA, deficit reduction act cuts Medicare and Medicaid. ’86, COBRA, reinforces right to healthcare by mandating continuation when unemployed, while also increasing eligability in some areas, but expands the quantitative evaluation of care and emphasizes the evaluation of reembursment based on efficiency and nebulous concept of fair payment.

1984: Approx. Start date of the growth of private hospitals (for profit in Kerala, centered in Chennai/Madras- 1985- Sri Ramachandra Medical Centre (SRMC) founded in Chennai for Profit, corporate ownership.1987- Madras Medical Mission founded, in Madras, associated with a church organization, now private and for profit.

1993: Failure of the Clinton’s Health Security ACT, popularizes the discussion of single payer, national healthcare and adds fire to debates about individual choice when it is accused of socialism, and partisan comparisons to Canada label the plan ineffective.

1994: As part of an active effort by American Medical Schools and University Health Centers to establish international linkages, the Harvard Medical School forms a subsidiary ‘Partners Healthcare’, as part of its international subsidiary Harvard Medical International (HMI). Partners owns hospitals in Mass, and offers consultation (for profit) while forming partnerships with hospitals in other countries.

1997: Medicare laws modified to include “Medicare+choice” plan c, in which differential care is available through modifier plans.

2000: Arbitrary date for increase in Asian India population in US, due to diaspora.

2000: Trent Accreditation Scheme becomes first formal international/intercontinental accreditation. Based in the UK, they accredit Union Hospital in HongKong. http://www.union.org/new/english/about_us/mission.htm

2001: Ruben Toral becomes Marketing director for Bumrungrad and pushes for rebranding as an international hospital. Having previously worked on “health and wellness” retirement villages aimed at expats to come to Thailand.

2003: India pushes medical tourism initiative. http://www.medical-tourism-india.com/

2003: Congress Passes largest ever Medicare/Medicaid Reform laws including the formation of supplemental pharmaceutical plans, and

2005: GlobalChoice, insurance, providing for medical tourism expenses as supplemental Medicare insurance is founded.

2005: President of Philippines announces National Medical Tourism Initiative, comparing plans to those successful in India, and referencing the national healthcare system in Singapore as a model. Cites need for income and development, as well as need to combat deficit of physicians and services, especially specialists.

2005-2006: Blue Ridge Paper sued by United Steelworkers, to prevent the company’s sending a union member to India for surgery, rather than providing care locally. Case became national news for two reasons, incentive offered to worker made him side against his union initially, and cost estimates placed savings over 80,000

2007: Joint Commission International –Founded by

2007: Bumrungrad, and 3 largest Chennai India Based private hospitals, report highest ever international patients, approximatly 1,000,000 individuals. Estimates of Med Tourism Industry beat 5-7 billion dollars US for direct healthcare delivery (ignoring pharmaceuticals), and participating patients globally estimated between 1,000,000 and 10,000,000 lacking to recording accuracy.

2007: State health insurance in California (one of the largest) and South Carolina (middle of the pack) both begin limited coverage of international medical tourism as care option. Later in the year several insurance companies announce coverage and incentives to encourage based on savings.

2007-2008: First Nonprofit industry organization forms as a watchdog/promoter. http://www.medicaltourismassociation.com/

2008: Indian Gov. starts offering “medical tourism” visa as a specific category, cites initiative funding for medical tourism of more than 6 Billion $ US over last two years, through ministry of tourism.

2008: Partners Healthcare, is to be broken off from HMI and Harvard Medical School because they are too profitable, and no longer appear to be closely connected with the goal of education. http://www.thecrimson.com/article.aspx?ref=521635

2009: State representatives of Kerala, India announce plans to be world leader in medical tourism by 2010.


 * __SPECIFIC YEARS: 2007__**

Jan. 14- Red Crystal formed as non-sectarian version of Red Cross/Red Crescent. Jan. 23- President Bush emphasizes competativeness, and price transparency as answers to health care crisis in the state of the union address. He has moved from the language of savings accounts to more nebulous emphasis on choice. Jan 26th, saw the lifting of Military rule of several states in Thailand, following the coup of the previous year. Some states remain under martial law until mid 2008. CDR officially has control. July 19 - Prathiba Patil, First Female President of India. July 21- Harry Potter Book 7 becomes the fastest selling book in history, over 11 million copies in 24 hours. Nov. 29, Manila Peninsula Rebellion Dec 28, Bhutto Assasinated in Pakistan Various- Medical Tourism formally part of major health insurance offerings. Various- US Presidential campaigns begin, for the first time a person of color and a woman are two central participants.