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Public Healthcare

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What is public health care and why do we need it? There is no clear definition of what public health care truly is, but many have made attempts to define the basic concepts that identify what public health care is and why we need it. Two of the most noted definitions of public health were developed by the Institute of Medicine (IOM) and Winslow, who base the definition of public health on what public health actually does and how it performs its functions:“…the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and for the development of the social machinery to insure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity.” (Turnock, 2007)There have been other definitions of public health, but none have gained as much recognition than the definitions provided by Winslow and the Institute of Medicine. Considering that the definition of public health has been quite difficult to define, the laws that govern the system must be extensive, but they also must be interpretable so that each local public health agency can adjust them to better suit their mission.
The Centers for Law and the Public’s Health (2008), in collaboration with Johns Hopkins and Georgetown Universities, have developed programs to help promote and implement the laws that govern public health. There are four Model Laws that the Centers for Law and Public Health help to implement: The Turning Point Model State Health Act (MSPHA), The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA), The Model State Emergency Health Powers Act (MSEHPA), and The Model State Public Health Privacy Act (MSPHPA). The Uniform Emergency Volunteer Health Practitioners Act and The Model State Emergency Health Powers Act are usually combined together because they are both applied in regards to public health in emergency situations. These laws are called “models” because they have been developed as a template for how each state can interpret and initiate its own public health laws. There are also laws that have been specifically initiated to protect people from the transmission of certain communicable diseases, like HIV.
Public Health Law Reform
The Turning Point Model State Health Act (MSPHA) was developed as a collaborative effort between several representatives from five states, several experts in public health, and nine national organizations and government agencies. The Turning Point Public Health Statute Modernization Collaborative (2003) did not plan the model as a mandate to place strict rules on how each agency is to regulate public health; however, it “is intended as a means for state, local, and tribal governments to assess their existing public health laws and identify the changes they deem necessary.” A comparative analysis of public health law reform based on the Turning Point Model State Health Act reinforced the idea that the model is not set in stone and each state can adjust their legislation to suit their needs because there was no definitive determining factor that could explain why the Turning Point Act was successful in some areas but failed in others (Meier, et. al., 2009).
Emergency Preparedness
The Model State Emergency Health Powers Act gave state and local public health authorities the right to act in a timely manner in an effort to aid the public and prevent further health issues during the time of emergencies. The Uniform Emergency Volunteer Health Practitioners Act was initiated to expand jurisdiction for licensure to practitioners that volunteer in different states during emergencies, like those that assisted after Hurricane Katrina (Centers, 2008). Since the attacks on the US in September of 2001, there has been further government emphasis on the need for more updated public health emergency laws that focus on educating emergency volunteers about being prepared, and coordinating volunteers over multiple sectors (Benjamin, et al., 2008).
Privacy and Diseases
The Model State Public Health Privacy Act was initiated in 1999 to address the issue of privacy as it pertains to the acquisition, usage, storage, and transmission of public health records (Centers, 2008). Protecting the privacy of patients has become a major issue, especially as it pertains to certain treatments, diagnoses, and test results. Disclosure of a patient’s HIV status, for example, is a sensitive issue because there is the problem of protecting public health while not violating a person’s right to privacy. In order to respect the privacy of patients with HIV while attempting to prevent further transmission of the disease, several states have passed laws that prohibit a person that is knowingly infected with the HIV virus from engaging in sexual activities with another person without disclosing their positive status. In the most strict form of the law, there can be no sexual contact between an HIV positive person and their partner without full disclosure. In the more flexible form of the law, an HIV positive person has the choice of full disclosure, using a condom, or engaging in less risky sexual behavior. An analysis of the effectiveness of the strict versus the flexible law demonstrated that while having either type of law was better than not having any law, the flexible law produced the greatest reduction in the risk of HIV transmission (Galletly, et al., 2008). This is probably due to the fact that a person’s privacy is not violated under the flexible law.
The laws involved in regulating public health are extensive but they are not carved in stone. Each law is planned to better improve the overall health of the public. Whether the law is in regards to emergency situations, patient privacy, or policy reform, public health laws are implemented to achieve the overall mission of public health: educating the public in an effort to prevent the further transmission of diseases through unsanitary practices in order to give each individual the opportunity to live a healthy life.

References

Benjamin, G., Moulton, A. (2008). Public health legal preparedness: a framework for action.
Journal of Law, Medicine & Ethics. Retrieved July 13, 2009 http://lirnproxy.museglobal.com/MuseSessionID=eafa945bcc92ddba444e57f6a3238729/MuseHost=find.galegroup.com/MusePath/itx/retrieve.do?contentSet=IAC-Documents&resultListType=RESULT_LIST&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%28ke%2CNone%2C18%29public+health+laws%24&sgHitCountType=None&inPS=true&sort=DateDescend&searchType=AdvancedSearchForm&tabID=T002&prodId=SPJ.SP01&searchId=R2¤tPosition=9&userGroupName=lirn_main&docId=A176480615&docType=IAC

Galletly, C., Pinkerton, S. (2008). Preventing HIV transmission via HIV exposure laws: applyinglogic and mathematical modeling to compare statutory approaches to penalizing undisclosed exposure to HIV. Journal of Law, Medicine & Ethics. Retrieved July 13, 2009 http://lirnproxy.museglobal.com/MuseSessionID=aa30fc5d6adcc35d5420a78e6f5b558c/MuseHost=find.galegroup.com/MusePath/itx/retrieve.do?contentSet=IAC-Documents&resultListType=RESULT_LIST&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%28ke%2CNone%2C18%29public+health+laws%24&sgHitCountType=None&inPS=true&sort=DateDescend&searchType=AdvancedSearchForm&tabID=T002&prodId=SPJ.SP01&searchId=R2¤tPosition=6&userGroupName=lirn_main&docId=A186516808&docType=IAC

Meier, B., Hodge, J., Gebbie, K. (2009, March). Transitions in state public health law:Comparative analysis of state public health law reform following the Turning Point Model State Public Health Act. American Journal of Public Health. Retrieved July 13, 2009 http://proquest.umi.com/pqdweb?index=6&did=1647955821&SrchMode=1&sid=2&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1247331194&clientId=83181

The Centers for Law & the Public’s Health. (2008). The Model State Emergency Health PowersAct (MSEHPA). Retrieved July 13, 2009 http://www.publichealthlaw.net/ModelLaws/MSEHPA.php

The Centers for Law & the Public’s Health. (2008). The Model State Public Health Privacy Act(MSPHPA). Retrieved July 13, 2009 http://www.publichealthlaw.net/ModelLaws/MSPHPA.php

The Centers for Law & the Public’s Health. (2008). The Uniform Emergency Volunteer HealthPractitioners Act (UEVHPA). Retrieved July 13, 2009 http://www.publichealthlaw.net/ModelLaws/UEVHPA.php

The Turning Point Public Health Statute Modernization Collaborative. (2003, September).
Turning Point: Collaborating for a new century in public health. Retrieved July 13, 2009 http://www.hss.state.ak.us/dph/improving/turningpoint/PDFs/MSPHAweb.pdf

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