How did the state's attention to public health care policy change in the twentieth century? Were the changes positive or negative?

Question

What will be an ideal response?

Answer 1

Answers will vary but correct responses should include: Planning worked best, perhaps, (and its primacy therefore lasted longest) in improving public health. Wherever states got involved in providing medical care, the results were spectacular. Compulsory, state-funded immunization ended the rapacious diseases that had regularly killed children, including polio, measles, mumps, whooping cough, and rubella. Many major killing and maiming diseases, which affected all age groups, were controlled and even eliminated, not only in rich countries, but across the world in the second half of the twentieth century. Health education, combined with fiscal measures, changed people's habits. In the 1970s, health mavens began to discourage, and even persecute, smoking—a universal relaxation in the early and mid-twentieth century. Publicly funded health campaigns even targeted fatty foods and alcoholic beverages, which adversely affected only a small minority of consumers. Campaigns appeared even in countries with no historic problems associated with these kinds of food and drink, including Chile and Canada, China and India. Above all, the state got increasingly involved in paying doctors and running hospitals. Except for the United States, all rich countries acquired huge public health establishments. The results again were positive in one way. Millions of poor people were liberated from the fear of neglect. Life, for the seriously sick, ceased to be a privilege confined only to those who could pay for treatment. On the other hand, the costs of medical care spiraled, and states struggled to pay the bills. National insurance schemes became symbols of modernity. They consumed huge proportions of national budgets, because their costs were uncontrollable. Government-run insurance schemes, which aimed to pay for sickness and retirement by state management of compulsory contributions, never succeeded in paying for themselves, and, wherever they were tried, new benefit-systems sooner or later replaced them. Increasingly, beginning with Britain´s National Health Service, established in 1949 on a lavish scale and widely regarded as a model to follow, taxation paid for health care and pensions. The British experiment absorbed the biggest slice of the country's budget by the 1980s. No country was too poor, or too ideologically averse, to have a public health policy and at least some public funding for medical care.