1.
Chile
–
Chile, officially the Republic of Chile, is a South American country occupying a long, narrow strip of land between the Andes to the east and the Pacific Ocean to the west. It borders Peru to the north, Bolivia to the northeast, Argentina to the east, Chilean territory includes the Pacific islands of Juan Fernández, Salas y Gómez, Desventuradas, and Easter Island in Oceania. Chile also claims about 1,250,000 square kilometres of Antarctica, the arid Atacama Desert in northern Chile contains great mineral wealth, principally copper. Southern Chile is rich in forests and grazing lands, and features a string of volcanoes and lakes, the southern coast is a labyrinth of fjords, inlets, canals, twisting peninsulas, and islands. Spain conquered and colonized Chile in the century, replacing Inca rule in northern and central Chile. After declaring its independence from Spain in 1818, Chile emerged in the 1830s as a relatively stable authoritarian republic, in the 1960s and 1970s the country experienced severe left-right political polarization and turmoil. The regime, headed by Augusto Pinochet, ended in 1990 after it lost a referendum in 1988 and was succeeded by a coalition which ruled through four presidencies until 2010. Chile is today one of South Americas most stable and prosperous nations and it leads Latin American nations in rankings of human development, competitiveness, income per capita, globalization, state of peace, economic freedom, and low perception of corruption. It also ranks high regionally in sustainability of the state, Chile is a founding member of the United Nations, the Union of South American Nations and the Community of Latin American and Caribbean States. There are various theories about the origin of the word Chile, another theory points to the similarity of the valley of the Aconcagua with that of the Casma Valley in Peru, where there was a town and valley named Chili. Another origin attributed to chilli is the onomatopoeic cheele-cheele—the Mapuche imitation of the warble of a locally known as trile. The Spanish conquistadors heard about this name from the Incas, ultimately, Almagro is credited with the universalization of the name Chile, after naming the Mapocho valley as such. The older spelling Chili was in use in English until at least 1900 before switching over to Chile, stone tool evidence indicates humans sporadically frequented the Monte Verde valley area as long as 18,500 years ago. About 10,000 years ago, migrating Native Americans settled in fertile valleys, settlement sites from very early human habitation include Monte Verde, Cueva del Milodon and the Pali Aike Craters lava tube. They fought against the Sapa Inca Tupac Yupanqui and his army, the result of the bloody three-day confrontation known as the Battle of the Maule was that the Inca conquest of the territories of Chile ended at the Maule river. The next Europeans to reach Chile were Diego de Almagro and his band of Spanish conquistadors, the Spanish encountered various cultures that supported themselves principally through slash-and-burn agriculture and hunting. The conquest of Chile began in earnest in 1540 and was carried out by Pedro de Valdivia, one of Francisco Pizarros lieutenants, who founded the city of Santiago on 12 February 1541. Although the Spanish did not find the gold and silver they sought, they recognized the agricultural potential of Chiles central valley
2.
Public health
–
It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people, Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health services. Environmental health, community health, behavioral health, health economics, public policy, mental health and occupational safety, the focus of public health intervention is to improve health and quality of life through prevention and treatment of disease and other physical and mental health conditions. This is done through surveillance of cases and health indicators, there is a great disparity in access to health care and public health initiatives between developed nations and developing nations. In the developing world, public health infrastructures are still forming, many diseases are preventable through simple, nonmedical methods. For example, research has shown that the act of hand washing with soap can prevent many contagious diseases. Public health communications programs, vaccination programs and distribution of condoms are examples of public health measures. Measures such as these have contributed greatly to the health of populations, Public health plays an important role in disease prevention efforts in both the developing world and in developed countries, through local health systems and non-governmental organizations. The World Health Organization is the agency that coordinates and acts on global public health issues. Most countries have their own government public health agencies, sometimes known as ministries of health, for example, in the United States, the front line of public health initiatives are state and local health departments. In Canada, the Public Health Agency of Canada is the agency responsible for public health, emergency preparedness and response. The Public health system in India is managed by the Ministry of Health & Family Welfare of the government of India with state-owned health care facilities. Public health programs providing vaccinations have made strides in promoting health, including the eradication of smallpox, antibiotic resistance, also known as drug resistance, was the theme of World Health Day 2011. Although the prioritization of pressing public health issues is important, Laurie Garrett argues that there are following consequences, when foreign aid is funnelled into disease-specific programs, the importance of public health in general is disregarded. This public health problem of stovepiping is thought to create a lack of funds to other existing diseases in a given country. For example, the WHO reports that at least 220 million people suffer from diabetes. Its incidence is increasing rapidly, and it is projected that the number of diabetes deaths will double by the year 2030, the risk of type 2 diabetes is closely linked with the growing problem of obesity. The WHO’s latest estimates highlighted that globally approximately 1.5 billion adults were overweight in 2008, the United States is the leading country with 30. 6% of its population being obese
3.
Rudolf Virchow
–
Rudolf Ludwig Carl Virchow was a German physician, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician, known for his advancement of public health. He is known as the father of modern pathology because his work helped to discredit humourism and he is also known as the founder of social medicine and veterinary pathology, and to his colleagues, the Pope of medicine. Born and raised in Schievelbein as a child of a working-class family. Dissuaded by his voice, he abandoned his initial interest in theology. With special military scholarship, he earned his degree from Friedrich-Wilhelms Institute under the tutelage of Johannes Peter Müller. He worked at the Charité hospital under Robert Froriep, whom he succeeded as the prosector. Although he failed to contain the 1847–1848 typhus epidemic in Upper Silesia, his report laid the foundation for health in Germany. From it, he coined a well known aphorism, Medicine is a social science and he participated in the Revolution of 1848, which led to his expulsion from Charité the next year. He published a newspaper Die medicinische Reform during this period to disseminate his social and political ideas and he took the first Chair of Pathological Anatomy at the University of Würzburg in 1849. After five years, Charité invited him back to direct its newly built Institute for Pathology, the campus of Charité is now named Campus Virchow Klinikum. He cofounded the political party Deutsche Fortschrittspartei, by which he was elected to the Prussian House of Representatives and his opposition to Otto von Bismarcks financial policy resulted in an anecdotal Sausage Duel between the two. But he ardently supported Bismarck in his campaigns, the social revolution he himself named as Kulturkampf. A prolific writer, his writings alone exceeded 2,000 in number. Among his books, Cellular Pathology published in 1858 is regarded as the root of modern pathology and this work also popularised the third dictum in cell theory, Omnis cellula e cellula, although his idea originated in 1855. He founded journals such as Archiv für pathologische Anatomie und Physiologie und für klinische Medizin, the latter is published by German Anthropological Association and the Berlin Society for Anthropology, Ethnology and Prehistory, the societies of which he also founded. Virchow was the first to describe and give names of diseases such as leukemia, chordoma, ochronosis, embolism. He coined scientific terms, chromatin, agenesis, parenchyma, osteoid, amyloid degeneration and his description of the transmission cycle of a roundworm Trichinella spiralis established the importance of meat inspection, which was started in Berlin. He developed the first systematic method of autopsy involving surgery of all body parts, a number of medical terms are named after him, including Virchows node, Virchow–Robin spaces, Virchow–Seckel syndrome, and Virchows triad
4.
Salvador Allende
–
Salvador Guillermo Allende Gossens was a Chilean physician and politician, known as the first Marxist to become president of a Latin American country through open elections. Allendes involvement in Chilean political life spanned a period of forty years. As a member of the Socialist Party, he was a senator, deputy and he unsuccessfully ran for the presidency in the 1952,1958, and 1964 elections. In 1970, he won the presidency in a close three-way race and he was elected in a run-off by Congress as no candidate had gained a majority. A centre-right majority including the Christian Democrats, whose support had enabled Allendes election, denounced his rule as unconstitutional, on 11 September 1973, the military moved to oust Allende in a coup détat sponsored by the United States Central Intelligence Agency. As troops surrounded La Moneda Palace, he gave his last speech vowing not to resign, later that day, Allende committed suicide with an assault rifle, according to an investigation conducted by a Chilean court with the assistance of international experts in 2011. Allende was born on 26 June 1908 in Santiago and he was the son of Salvador Allende Castro and Laura Gossens Uribe. Allendes family belonged to the Chilean upper middle class and had a tradition of political involvement in progressive. His grandfather was a prominent physician and a social reformist who founded one of the first secular schools in Chile, Salvador Allende was of Belgian and Basque descent. Allende attended high school at the Liceo Eduardo de la Barra in Valparaíso, as a teenager, his main intellectual and political influence came from the shoe-maker Juan De Marchi, an Italian-born anarchist. Allende was an athlete in his youth, being a member of the Everton de Viña del Mar sports club. Allende then graduated with a degree in 1933 from the University of Chile. During his time at medical school Allende was influenced by Professor Max Westenhofer, Allende co-founded a section of the Socialist Party of Chile in Valparaíso and became its chairman. He married Hortensia Bussi with whom he had three daughters and he was a Freemason, a member of the Lodge Progreso No.4 in Valparaíso. In 1933, he published his doctoral thesis Higiene Mental y Delincuencia in which he criticized Cesare Lombrosos proposals, in 1938, Allende was in charge of the electoral campaign of the Popular Front headed by Pedro Aguirre Cerda. The Popular Fronts slogan was Bread, a Roof and Work, after its electoral victory, he became Minister of Health in the Reformist Popular Front government which was dominated by the Radicals. Upon entering the government, Allende relinquished his seat for Valparaíso. Around that time, he wrote La Realidad Médico Social de Chile, after the Kristallnacht in Nazi Germany, Allende was one of 76 members of the Congress who sent a telegram to Adolf Hitler denouncing the persecution of Jews
5.
Euthenics
–
Euthenics /juːˈθɛnɪks/ is the study of the improvement of human functioning and well-being by improvement of living conditions. Rose Field notes of the definition in a May 23,1926 New York Times article, the Flynn effect has been often cited as an example of euthenics. Another example is the increase in body size in industrialized countries since the beginning of the 20th century. The term was derived in the late 19th century from the Greek verb eutheneo, also from the Greek Euthenia, Εὐθηνία. Good state of the body, prosperity, good fortune, abundance. —Herodotus, the opposite of Euthenia is Penia, Πενία the personification of poverty and need. Ellen H. Swallow Richards was one of the first writers to use the term, in The Cost of Shelter and it is unclear if any of the study programs of euthenics ever completely embraced Richards multidisciplinary concept, though several nuances remain today, especially that of interdisciplinarity. After Richards death in 1911, Julia Lathrop - one of Vassars most distinguished alumnae - continued to promote the development of a program in euthenics at the college. Lathrop soon teamed with alumna Minnie Cumnock Blodgett, who with her husband, John Wood Blodgett, curriculum planning, suggested by Vassar president Henry Noble MacCracken in 1922, began in earnest by 1923, under the direction of Professor Annie Louise Macleod. According to Vassars chronology entry for March 17,1924, the faculty recognized euthenics as a field for sequential study. With the new division came the first major in child study at an American liberal arts college, the Vassar Summer Institute of Euthenics accepted its first students in June 1926. Created to supplement the controversial euthenics major which began February 21,1925, some Vassar faculty members contentiously believed the entire concept of euthenics was vague and counter-productive to womens progress. Having overcome a lukewarm reception, Vassar College officially opened its Minnie Cumnock Blodgett Hall of Euthenics in 1929, Dr. Ruth Wheeler took over as director of euthenics studies in 1924. Wheeler remained director until Mary Shattuck Fisher Langmuir succeeded her in 1944, the college continued for the 1934–35 academic year its successful cooperative housing experiment in three residence halls. Intended to help meet their college costs by working in their residences. For example, in Main, students earned $40 a year by doing relatively light work such as cleaning their rooms. In 1951, Katharine Blodgett Hadley donated $400,000, through the Rubicon Foundation, to Vassar to help fund operating deficits in the current and succeeding years and to improve faculty salaries. Discontinued for financial reasons, the Vassar Summer Institute for Family and Community Living, founded in 1926 as the Vassar Summer Institute of Euthenics, held its last session and this was the first and last session for the institutes new director, Dr. Mervin Freedman. Elmira College is noted as the oldest college still in existence which granted degrees to women which were the equivalent of those given to men, Elmira College became coeducational in all of its programs in 1969
6.
Jim Yong Kim
–
Jim Yong Kim MD, PhD, also known as Kim Yong, is a South Korean-American physician and anthropologist who has served as the 12th President of the World Bank since July 1,2012. Kim was named the worlds 50th most powerful person by Forbes Magazines List of The Worlds Most Powerful People in 2013. Born in Seoul, South Korea in 1959, Jim Yong Kim immigrated with his family to the U. S. at the age of five and grew up in Muscatine and his father taught dentistry at the University of Iowa, while his mother received her PhD in philosophy. Kim attended Muscatine High School, where he was valedictorian, president of his class, after a year and a half at the University of Iowa, he transferred to Brown University, where he graduated magna cum laude with a Bachelor of Arts in human biology in 1982. He was awarded an M. D. at Harvard Medical School in 1991, and he was among the first enrollees of Harvards experimental MD/PhD program in the social sciences. Jim Yong Kim, along with Paul Farmer, Todd McCormack, Thomas J. White and Ophelia Dahl, the organization began with radical new, community-focused health care programs in Haiti, which executed treatments based on local needs and by training community members to implement them. By the early 1990s, the program in Haiti was serving more than 100,000 people, Kim was instrumental in designing treatment protocols and cutting deals for cheaper, more effective drugs. The PIH model was expanded to Peru in 1994, Kims work with PIH to treat MDR-TB was the first large-scale attempt to treat the disease in a poor country, and the efforts have now been replicated in more than 40 countries around the world. PIH now employs more than 13,000 people in 12 countries, Kim left the organization as Executive Director in 2003. Kim left PIH in 2003 to join the World Health Organization as an adviser to the director-general, in March 2004, he was appointed as director of WHO’s HIV/AIDS department, after having success creating programs to fight the disease at PIH. Dr. Kim oversaw all of WHO’s work related to HIV/AIDS, focusing on initiatives to help developing countries scale up their treatment, prevention and this included an ambitious “3x5 initiative” that was designed to put three million people in developing countries on AIDS treatment by the end of 2005. The goal was not met until 2007, but according to the WHO, as of 2012, the program has treated more than 7 million Africans with HIV. Beginning in 1993, Dr. Kim served as a lecturer at Harvard Medical School, eventually holding professorships in medicine, social medicine, over his two decade career working to improve health in developing countries, Kim has been involved in a number of research and academic efforts. In recent years, Kim spearheaded the development of a new field focused on improving the implementation and this new field will rigorously gather, analyze, and widely disseminate a comprehensive body of practical, actionable insights on effective global health delivery. The global health field case studies produced by this form the core of a new global health delivery curriculum now taught at Harvard School of Public Health. An expert in tuberculosis, Kim also chaired or served on a number of committees on international TB policy, in March 2009, Kim was named the 17th President of Dartmouth College, becoming the first Asian-American to assume the post of president at an Ivy League institution. Kim has overseen the development of innovative programs at Dartmouth, utilizing his past experience in health care. In April 2010, Kim launched the National College Health Improvement Project, the project launched its inaugural program, an effort to address binge drinking, in April 2011
7.
Health system
–
There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. In some countries, health system planning is distributed among market participants, however, health care planning has been described as often evolutionary rather than revolutionary. According to WHO, healthcare systems goals are good health for the citizens, responsiveness to the expectations of the population, progress towards them depends on how systems carry out four vital functions, provision of health care services, resource generation, financing, and stewardship. Other dimensions for the evaluation of systems include quality, efficiency, acceptability. They have also described in the United States as the five Cs, Cost, Coverage, Consistency, Complexity. Also, continuity of care is a major goal. Often health system has been defined with a reductionist perspective, for reducing it to healthcare system. In many publications, for example, both expressions are used interchangeably, the World Health Organization defines health systems as follows, A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities, a health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes inter-sectoral action by staff, for example, encouraging the ministry of education to promote female education. Healthcare providers are institutions or individuals providing healthcare services and they may also work outside of direct patient care such as in a government health department or other agency, medical laboratory, or health training institution. One study based on data from the OECD concluded that all types of health care finance are compatible with an efficient health system, the study also found no relationship between financing and cost control. The term health insurance is used to describe a form of insurance that pays for medical expenses. It is sometimes used broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through an insurance program, or from private insurance companies. It may be obtained on a basis or purchased by individual consumers. In each case premiums or taxes protect the insured from high or unexpected health care expenses, the benefit is typically administered by a government agency, a non-profit health fund or a corporation operating seeking to make a profit. Many government schemes also have co-payment schemes but exclusions are rare because of political pressure, the larger insurance schemes may also negotiate fees with providers
8.
Biological hazard
–
Biological hazards, also known as biohazards, refer to biological substances that pose a threat to the health of living organisms, primarily that of humans. This can include medical waste or samples of a microorganism, virus or toxin that can affect human health and it can also include substances harmful to other animals. The term and its symbol are generally used as a warning. The biohazard symbol was developed in 1966 by Charles Baldwin, an engineer working for the Dow Chemical Company on the containment products. It is used in the labeling of biological materials that carry a significant health risk, including viral samples, in Unicode, the biohazard symbol is U+2623. Category B, UN3373 – Biological substance transported for diagnostic or investigative purposes, regulated Medical Waste, UN3291 – Waste or reusable material derived from medical treatment of an animal or human, or from biomedical research, which includes the production and testing. The United States Centers for Disease Control and Prevention categorizes various diseases in levels of biohazard, Level 1 being minimum risk, Laboratories and other facilities are categorized as BSL 1-4 or as P1 through P4 for short. Biohazard Level 1, Bacteria and viruses including Bacillus subtilis, canine hepatitis, Escherichia coli, varicella, as well as cell cultures. At this level precautions against the materials in question are minimal, most likely involving gloves. Routine diagnostic work with clinical specimens can be done safely at Biosafety Level 2, research work can be done in a BSL-2 facility, using BSL-3 practices and procedures. Variola virus is an agent that is worked with at BSL-4 despite the existence of a vaccine, when dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply, is mandatory. Multiple airlocks are employed and are secured to prevent both doors opening at the same time. All air and water going to and coming from a Biosafety Level 4 lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release. Currently there are no bacteria classified at this level, the biohazard symbol was developed by the Dow Chemical Company in 1966 for their containment products. In an article he wrote for Science in 1967, the symbol was presented as the new standard for all biological hazards, the chosen symbol scored the best on nationwide testing for memorability. The design was first specified in 39 FR23680 but was dropped in the succeeding amendment, however, various US states adopted the specification for their state code. Biological agent Biosafety level Biocontainment Planetary protection and Interplanetary contamination Public health Biosafety in Microbiological and Biomedical Laboratories, Prevention of Biological Hazards, EU-OSHA Symbol Making, an account of the development of the symbol in 1966. BioSeal Systems, Biosafety level 4 containment, Biohazard Remediation Compliance Overview Example of Reclassified Biohazard to Level 4, article from The Lancet concerning the reclassification of Ebola after observation
9.
OCLC
–
The Online Computer Library Center is a US-based nonprofit cooperative organization dedicated to the public purposes of furthering access to the worlds information and reducing information costs. It was founded in 1967 as the Ohio College Library Center, OCLC and its member libraries cooperatively produce and maintain WorldCat, the largest online public access catalog in the world. OCLC is funded mainly by the fees that libraries have to pay for its services, the group first met on July 5,1967 on the campus of the Ohio State University to sign the articles of incorporation for the nonprofit organization. The group hired Frederick G. Kilgour, a former Yale University medical school librarian, Kilgour wished to merge the latest information storage and retrieval system of the time, the computer, with the oldest, the library. The goal of network and database was to bring libraries together to cooperatively keep track of the worlds information in order to best serve researchers and scholars. The first library to do online cataloging through OCLC was the Alden Library at Ohio University on August 26,1971 and this was the first occurrence of online cataloging by any library worldwide. Membership in OCLC is based on use of services and contribution of data, between 1967 and 1977, OCLC membership was limited to institutions in Ohio, but in 1978, a new governance structure was established that allowed institutions from other states to join. In 2002, the structure was again modified to accommodate participation from outside the United States. As OCLC expanded services in the United States outside of Ohio, it relied on establishing strategic partnerships with networks, organizations that provided training, support, by 2008, there were 15 independent United States regional service providers. OCLC networks played a key role in OCLC governance, with networks electing delegates to serve on OCLC Members Council, in early 2009, OCLC negotiated new contracts with the former networks and opened a centralized support center. OCLC provides bibliographic, abstract and full-text information to anyone, OCLC and its member libraries cooperatively produce and maintain WorldCat—the OCLC Online Union Catalog, the largest online public access catalog in the world. WorldCat has holding records from public and private libraries worldwide. org, in October 2005, the OCLC technical staff began a wiki project, WikiD, allowing readers to add commentary and structured-field information associated with any WorldCat record. The Online Computer Library Center acquired the trademark and copyrights associated with the Dewey Decimal Classification System when it bought Forest Press in 1988, a browser for books with their Dewey Decimal Classifications was available until July 2013, it was replaced by the Classify Service. S. The reference management service QuestionPoint provides libraries with tools to communicate with users and this around-the-clock reference service is provided by a cooperative of participating global libraries. OCLC has produced cards for members since 1971 with its shared online catalog. OCLC commercially sells software, e. g. CONTENTdm for managing digital collections, OCLC has been conducting research for the library community for more than 30 years. In accordance with its mission, OCLC makes its research outcomes known through various publications and these publications, including journal articles, reports, newsletters, and presentations, are available through the organizations website. The most recent publications are displayed first, and all archived resources, membership Reports – A number of significant reports on topics ranging from virtual reference in libraries to perceptions about library funding
10.
Social psychology
–
Social psychology is the scientific study of how peoples thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others. In this definition, scientific refers to the method of investigation. The terms thoughts, feelings, and behaviors include all psychological variables that are measurable in a human being, Social psychologists typically explain human behavior as a result of the interaction of mental states and immediate social situations. Social psychology is a discipline that had traditionally bridged the gap between psychology and sociology, during the years immediately following World War II there was frequent collaboration between psychologists and sociologists. However, the two disciplines have become increasingly specialized and isolated from other in recent years, with sociologists focusing on macro variables to a much greater extent. Nevertheless, sociological approaches to social psychology remain an important counterpart to psychological research in this area, in addition to the split between psychology and sociology, there has been a somewhat less pronounced difference in emphasis between American social psychologists and European social psychologists. As a generalization, American researchers traditionally have focused more on the individual, however, the discipline had already developed a significant foundation. Following the 18th century, those in the field of social psychology were concerned with developing concrete explanations for different aspects of human nature. They desired to discover concrete cause and effect relationships that explained the social interactions in the world around them, in order to do so, they believed that the scientific method, an empirically based scientific measure, could be applied to human behavior. The first published study in this area was an experiment in 1898 by Norman Triplett, during the 1930s, many Gestalt psychologists, most notably Kurt Lewin, fled to the United States from Nazi Germany. Attitudes and small group phenomena were the most commonly studied topics in this era, during World War II, social psychologists studied persuasion and propaganda for the U. S. military. After the war, researchers interested in a variety of social problems, including gender issues. Most notable, revealing, and contentious of these were the Stanley Milgram shock experiments on obedience to authority, in the sixties, there was growing interest in new topics, such as cognitive dissonance, bystander intervention, and aggression. By the 1970s, however, social psychology in America had reached a crisis, there was heated debate over the ethics of laboratory experimentation, whether or not attitudes really predicted behavior, and how much science could be done in a cultural context. This was also the time when a radical situationist approach challenged the relevance of self, throughout the 1980s and 1990s social psychology reached a more mature level. Two of the social psychology matured in were theories and methods. Careful ethical standards now regulate research, pluralistic and multicultural perspectives have emerged. Modern researchers are interested in many phenomena, but attribution, social cognition, Social psychologists have also maintained their applied interests with contributions in health, environmental, and legal psychology
11.
Health care reform
–
Health care reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place. The authors of the concluded that the prices paid for health care services are much higher in the U. S. In spite of the amount spent on care in the U. S. according to a 2008 Commonwealth Fund report. The World Health Organization, in 2000, ranked the US health care system 37th in overall performance, international comparisons that could lead to conclusions about the quality of the health care received by Americans are subject to debate. Many people are underinsured, for example, in Colorado of those with insurance for a year,36. 3% were underinsured. About 10.7 million insured Americans spend more than a quarter of their annual paychecks on health care because of the high deductible polices, the Patient Protection and Affordable Care Act was signed into law by President Barack Obama on March 23,2010. The Congressional Budget Office estimates that the net effect of both laws will be a reduction in the deficit by $143 billion over the first decade. The universal health care proposal pending in the U. S, Health care providers receive payment more frequently as the number of insured people increases and the number of uninsured patients unable to pay out of pocket declines. Many healthcare facilities are struggling to break even since the cost of providing health services has increased, due to wages, technology, and resources. The changes in regulations regarding risk pool assessment and the inclusion of 10 essential health benefits to every insurance plan have also contributed to the rise in cost of insurance premiums. Both Hawaii and Massachusetts have implemented some reforms in health care. For example, data from the Kaiser Family Foundation shows that 5% of Massachusetts, the United States spends more on health care than any other country in the world, and, yet, has poorer health status by many measures. In 2007, the United States spent $7,290 per capita on health care, the average among peer nations in the Organisation for Economic Cooperation and Development is $3075, just 42 percent of U. S. spending. Health spending is concentrated on a few consumers, in 2006, almost half of all health care spending was used to treat just 5 percent of the population, according to the Kaiser Family Foundation. More than half of bankruptcy filings are related to health care expenses, and sixty-eight percent of these cases are filed by people who have health insurance. According to the White House Council of Economic Advisors, the family income will be $2,600 lower by 2020. The cost of insurance premiums more than doubled between 1999 and 2008 while workers earnings stagnated. In 2008, the annual cost for family insurance coverage was $12,700
. PMID 17076568.
