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1、本科畢業(yè)論文（設(shè)計(jì)）外文翻譯外文出處PublichealthUnitedStates外文作者M(jìn)ichaelR.GreyMDMPH原文：原文：PublicHealthThenNowTheMedicalCareProgramsoftheFarmSecurityAdministration1932through1947:ARehearsalfNationalHealthInsuranceIntroductionFrom1935to1947th

2、efederalgovernmentsponsedanextensivecivilianmedicalcareprogramundertheaegisoftheUSDepartmentofAgriculturesFarmSecurityAdministration(FSA).TheFSAsmission—torehabilitatelowincomefarmerssharecroppersmigrantwkers—ledittodeve

3、lopacomprehensivemedicalcareprogramdescribedbytheSaturdayEveningPostasa“giganticrehearsalfhealthinsurance.“Attheprogramspeakmethan650(XH)pK)rfannersamillionmigrantswereenrolledinmedicalcarecooperativesfarmlabclinicsinath

4、irdofallruralcounties(FigureI).AlthoughtheNewDealhasbeenrichlyminedbyhistiansremarkablylittlehasbeenwrittenatK)utthis“giganticrehearsal“inthenearlyhalfcenturysinceitended.UntilthepassageofMedicareMedicaidtheFSAprogramwas

5、thelargestgovernmentsponsedprogramdedicatedtoprovidingmedicalcarefaspecifiedciviliangroup.TheFSAssuccessowesmuchtostrategiestheagencyadoptedtopromoteitsmedicalprogramamongskepticalphysicians.Thesestrategiesarerelevantgui

6、delinesasournationagainconfrontstheissueofnationalhealthsecurity.Eagertoavoidconfrontationwithbothlocalphysiciansganizedsteadygainsinthepostwarera.InretrospecthowevertherootcauseoftheFSAplanseventualdemisewasanideologica

7、lconflictbetweenthegovernmentthemedicalprofession.FthisreasonthehistyoftheFSAmedicalcareprogramilluminatestheideologicaleconomichumanitarianmotivationsofAmericanphysiciansinthefaceofhealthcarerefmMedicineHealthinthe1930s

8、Americanmedicinelikemuchofsocietyinthe1930swasintransition.Solopracticefeefservicestilldominatedmedicalpracticeruralhospitalswerefewoftenproprietary.Howeverthewaninginfluenceofgeneralpractitionerstherisingdominanceofspec

9、ialistscentralizationofcareinhospitalswerewellunderwaybythattime.^In1932theCommitteeontheCostsofMedicalCarepublisheditslmarkreptMedicalCareftheAmericanPeoplethemostexhaustiveinfluentialstudyofthestateofAmericanhealthmedi

10、cinethathadeverbeenpublished.Thecommitteefoundthatpocommunitiesexperiencedmesicknessreceivedlesscarethanmeaffluentcommunities.Medicalresourceswhileplentifulwerenot“distributedaccdingtoneedsbutratheraccdingtotherealsuppos

11、edabilityofpatientstopayfservices.““Thenumericalincomegeographicalimbalancebetweengeneralpractitionersspecialistsledthecommitteetoconcludethatthenationneededfarfewerspecialistsfarmegeneralpractitioners.Finallythecommitte

12、elinkedaccesscostbarriersascriticalissuesfundersenedpopulationssettingthetonefvirtuallyallheaithcarerefmstothepresentday“Anobviousbutoftenneglectedfactisthatthemosttlesomeproblemsinourhealthcaresystemantedatedchangessuch

13、astheexplosionofmedicaltechnologytheaccelerationofmedicalspecializationthedominanceofhospitalbasedcareinthewakeofWldWarII.Thecommittees1932reptcallingfanintegratedsysteminwhichgenerallstsprovidethemajityofacutepreventive

14、serviceswasprescient.TheGreatDepressiongreatlyexacerbatedbutdidnotcreatetheproblemshighlightedbytheCommitteeontheCostsofMedicalCare.Unemploymentsoaredtoanunprecedented25%overwhelmingprivatelocalreliefagencies.Lackofmoney

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