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Surgery is one of the most difficult procedures in medicine.

 

Researchers looking at monoclonal antibodies.

 

The International Red Cross and Red Crescent Movement is a well-known international health care movement.

Health care, or healthcare, refers to the treatment and management of illness, and the preservation of health through services offered by the medical, pharmaceutical, dental, clinical laboratory sciences (in vitro diagnostics), nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”.^[1]

Before the term health care became popular, English-speakers referred to medicine or to the health sector and spoke of the treatment and prevention of illness and disease.

[edit] History

When considering the history of Universal Health Care and the giants of Canadian politics, T.C. Douglas surely stands at the forefront. Tommy Douglas was a remarkable Canadian whose contributions have helped to shape the great nation. Although he is most famous as the founding father of Medicare, the most advanced health-care system in the world, Douglas’ contributions to Saskatchewan and Canada were tremendous.

Tommy Clement Douglas was born on October 20, 1904 in Falkirk, Scotland. In 1911, Tommy, his mother and his sister moved to Winnipeg to join his father who had moved there the previous year. Shortly after settling in Winnipeg, Tommy was diagnosed with osteoarthritis in his right leg. Tommy’s family was not wealthy and subsequently his family could not pay for the best or most immediate treatment. The delay nearly cost Tommy his leg. This experience marked the beginning of Tommy’s quest for universal, public health care.

In 1961, In Saskatchewan, Canada, The North American Medical Establishment tried to defy Medicare, Douglas’s top priority project, and Saskatchewan politics became an intense battleground. This turbulent time was marked by the Doctor’s Strike as the physicians of the province protested socialized healthcare. However, the striking doctors were no match for Douglas. When the dust settled with the resolution of the strike, Medicare in Saskatchewan was born. Douglas showed Canada two things: that it was possible to develop and finance a universal Medicare system and that the medical profession could be confronted. Had Douglas not have made these first ground breaking steps, national Medicare would never have happened. This movement and political struggle helped pave the way for universal health care on a global scale. Since then, Canada's system of health care has been imitated and implemented in various countries around the world.

[edit] Terms

Health care can encompass a wide number of settings - from the informal (house calls, emergency medicine at an accident spot) to settings like nursing homes or rest homes, to 'typical' medical settings like doctor's practices, clinics and hospitals.

• A health care provider or health professional is an organization or person who delivers proper health care in a systematic way professionally to any individual in need of health care services. A health care provider could be government, the health care industry, a health care equipment company, an institution such as a hospital or medical laboratory, physicians, dentists, support staff, nurses, therapists, psychologists, pharmacists, chiropractors, and optometrists.

• Emergency medicine is a speciality of medicine that focuses on the diagnosis and treatment of acute illnesses and injuries that require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a wide array of pathology and undertake acute interventions to stabilize the patient. These professionals practice in hospital emergency departments, in the prehospital setting via emergency medical service and other locations where initial medical treatment of illness takes place. Just as clinicians operate by immediacy rules under large emergency systems, emergency practioniers aim to diagnose emergent conditions and stabilize the patient for definitive care.

• Chronic care management encompasses the oversight and education activities conducted by professionals to help patients with chronic diseases such as diabetes, high blood pressure, lupus, multiple sclerosis and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management (health) for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.

• Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often lead to adverse healthcare events. The frequency and magnitude of avoidable adverse patient events was not well known until the 1990s, when multiple countries reported staggering numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization calls patient safety an endemic concern.^[2] Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety.^[3] The resulting patient safety knowledge continually informs improvement efforts such as: applying lessons learned from business and industry, adopting innovative technologies, educating providers and consumers, enhancing error reporting systems, and developing new economic incentives. This patient safety page provides an evidence-based and peer-reviewed forum to learn about contemporary error and adverse event knowledge.

[edit] Industry

Main article: Health care industry

The health care industry is considered an industry or profession which includes peoples' exercise of skill or judgment or the providing of a service related to the preservation or improvement of the health of individuals or the treatment or care of individuals who are injured, sick, disabled, or infirm. The delivery of modern health care depends on an expanding group of trained professionals coming together as an interdisciplinary team.^[4][5]

Consuming just under 10 percent of gross domestic product of most developed nations, health care can form an enormous part of a country's economy. In 2003, health care costs paid to hospitals, physicians, nursing homes, diagnostic laboratories, pharmacies, medical device manufacturers and other components of the health care system, consumed 16.3 percent^[6] of the GDP of the United States, the largest of any country in the world. For the United States, the health share of gross domestic product (GDP) is expected to hold steady in 2006 before resuming its historical upward trend, reaching 19.5 percent of GDP by 2016.^[7] In 2001, for the OECD countries the average was 8.4 percent^[8] with the United States (13.9%), Switzerland (10.9%), and Germany (10.7%) being the top three.

[edit] Research

See also: List of health care journals, List of medical journals, List of pharmaceutical sciences journals, List of bioinformatics journals, and Medical literature

Top impact factor academic journals in the health car field include Health Affairs and Milbank Quarterly. New England Journal of Medicine, British Medical Journal and Journal of the American Medical Association are more general journals.

Biomedical research (or experimental medicine), in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid the body of knowledge in the field of medicine. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are termed clinical trials, and all other research that contributes to the development of new treatments. The latter is termed preclinical research if its goal is specifically to elaborate knowledge for the development of new therapeutic strategies. A new paradigm to biomedical research is being termed translational research, which focuses on iterative feedback loops between the basic and clinical research domains to accelerate knowledge translation from the bedside to the bench, and back again.

[edit] World Health Organization

Main article: World Health Organization

See also: Global health

The World Health Organization (WHO) is a specialised United Nations agency which acts as a coordinator and researcher for public health around the world. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the League of Nations. The WHO's constitution states that its mission "is the attainment by all peoples of the highest possible level of health." Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the peoples of the world. Examples of its work include years of fighting smallpox. In 1979 the WHO declared that the disease had been eradicated - the first disease in history to be completely eliminated by deliberate human design. The WHO is nearing success in developing vaccines against malaria and schistosomiasis and aims to eradicate polio within the next few years. The organization has already endorsed the world's first official HIV/AIDS Toolkit for Zimbabwe from October 3, 2006, making it an international standard.^[9]

The WHO is financed by contributions from member states and from donors. In recent years the WHO's work has involved more collaboration, currently around 80 such partnerships, with NGOs and the pharmaceutical industry, as well as with foundations such as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. Voluntary contributions to the WHO from national and local governments, foundations and NGOs, other UN organizations, and the private sector (including pharmaceutical companies), now exceed that of assessed contributions (dues) from its 193 member nations.^[10]

[edit] Economics

Main article: Health care economics

Health economics is a branch of economics concerned with issues related to scarcity in the allocation of health and health care. Broadly, health economists study the functioning of the health care system and the private and social causes of health-affecting behaviors such as smoking.

A seminal 1963 article by Kenneth Arrow, often credited with giving rise to the health economics as a discipline, drew conceptual distinctions between health and other goals.^[11] Factors that distinguish health economics from other areas include extensive government intervention, intractable uncertainty in several dimensions, asymmetric information, and externalities.^[12] Governments tend to regulate the health care industry heavily and also tend to be the largest payer within the market. Uncertainty is intrinsic to health, both in patient outcomes and financial concerns. The knowledge gap that exists between a physician and a patient creates a situation of distinct advantage for the physician, which is called asymmetric information. Externalities arise frequently when considering health and health care, notably in the context of infectious disease. For example, making an effort to avoid catching a cold, or practising safer sex, affects people other than the decision maker.

The scope of health economics is neatly encapsulated by Alan William's "plumbing diagram"^[13] dividing the discipline into eight distinct topics:

• What influences health? (other than health care)
• What is health and what is its value
• The demand for health care
• The supply of health care
• Micro-economic evaluation at treatment level
• Market equilibrium
• Evaluation at whole system level; and,
• Planning, budgeting and monitoring mechanisms.

[edit] Systems

Main article: Health care systems

See also: Preventive medicine and Social medicine

A single-payer universal health care system will save money through reduced bureaucratic administration costs.^[14] Social health insurance is where the whole population or most of the population is a member of a sickness insurance company. Most health services are provided by private enterprises which act as contractors, billing the government for patient care.^[15] In almost every country with a government health care system a parallel private system is allowed to operate. This is sometimes referred to as two-tier health care. The scale, extent, and funding of these private systems is very variable.

A traditional view is that improvements in health result from advancements in medical science. The medical model of health focuses on the eradication of illness through diagnosis and effective treatment. In contrast, the social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier. It defines illness from the point of view of the individual's functioning within their society rather than by monitoring for changes in biological or physiological signs.^[16]

[edit] Politics

Main article: Health care politics

The politics of health care depends largely on which country one is in. Current concerns in England, for instance, revolve around the use of private finance initiatives to build hospitals or the excessive use of targets in cutting waiting lists. In Germany and France, concerns are more based on the rising cost of drugs to the governments. In Brazil, an important political issue is the breach of intellectual property rights, or patents, for the domestic manufacture of antiretroviral drugs used in the treatment of HIV/AIDS.

The South African government, whose population sets the record for HIV infections, came under pressure for its refusal to admit there is any connection with AIDS^[17] because of the cost it would have involved. In the United States 12% to 16% of the citizens are still unable to afford health insurance. State boards and the Department of Health regulate inpatient care to reduce the national health care deficit. To tackle the problems of the perpetually increasing number of uninsured, and costs associated with the US health care system, President Barack Obama says he favors the creation of a universal health care system ^[18]. However, New York Times columnist Paul Krugman said that Obama's plan would not actually provide universal coverage.^[19] (In contrast, Dennis Kucinich, an early candidate who did not get on the ballot, supported a single-payer system.) Factcheck.org said that Obama's predicted savings were exaggerated. ^[20]