Telma Reca en la gestión estatal de la sanidad argentina (1930-1948) / Telma Reca: an argentine physician in the state (1930-1948)

Este artículo aporta nuevos datos sobre la médica argentina Telma Reca (1904-1979), particularmente en relación con su inserción en ámbitos académicos y en la gestión estatal a partir de los años treinta del siglo XX. Nos focalizaremos en su trayectoria profesional desde que obtuvo su doctorado en la Universidad de Buenos Aires (1932) hasta que se retiró de la División de Maternidad e Infancia del Departamento Nacional de Higiene en 1948. Durante ese período aplicó en la gestión estatal sus investigaciones sobre el estudio de las condiciones sociales de la delincuencia juvenil y de la educación. Su perspectiva crítica, lejos de implementar medidas punitivas generadoras de una mayor exclusión social, buscó la integración de los menores en la comunidad por medio de políticas educativas y sanitarias

This article will reconstruct the biography of the Argentine physician Telma Reca (1904-1979) who managed to get involved in academic fields and the state administration in the 30's. We will address ourselves to tracking her professional career from her PhD degree in Medicine (1932) until her withdrawal from the División de Maternidad e Infancia del Departamento Nacional de Higiene (Maternity and Childhood Division of the National Hygiene Department) in 1948. During this period, she focused her research on the study of the social conditions of juvenile delinquency on the public administration. With a critical eye, far from social exclusion and punitive measures, she managed to promote social integration through health and education policies

Psychiatry, homeless patients and welfare reforms: historical links and chains.

The birthplace of the specialty of psychiatry was in the asylum, which was created to divert patients from workhouses where the most disadvantaged and destitute people with mental illness were to be found. The current welfare reforms are endangering the welfare and livelihood of the most disadvantaged of our patients. These reforms in the authors' opinion are related more to the historical cycle of societal attitude to homeless people than to seeing them as the undeserving poor. This is particularly true since the current economic crisis was not caused by the poor, so it is very unfair that our poorest patients should suffer most as a result of the welfare reforms.

A short history of health care reform: Minnesota Medicine's perspective, 1934-1967.

From 1934 through 1967, Minnesota Medicine published a section called Medical Economics. The editors used the section to address the politics and economics of health care and health insurance by excerpting news items, reprinting opinion pieces, and contributing original material to inform and influence the readership. This article reviews the history of health care reform and organized medicine's response to it as reflected in this section of the journal.

Frederick L. Hoffman, LLD (Hon), 1865-1946.

This biographical sketch on Frederick L. Hoffman corresponds to the historic text, The Classic: A Plan for a More Effective Federal and State Health Administration, available at DOI 10.1007/s11999-009-1000-x. The article can also be accessed on the American Journal of Public Health web site at (http://www.ajph.org/cgi/reprint/9/3/161-a).

A plan for a more effective federal and state health administration. 1919.

This Classic article is a reprint of the original work by Frederick L. Hoffman, LLD, A Plan for a More Effective Federal and State Health Administration. An accompanying biographical sketch on Frederick L. Hoffman, LLD, is available at DOI 10.1007/s11999-009-1001-9. The Classic Article is (c)1919 by the American Public Health Association and is reprinted with permission from Hoffman FL. A plan for a more effective federal and state health administration. Am J Public Health. 1919;9:161-169. The article can also be accessed on the American Journal of Public Health web site at (http://www.ajph.org/cgi/reprint/9/3/161-a).

Impeding Earl Warren: California's health insurance plan that wasn't and what might have been.

It is widely believed that the turning point for U.S. health insurance came in 1949 when Congress failed to adopt President Harry Truman's proposal for a national system. The possibility that a system of state-level health plans might have emerged before Truman's plan has received little attention. Yet several attempts to enact such a plan were made in California by Governor Earl Warren in the mid-1940s. Had Warren succeeded, the California example might have been emulated by other states and the United States might have evolved a system similar to Canada's provincial programs.

John Kitzhaber and the Oregon Health Plan.

The Oregon Health Plan could not have developed into its current form without strong leadership. Criticism, which has shifted from the political left to the right, has been a constant companion, making integration of mental health services more precarious.

State health agencies and quality improvement in perinatal care.

The origin of the federal-state partnership in Maternal and Child Health (MCH) can be traced from the Children's Bureau grants of 1912, through the Sheppard-Towner Act, to the creation of Title V and other programs of today that mandate planning, accountability, and systems development. In the past decade with the transformation of the health care system and the emergence of managed care, there has been a resurgence of interest in public, professional, and governmental interest in quality measurement and accountability. Regional perinatal systems have been implemented in all states with varying levels of involvement by state health agencies and the public sector. This historical framework discusses two primary themes: the decades of evolution in the federal-state partnership, and the emergence in the last three decades of perinatal regional system policy, and suggests that the structure of the federal-state partnership has encouraged state variation. A survey of state MCH programs was undertaken to clarify their operational and perceived role in promoting quality improvement in perinatal care. Data and information from the survey, along with five illustrative state case studies, demonstrate great variation in how individual state agencies function. State efforts in quality improvement, a process to make things better, have four arenas of activity: policy development and implementation, definition and measurement of quality, data collection and analysis, and communication to affect change. Few state health agencies (through their MCH programs and perinatal staff) are taking action in all four arenas. This analysis concludes that there are improvements MCH programs could implement without significant expansion in their authority or resources and points out that there is an opportunity for states to be more proactive as they have the legal authority and responsibility for assuring MCH outcomes.

Health reform in Israel: some aspects of seventy years of struggle (1925-1995).

This work traces attempts to bring about the passage of a compulsory health insurance law in Israel-from initial efforts in 1925 to the actual passage of such legislation in 1995. It examines the course of events in historical perspective, documenting positions adopted by various bodies-governmental, political, quasi-political, professional, and other-at various stages, clarifying why early initiatives failed. Most of this work is founded on historical archival documents found in London and Israel.

Psychiatric expansionism and social control: the intersectioin of community care and state policy.

Informed by the theories of political economy and professional interests, this research argues that psychiatric commitments to community care and to scientific categorization have contributed to expanding control of the mentally ill, and that these ideological commitments run parallel to and are exacerbated by state responses to macro-economic conditions. Time series analysis of the period from 1932 to 1975 is used to assess the relative impact of deinstitutionalization, medical entrenchment, and state fiscal policy on psychiatric expansionism. The findings demonstrate that a professional interests explanation (indicated by a commitment to community and to science) provides a significant contribution to a materialist-based explanation of expanding psychiatric control.

Análises dos Planos de Saúde elaborados no Paraguai no período stronista - 1954-1989 / Analyses of health plans elaborated in Paraguay during the Stroessner's government - 1954-1989

Caracteriza os Planos de Saúde elaborados durante a longa ditadura militar que se instalou no Paraguai entre os anos de 1954-1989. Pretende contrastar as políticas e estratégias sanitárias estabelecidas no plano discursivo com a prática baseada nos resultados obtidos por estes planos. Observa que o governo stronista teve o mérito de haver iniciado a prática de planejamento com a elaboraçäo do primeiro plano de saúde no ano de 1957. Como conclusäo, pode-se ressaltar que o crescimento econômico que caracterizou o país neste período näo corresponde ao melhoramento das condiçöes de saúde da populaçäo, bem como as políticas sociais voltadas para a melhora das condiçöes de vida da populaçäo nunca foram prioritárias para o governo stronista.(AU)