Government and Public Health in America

Government and Public Health in America

Ronald Hamowy

How involved should the government be in American healthcare? Ronald Hamowy argues that to answer this pressing question, we must understand the genesis of the five main federal agencies charged with responsibility for our health: the Public Health Service, the Food and Drug Administration, the Veterans Administration, the National Institutes of Health, and Medicare. In examining these, he traces the growth of federal influence from its tentative beginnings in 1798 through the ambitious infrastructures of today – and offers startling insights on the current debate.

Chapter 4: The National Institutes of Health

Ronald Hamowy

Subjects: economics and finance, health policy and economics, politics and public policy, public policy, social policy and sociology, economics of social policy, health policy and economics


One of the earliest goals of the American Public Health Association, formed in 1872 to advance the field of ‘sanitary science’ through extensive government regulation of all matters pertaining to the health and safety of Americans, was the creation of a cabinet-level department of public health. At the Association’s first annual meeting in 1873, one speaker called for the establishment of a National Sanitary Bureau and this view was echoed at the 1875 annual meeting of the American Medical Association.1 Its supporters regarded ‘continuous scientific investigations’ as a primary function of such a department and, toward this end, the forerunner of the Public Health Service, the Marine Hospital Service, formally established a Hygienic Laboratory for medical research in New York in August 1887. In 1883 Congress had empowered the Marine Hospital Service (MHS), the forerunner of the Public Health Service, to quarantine foreign ships seeking entry into American ports if there was indication that any passenger harbored an infectious disease. As a consequence the MHS set up a bacteriological laboratory at the Marine Hospital on Staten Island and it was this research facility that served as the foundation of the Hygienic Laboratory established in Washington, DC four years later. As its first director, the Supervising Surgeon, John B. Hamilton, chose Dr Joseph J. Kinyoun, who had studied with Pasteur and Koch in Europe. In 1887 and 1888 Kinyoun isolated Vibrio cholera from immigrants at Ellis Island but the imposition of a strict quarantine appears to have prevented the entry of...

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