Government and Public Health in America
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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.
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Chapter 3: The Veterans Administration

Ronald Hamowy


Prior to World War I, the federal government provided no hospital or medical care to veterans other than extending domiciliary care, including incidental medical care, to a few disabled veterans.1 The United States Soldiers’ Home in Washington, DC, which began operations in 1851, and the National Home for Disabled Volunteer Soldiers2 provided domiciliary care to disabled veterans incapable of earning a livelihood because of age or disability.3 While it had been the policy of the National Home that veterans who had not been disabled in the line of duty were ineligible for domiciliary care, disabled soldiers who had been honorably discharged and who were incapacitated, regardless of cause, were extended such care by federal statute in 1884.4 Despite the fact that the statute provided that applicants had to prove that they were incapable of earning a living by virtue of their disability, the provisions of the 1884 Act so enlarged the number of veterans eligible for admission to the National Home that Congress was compelled to establish additional branches over the course of the following few years.5 Domiciliary care, with its ancillary medical benefits, was, at best, limited to a very small number of American veterans.6 The traditional method of dealing with those who had served in the military prior to World War I was to award them pensions, although, even then, earlier legislation limited pensions to soldiers who had been disabled or killed in the line of duty and their widows. However, during the Presidential campaign of 1878, Rutherford...

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