The Affordable Care Act (ACA) was signed into law on March 23, 2010 and will fundamentally alter health care in the United States for years to come. The US is currently one of the only industrialized countries without universal health insurance. The new law expands existing public insurance for the poor. It also provides financial credits to low income individuals and some small businesses to purchase health insurance. By government estimates, the law will bring insurance to 30 million people. The law also provides for a significant new investment in prevention and wellness. It appropriates an unprecedented $15 billion in a prevention and public health fund, to be disbursed over 10 years, as well as creates a national prevention council to oversee the government's prevention efforts. This paper discusses 3 major prevention provisions in the legislation: 1) the waiving of cost-sharing for clinical preventive services, 2) new funding for community preventive services, and 3) new funding for workplace wellness programs. The paper examines the scientific evidence behind these provisions as well as provides examples of some model programs. Taken together, these provisions represent a significant advancement for prevention in the US health care system, including a shift towards healthier environments. However, in this turbulent economic and political environment, there is a real threat that much of the law, including the prevention provisions, will not receive adequate funding.
Purpose: The object of this study is to identify the reason why school health education act had not been enforced properly, and to find out implications for improving. Methods: The implementation process of school health education act was described and the imperatives of the process were analysed. M. Rein's Policy Implementation Model was used as an analysis framework. The sources of this study was based on the minutes of parliament, government reports, materials for the meetings of policy makers, the press, etc. Results: The school health education act clarified mandatory and systemic health education in it, but it did not clearly mentioned about 'the introduction of compulsory health education subject'. The bureaucrats of National Educational Ministry who are responsible for policy implementation, did not behave in a friendly manner toward the school health education act. What is more, the ways of mandatory and systemic school health education could not be discussed reasonably in the implementation process. Through this study it was found that the rational-bureaucratic imperative played the main role in the implementation process of school health education act due to the limitation of the legal imperative and the consensual imperative. Conclusion: The result of this study suggests the strong need to make up for the defect of the two imperatives, and to reform the rational-bureaucratic imperative.
EIA has been introduced as a tool for environment protection into promulgation of the Environment Preservation Act in 1977, which replaced the Pollution Control Act in Korea. EIA system has been improved with the enlargement of project type, public participation, guideline improvement, and regulatory development. Recently, Environmental Impact Assessment(EIA) Act will have an important role for sustainable development. This article deals with regulatory development, implementation order, EIA project type, and EIS preparation guidelines by Act promulgated and amended, also it explains comparison analysis of Environmental Policy Act and Environment Impact Assessment Act Major results are summarized in the table.
EIA has been developed as a tool for environmental protection into promulgation of the Environment Preservation Act in 1977, with the introduction of EIA concept in the Pollution Control Act amended in 1971. EIA system has been improved with the enlargement of project type, public participation, guiderline improvement, and amendment of Act and presidential decree. Also, this system has been developed to reduce adverse effects affecting environment and human beings for environmentally sound and sustainable development. This study is to analyze contents of Acts and regulations relative to Environmental Impact Assessment from 1971 to recently.
Purpose: Today, the proportion of the elderly is increasing especially in a province. For elder people, local government has conducted the health promotion act by oriental medicine. For oriental medicine hub health promotion act, Eumseong -gun carried out a program that is urinary incontinence clinic for the elderly. The purpose of this study is to show how effective the public health promotion program using oriental medicine is. Methods: The 42 patients had been treated for urinary incontinence during the 10 or 11 weeks. They were put on oriental medical treatment in the Eumseong-gun public health center. Results: 1. There was significant decreases in the degree of urinary incontinence after the treatment. 2. The treatment made the patients regain their mental security. 3. People who were treated by public health promotion program were the most satisfied. Conclusion: The results suggested that public health promotion program using oriental medicine is effective for urinary incontinence.
Objectives: To review reference levels by the international and domestic management and provide the basis for setting occupational exposure limits(OELs) of radon in Korea Methods: Government's organizations with laws and systems for monitoring radon exposure were investigated and compared. There are five laws governing Indoor Air Quality(IAQ) control such as Occupational Safety and Health Act, Indoor Air Quality Control in Public Use Facilities, Etc. Act, School Health Act, Public Health Control Act and Parking Lot Act in Korea. It was surveyed that a total of 32 countries including 24 countries in the European Union(EU), six countries in Asian and two countries in North America setting the reference levels for radon in the world. Results: In Korea, there are set guidelines for radon in the Ministry of Environment and the Ministry of Education. Reference levels of radon for existing dwellings were $150{\sim}400Bq/m^3$ for Western European countries, and $200{\sim}1,500Bq/m^3$ in Eastern European countries. Approximately 67% of those EU countries were set up $400Bq/m^3$ to the standards for existing dwellings. EU countries such as Luxembourg, Finland, Norway, Sweden and Russia had adopted mandatory level for radon. Radon guidelines for new dwellings were set more strictly reference level($200Bq/m^3$) than existing dwellings. Conclusions: International organizations such as ICRP, UNSCEAR and NCRP, etc. had recommended the guidelines for radon. It was calculated the relation of the dose conversion factors with the annual effective doses. the OELs of radon suggest to need to establish $150Bq/m^3$ for office room and $400{\sim}1,000Bq/m^3$ for the workplace.
Hazardous wastes released into the general environment are of concern to the public and to public health authorities. In response to this concern, the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (commonly called Superfund), was enacted in 1980 to provide a framework for environmental, public health, and legal actions concerning uncontrolled releases of hazardous substances. The Agency for Toxic Substances and Disease Registry (ATSDR) was created by Superfund to address the public health issues of hazardous wastes in the community environment. Two key Agency programs, Public Health Assessments and Toxicological Profiles, are designed to assess the risk to human health of exposures to hazardous substances that migrate from waste sites or through emergency releases (e.g., chemical spills). The Agency's public health assessment is a structured process that permits ATSDR to identify which waste sites or other point sources require traditional public health actions (e.g.. human exposure studies, health studies, registries, health surveillance, health advisories). The ATSDR qualitative public health assessment complements the U.S. Environmental Protection Agency's quantitative risk assessment. For Superfund purposes, both assessments are sitespecific. ATSDR's toxicological profiles are prepared for priority hazardous substances found most frequently at Superfund sites. Each profile presents the current toxicologic and human health effects information about the substance being profiled. Each profile also contains Minimal Risk Levels (MRLs), a type of risk assessment value. This paper covers ATSDR's experience in conducting public health assessments and developing MRLs, and it relates this experience to recommendations on how to improve chemical risk assessments.
The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.
This paper reviews the past of community-based health promotion program through public health center to suggest the direction of future. The Minister of Health and Welfare has implemented health promotion demonstration programs at 18 public health centers in September 1998. Health promotion programs were spread nationwide in 2005. Now, 251 public health centers have performed health promotion programs. Health promotion includes both actions towards changing determinants, within the more immediate control of individuals, including individual health behavior, and those factors largely outside the control of individuals, including social, economic and environmental conditions. Direction of health promotion programs in public health is divided into two categories: creating environment for healthy lifestyle and health promotion services. The result of this paper will be able to act as a guide for future operation plan in health center.
Along with the development of digital technologies, the information obtained during the medical procedures was working as a source of valuable assets. Especially, the secondary use of personal health information gives the ordeal to privacy protection problems. In korea, the usage of personal medical information is basically regulated by the several laws in view of general and administrative Act like Medicine Act, Public institutions' personal information protection Act, Information-Network Act etc. There is no specific health information protection Act. Health information exchange program for the blood donor referral related with teratogenic drugs and contagious disease and medical treatment reporting system for income tax convenience are the two examples of recently occurred secondary use of health information in Korea. Basically the secondary use of protected health information is depend on the risk-benefit analysis. But to accomplish the minimal invasion to privacy, we need to consider collection limitation principle first. If the expected results were attained with alternative method which is less privacy invasive, we could consider the present method is unconstitutional due to the violation of proportionality rule.
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