Health Planning in the United States: Some Categorical and General Approaches

Abstract

It is rather amazing that in 1971, the United States does not have a comprehensive health policy or national health plan. Our advanced science and technology have not taken root on a broad basis in the health field. Yet categorical planning has been done in several fields of health ever since the enactment of the Social Security Act in 1935. Planning was initiated in the fields of maternal and child health and crippled children by the federal Children's Bureau.

This article gives some examples of both categorical and general approaches to health planning, how they came into being, and what planning concepts and processes were developed and used. These examples may be of some value to planners who have to employ categorical approaches—largely pragmatic—pending the time that comprehensive national health planning becomes feasible.

The categorical areas chosen for discussion are: (a) health facilities, (b) heart, cancer, stroke, and kidney disease (Regional Medical Programs), (c) mental health, and (d) American Indian health. The general area includes comprehensive health planning.

Following the passage of the Social Security Act of 1935, personal and environmental health services have been fragmented into a number of pieces. In 1971, utter confusion reigns in the federal and state structure and functions of health. Hopefully, the Congress may soon realize that a national system of health services is essential to provide 205 million people with the quality and distribution of services—without financial barriers—that $70 billion dollars a year should buy. Certainly the experiences gained with the categorical approaches to health planning can be of value to governmental leaders and their advisers as they prepare comprehensive health policies and national health plans for the 1970s.