Marine Hospital Service

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The Marine Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the U.S. Merchant Marine, the U.S. Coast Guard and other federal beneficiaries. The Marine Hospital Service evolved into the U.S. Public Health Service Commissioned Corps.

United States Public Health Service Commissioned Corps federal uniformed service of the U.S. Public Health Service

The United States Public Health Service Commissioned Corps (PHSCC), also referred to as the Commissioned Corps of the United States Public Health Service, is the federal uniformed service of the U.S. Public Health Service (PHS), and is one of the seven uniformed services of the United States.

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It was the point of origin for the Public Health Service and the Public Health Service Commissioned Corps of the present-day Department of Health and Human Services, and current Operating Divisions (OPDIV) and Staffing Divisions that include the National Institutes of Health, the Centers for Disease Control and Prevention, Indian Health Service, and a host of other federal-level health programs.

National Institutes of Health Medical research organization in the United States

The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1870s and is now part of the United States Department of Health and Human Services. The majority of NIH facilities are located in Bethesda, Maryland. The NIH conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.

Centers for Disease Control and Prevention government agency

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.

Indian Health Service Branch of the United States Health Department regarding the health of Native Americans

The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally-recognized Native American Tribes and Alaska Native people. IHS is the principal federal health care provider and health advocate for Indian people, and its mission is to raise their health status to the highest possible level.

History

Founding

The Marine Hospital, Staten Island, N.Y. In 1887, the National Institute of Health began as a single room Laboratory of Hygiene for bacteriological investigation established by the U.S. Marine Hospital Service at Stapleton, Staten Island, New York. From 1887 to 1891, the hygienic laboratory was located in the attic of the Marine Hospital on Staten Island. Marine Hospital Service Stapleton Staten Island 19thcentury.gif
The Marine Hospital, Staten Island, N.Y. In 1887, the National Institute of Health began as a single room Laboratory of Hygiene for bacteriological investigation established by the U.S. Marine Hospital Service at Stapleton, Staten Island, New York. From 1887 to 1891, the hygienic laboratory was located in the attic of the Marine Hospital on Staten Island.
Marine Hospital in Charleston, South Carolina, built in 1833 Old Marine Hospital (Charleston).jpg
Marine Hospital in Charleston, South Carolina, built in 1833

The origins of the Marine Hospital Service can be traced to the passage, by the 5th Congress of the United States, of "An Act for the Relief of Sick and Disabled Seamen" in 1798. This act created Marine Hospitals to care for sick seamen. They were initially located along the East Coast, at the harbors of the major port cities, with Boston being the site of the first such facility, followed later by others including in the Baltimore vicinity at Curtis Bay. [1] [2] The Marine Hospital Service was placed under the Revenue Marine Service (a forerunner of the present-day Coast Guard) within the Department of the Treasury. [3]

5th United States Congress 1797-1799 legislative term

The Fifth United States Congress was a meeting of the legislative branch of the United States federal government, consisting of the United States Senate and the United States House of Representatives. It met at Congress Hall in Philadelphia, Pennsylvania, from March 4, 1797, to March 4, 1799, during the first two years of John Adams' presidency.

An Act for the relief of sick and disabled seamen United States law of 1798

An Act for the relief of sick and disabled seamen was passed by the 5th Congress. It was signed by President John Adams on July 16, 1798. The Act authorized the deduction of twenty cents per month from the wages of seamen, for the sole purpose of funding medical care for sick and disabled seamen, as well as building additional hospitals for the treatment of seamen. While some argue this is the first Federal individual mandate levied on individuals for health insurance, preceding the Patient Protection and Affordable Care Act ("Obamacare"), passed in early 2010, by nearly 212 years; others would point to the fact that this law solely regulated employers engaged in interstate and foreign commerce, and was enacted as a matter of national security.

East Coast of the United States Coastline in the United States

The East Coast of the United States, also known as the Eastern Seaboard, the Atlantic Coast, and the Atlantic Seaboard, is the coastline along which the Eastern United States meets the North Atlantic Ocean. The coastal states that have shoreline on the Atlantic Ocean are, from north to south, Maine, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Delaware, Maryland, Virginia, North Carolina, South Carolina, Georgia, and Florida.

It was the first federal health law. [2] It authorized a tax, which was the deduction of twenty cents per month from the wages of the seamen. [4] This tax raised funds for physicians and to support the network of hospitals. [5] Funding for the hospitals was provided by a mandatory tax of about 1% of the wages of all maritime sailors. [6] [7] (In 1884, the tax was abolished and in 1906 funds were dispensed by Congress.)

The act led to the gradual creation of a network of hospitals along coastal and inland waterways. [8] At the time the act was passed the east coast was the only shore with harbors. As the boundaries of the United States expanded, and harbors were built on other coasts, so too were marine hospitals. In the 1830s and 1840s they were built along inland waterways, the Great Lakes, and the Gulf of Mexico. After the acquisition of the Oregon Territory (1846) and California (1848) hospitals were built in 1850s at Pacific Coast harbors. [6]

United States territorial acquisitions

This is a list of United States territorial acquisitions and conquests, beginning with American independence. Note that this list primarily concerns land the United States of America acquired from other nation-states. Early American expansion was tied to a national concept of manifest destiny. Manifest destiny is an idea that white settlers are destined by God to expand their territories westwards, spread their ideologies on the land, and put leverages on the Indigenous people in order to gain larger territories. Manifest Destiny not only resulted in war with Mexico during the mid-19th century, but in relocation and brutal massacre and mistreatment of the Indigenous peoples, Hispanic, and other non-Europeans, such as afro-descendants, who resided in the territories no occupied by the United States.

Great Lakes lakes in North America

The Great Lakes, also called the Laurentian Great Lakes and the Great Lakes of North America, are a series of interconnected freshwater lakes primarily in the upper mid-east region of North America, on the Canada–United States border, which connect to the Atlantic Ocean through the Saint Lawrence River. They consist of Lakes Superior, Michigan, Huron, Erie, and Ontario, although hydrologically, there are four lakes, Superior, Erie, Ontario, and Michigan-Huron. The connected lakes form the Great Lakes Waterway.

Gulf of Mexico An Atlantic Ocean basin extending into southern North America

The Gulf of Mexico is an ocean basin and a marginal sea of the Atlantic Ocean, largely surrounded by the North American continent. It is bounded on the northeast, north and northwest by the Gulf Coast of the United States, on the southwest and south by Mexico, and on the southeast by Cuba. The U.S. states of Texas, Louisiana, Mississippi, Alabama, and Florida border the Gulf on the north, which are often referred to as the "Third Coast", in comparison with the U.S. Atlantic and Pacific coasts.

Reorganization

Flag of the Marine Hospital Service Flag of the United States Marine Hospital Service.svg
Flag of the Marine Hospital Service
Flag of the Public Health and Marine-Hospital Service Flag of the United States Public Health and Marine-Hospital Service.svg
Flag of the Public Health and Marine-Hospital Service

Following the Civil War, public outcry and scandal surrounded the Marine Hospital Fund. In 1869, Dr. John Shaw Billings, a prominent Army surgeon, was appointed to head an investigation of the Marine Hospital Fund. Dr. Billings found the hospital fund to be inadequate and completely disorganized.

American Civil War Civil war in the United States from 1861 to 1865

The American Civil War was a civil war fought in the United States from 1861 to 1865, between the North and the South. The most studied and written about episode in U.S. history, the Civil War began primarily as a result of the long-standing controversy over the enslavement of black people. War broke out in April 1861 when secessionist forces attacked Fort Sumter in South Carolina shortly after Abraham Lincoln had been inaugurated as the President of the United States. The loyalists of the Union in the North proclaimed support for the Constitution. They faced secessionists of the Confederate States in the South, who advocated for states' rights to uphold slavery.

John Shaw Billings American surgeon, statistician, United States Army officer, designer of New York Public library

John Shaw Billings was an American librarian, building designer, and surgeon. However, he is best known as the modernizer of the Library of the Surgeon General's Office of the Army and as the first director of the New York Public Library. In his early years, he was a surgeon and a statistician on medicine in the U.S. Army. Billings oversaw the building of the Surgeon General's Library, the nation's first comprehensive library for medicine. Because of his innovative approaches to improving public health and hospitals, Billings headed the U.S. Census Bureau's division of Vital Statistics and oversaw statistical compilation of censuses. Along with Robert Fletcher, Billings started Index Medicus, a monthly guide to contemporary medicine that ran for 16 months until his retirement at the Medical Museum and Library. He also served as Johns Hopkins Hospital's medical advisor and authored reports regarding criteria for medical and nursing curricula as well as hospital design. In addition to his work at Johns Hopkins Hospital, he was a hygiene faculty member at the University of Pennsylvania, the director at University Hospital, and the Chairman at the Carnegie Institution.

In June 1870 the 41st Congress formally converted the loose network of locally controlled marine hospitals, the Marine Hospital Fund, into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. This reorganization made the Marine Hospital Service into its own bureau within the Department of the Treasury. [3]

Dr. John Maynard Woodworth was subsequently appointed to the Service as "Supervising Surgeon." He transformed the service into a disciplined organization based on his experience in the Union Army as a surgeon. Dr. Woodworth required his physicians to be a mobile work force stationed where the service was in need, and he mandated the daily wear uniforms. This eventually led to the creation of the modern-day Public Health Service Commissioned Corps. Dr. Woodworth, using Army-style heraldry, created the Marine Hospital Service fouled anchor and caduceus seal which is used to this day by the Public Health Service. In 1873, Dr. Woodworth’s title was changed to "Supervising Surgeon General," a forerunner of the modern-day office of Surgeon General of the United States. [9]

Woodworth created a cadre of mobile, career service physicians, who could be assigned as needed to the various Marine Hospitals. The commissioned officer corps was established by legislation in 1889, and signed by President Grover Cleveland. At first open only to physicians, over the course of the 20th Century, the Corps expanded to include veterinarians, dentists, physician assistants, sanitary engineers, pharmacists, nurses, environmental health officers, scientists, and other types of health professionals. It is now known as the Commissioned Corps of the U.S. Public Health Service.

Increasing scope

U.S. Marine Hospital in Louisville, Kentucky (c.1909). It is currently under renovation. LouisvilleMarineHospital.jpg
U.S. Marine Hospital in Louisville, Kentucky (c.1909). It is currently under renovation.

The scope of activities of the Marine Hospital Service began to expand well beyond the care of merchant seamen in the closing decades of the nineteenth century, beginning with the control of infectious disease. Starting in the mid-14th century, ships entering harbors were quarantined when any of the crew was sick. This practice was normal procedure at United States harbors, with quarantine originally a function of the individual states, rather than of the Federal Government. The National Quarantine Act of 1878 vested quarantine authority to the Marine Hospital Service. and the National Board of Health. The National Board was not reauthorized by Congress in 1883 and its powers reverted to the Marine Hospital Service. [10] Over the next half a century, the Marine Hospital Service increasingly took over quarantine functions from individual state authorities.

The Marine Hospitals, as their name suggests, were hospitals constructed at key sea and river ports across the nation to provide health care for merchant marine sailors. Aside from the well-being of these sailors, the hospitals provided a key monitoring and gate-keeping function against pathogenic diseases. [3] As immigration increased dramatically in the late 19th Century, the Federal Government also took over the processing of immigrants from the individual states, beginning in 1891. The Marine Hospital Service was assigned the responsibility for the medical inspection of arriving immigrants at sites such as Ellis Island in New York Harbor. Commissioned officers played a major role in fulfilling the Service's commitment to prevent disease from entering the country.

As the nation grew, the scope of Marine Hospital Service's scope of duties grew to include domestic and foreign quarantine and other national public health functions. Over time, the hospitals of the service were also expanded to include research and prevention work as well as the care of patients. Aside from merchant seamen, members of the military, immigrants, Native Americans, other federal beneficiaries, and people affected by chronic and epidemic diseases found a source for health care in the PHS and its hospitals.[ citation needed ]

Transformation into Public Health Service

Venereal disease treatment, Marine Hospital New Orleans, 1942 WPADoctorNursePatientNOLA.jpg
Venereal disease treatment, Marine Hospital New Orleans, 1942

In 1902, the Marine Hospital Service was renamed the "Public Health and Marine-Hospital Service." In 1912, as the emphasis of its responsibilities shifted from sailors to general public health and with the decommissioning of various old marine hospitals, the name was changed again to the "Public Health Service" to encompass its diverse and changing mission.

As a result of the Reorganization Act of 1939, the Public Health Service was transferred from the Department of the Treasury into the new Federal Security Agency. [11] All of the laws affecting the functions of the public health agencies were consolidated for the first time in the Public Health Service Act of 1944. [3] In 1953 the Federal Security Agency was replaced with the newly formed Department of Health, Education and Welfare, which was later renamed the Department of Health and Human Services in 1980.

Today, the records for these institutions sit in storage at the National Library of Medicine in Bethesda, Maryland and the National Archives in College Park, Maryland.[ citation needed ]

Buildings

The hospitals themselves were, by the middle of the 19th century, fairly imposing and architecturally grand structures in many cases. As long as ample federal funding was available for their construction, these hospitals were impressive examples of government-provided health care. The hospitals of the early 20th century in major port cities such as New Orleans, San Francisco, and Savannah displayed ornate architectural detail and reflected many of the changes sweeping medicine at the time.[ citation needed ]

During the Nixon administration, funding was cut to the PHS hospitals program and many of these institutions closed or were turned over to local public health offices. Eight survived as federal institutions until the early 1980s, when further budget cuts put an end to their funding. Some, such as the one in Savannah, Georgia, continued as outpatient low-income health clinics up to 2003 while others, such as the large hospital in San Francisco on the grounds of the US Army Presidio, were diverted to other Federal and military uses. In the case of the Presidio, the PHS Hospital was used as a site for language training for military officers in the late 1980s.

See also

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References

  1. Gostin, Lawrence O. (2008). "Box 8: The Federal Presence in Public Health". Public Health Law: Power, Duty, Restraint, Revised and Expanded (2nd ed.). University of California Press. p. 156. ISBN   0520253760 . Retrieved 2012-11-08.
  2. 1 2 "Public Health". marinehospital.org. Retrieved 2018-03-07.
  3. 1 2 3 4 "Images From the History of the Public Health Service: Introduction". www.nlm.nih.gov. Retrieved 2017-12-03.
  4. "Justice Network - Sick and Disabled Seaman Act of 1798 Govt. Healthcare". www.nosue.org. Retrieved 2018-03-07.
  5. "Public Health in the United States". sphweb.bumc.bu.edu. Retrieved 2018-03-07.
  6. 1 2 Gostin, Lawrence O. (2008). "Box 8: The Federal Presence in Public Health". Public Health Law: Power, Duty, Restraint, Revised and Expanded (2nd ed.). University of California Press. p. 156. ISBN   0520253760 . Retrieved 2012-11-08.
  7. Ungar, Rick (January 17, 2011). "Congress Passes Socialized Medicine and Mandates Health Insurance -In 1798". Forbes.com . Retrieved 2012-11-08.
  8. "https://www.usphs.gov/aboutus/history.aspx". www.usphs.gov. Retrieved 2018-03-07.External link in |title= (help)
  9. ASPA. "John Maynard Woodworth (1871-1879)". www.surgeongeneral.gov. Retrieved 2017-12-03.
  10. Smillie, W. G. "The National Board of Health, 1879-1883" American Journal of Public Health and The Nation's Health (1943) 33(8):925-930.
  11. "Message to Congress on the Reorganization Act". The American Presidency Project. 1939-04-25. Retrieved 2018-10-23.