Pierce J R, Blackburn C P
Dept. of Public Health, Amarillo, TX 79105, USA.
Public Health Rep. 1998 Mar-Apr;113(2):152-9.
In 1993, the health department serving the city of Amarillo, Texas, and surrounding communities was merged with the city's tax-supported Hospital District, which operated a public hospital and clinics providing medical care to poor people. Three years later, the public hospital and clinics were sold to a for-profit corporation, privatizing most medical services for the poor. The proceeds from this sale created a community trust fund for the provision of indigent care and eliminated Hospital District taxes. The city government reassumed operation of the Health Department, which redefined itself primarily in terms of public health functions not involving the provision of personal health services. These functions included communicable disease control, monitoring the health status of the community, identification of public health problems, and health promotion. The new Health Department, with a smaller budget and fewer staff members, is now funded by the for-profit corporation that purchased the public hospital, the community trust fund, and grants from the state health department.
1993年，为得克萨斯州阿马里洛市及周边社区服务的卫生部门与该市由税收支持的医院区合并，该医院区运营着一家公立医院和几家为贫困人口提供医疗服务的诊所。三年后，公立医院和诊所被出售给一家营利性公司，将大多数为贫困人口提供的医疗服务私有化。此次出售所得创建了一个社区信托基金，用于提供贫困医疗救助，并取消了医院区的税收。市政府重新承担了卫生部门的运营，该部门主要将自身重新定义为不涉及提供个人健康服务的公共卫生职能。这些职能包括传染病控制、监测社区健康状况、识别公共卫生问题以及促进健康。新的卫生部门预算减少、工作人员也更少，现在由购买了公立医院的营利性公司、社区信托基金以及州卫生部门的拨款提供资金。
