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This policy was established in 1965 and set down protocols for the Medicaid program. The medicaid program provides funding for medical and health related services to people who have a limited income. This policy specifically denotes what defines an institution, determining whether or not an institution is IMD and other aspect such as ages, costs and the definition of IMD are also set forth. Ultimately proving to set parameters and expectancies to those people and institutions that find themselves operating within this policy or referencing it. 

I read up on what constitutes people who can classify as peri-disaster personnel, I found the concept interesting and didn't realize there was a specific name to classify those people, I always wondered about the people who were indirectly effected by a disaster or partially effected due to proximity. I also researched comorbidity and common forms of mental illness that arise in post disaster survivors. 

The report shows that there are obvious measures of fallout and exposure due to the disaster. The numbers show a clear effect of the disaster on the environment, animals and humans surrounding the area. Due to this, this puts technical professionals in a position in where they must take obvious precautions, and proceed with this data ethically and attempt to combat it and increase the preservation of the environment as well as areas and people surrounding the area of disaster. Professionals now must with this data and these findings apply their degrees and background to help improve the conditions ad fallout. They now have a duty in their respective fields to work with these findings and use them to better the situation to the best of their abilities. 

Technical professionals can use this data to perhaps launch other studies to analyze the true effects of the disaster in Japan on thyroid cancer rates in adjacent areas. This study and data finings from this can be used to show the need for further studies on the matter in order to determine the correlation between cancer rates and the disaster. The study overall shows that there were high screening rates for thyroid cancer after the disaster, yet attributes it to the possibility of over diagnosis. This study can open the doors for numerous more studies on this matter. This study can also be used down the road as a reference for anyone who wishes to study the degree of fallout and cancer rates caused by a nuclear disaster. Methods used in this study can be modeled down the road for other disasters, with adjustments accounting for the possibility of over diagnosis. 

There was no emergency response addressed in this article directly. Yet, I believe patient narrative and the understanding of the connection between cultural stigmas or background and patient narrative is so imperative for EMS and other healthcare providers. It is crucial for emergency responders to understand possible cultural influences on patients and how that might effect their perception of their illness or how they reflect what they are experiencing to you as the their health care provider. 

According to the history page of American Red Cross, the organization began in 1882. In the 23 years following that, the organization aided in disaster relief efforts with the US Army during the Spanish American War. Not until prior to WW1 was the first water safety, first aid and health program introduced by the organization, where they first expanded their efforts and scope of what they can offer. What truly motivated the way and thinking of disaster relief was the outbreak of war America had. The organization grew tremendously because of war. In the 4 years between 1914 an 1918, chapters of American Red Cross went from 107 to 3,864- which is astonishing. Membership also grew from 17,000 to 20 million in that time. With this large jump of people and chapters came a large growth in funding and material to cover programs, hospitals, nurses, etc to aid refugees and American and Allied forces. Then in 1918, influenza pandemic struck and American Red Cross was able to help combat that and in the process took on more nurses to do so. This trend of growth is seen during times of war, or devastation such as the Great Depression, Mississippi River flood and WW2. Ultimately, what motivated the growth and disaster response was the need for it. As need increased for care during times of war, devastation or disease, American Red Cross grew, due to those in support of troops overseas, volunteering time and money, which allowed for the organization to grow and gain the moment needed to combat epidemics and eventually natural disasters.

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.