Primary care may be provided in community health centres.

Primary care is the term for the health services by providers who act as the principal point of consultation for patients within a health care system.^[1][2] Such a professional can be a primary care physician, such as a general practitioner or family physician, or depending on the locality, health system organization, and patient's discretion, they may see a pharmacist, a physician assistant, a nurse practitioner, a nurse (such as in the United Kingdom), a clinical officer (such as in parts of Africa), or an Ayurvedic or other traditional medicine professional (such as in parts of Asia). Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.

Background[link]

The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy. Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care.

The International Classification of Primary Care (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit.^[3] Common chronic illnesses usually treated in primary care may include, for example: hypertension, angina, diabetes, asthma, COPD, depression and anxiety, back pain, arthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations.

In context of global population ageing, with increasing numbers of older adults at greater risk of chonic non-communicable diseases, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries.^[4][5]

Primary care by country[link]

Canada[link]

In Canada, access to primary and other health care services are guaranteed for all citizens through the Canada Health Act.

Nigeria[link]

In Nigeria, health care is a concurrent responsibility of three tiers of government. Local governments focus on the delivery of primary care (e.g. through a system of dispensaries), state governments manage the various general hospitals (secondary care), while the federal government's role is mostly limited to coordinating the affairs of the Federal Medical Centres and university teaching hospitals (tertiary care).

United States[link]

A 2009 report by the New England Healthcare Institute determined that an increased demand on primary care by older, sicker patients and decreased supply of primary care practitioners has led to a crisis in primary care delivery. The research identified a set of innovations that could enhance the quality, efficiency and effectiveness of primary care in the United States.^[5]

See also[link]

Medicine portal

• Anatomical Therapeutic Chemical Classification System (ATC classification for drugs)
• Classification of Pharmaco-Therapeutic Referrals (CPR)
• Direct primary care (United States)
• Family medicine / Family practice
• International Classification of Diseases (ICD)
• Medical classification
• Nursing shortage
• Physician shortage
• Primary care physician
• Primary care ethics
• Primary Health Organisation (New Zealand)

References[link]

External links[link]

• Defining Primary Care from Institute of Medicine IOM - Primary Care: America's Health in a New Era (1996)
• Primary Care Definitions from American Academy of Family Physicians AAFP
• Definition of Primary Care from American Medical Association AMA
• Defining primary health care Department of Health United Kingdom UK
• International Primary Care Established in 2006, the International Primary Care Association IPCA is an international membership-based organisation of doctors, nurses and allied healthcare professionals.
• What is primary health care? Aboriginal Medical Services Alliance Northern Territory (AMSANT) Australia

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Elizabeth Warren (born June 22, 1949) is an American bankruptcy law expert, policy advocate, Harvard Law School professor, and Democratic Party candidate in the 2012 United States Senate election in Massachusetts. She has written several academic and popular books concerning the American economy and personal finance. She contributed to the oversight of the 2008 U.S. bailout program, and also led the conception and establishment of the Consumer Financial Protection Bureau.

Born in Oklahoma City, Oklahoma, Warren attended The George Washington University and the University of Houston. She received a J.D. from Rutgers School of Law–Newark in 1976. Warren taught law at several universities and was listed by the Association of American Law Schools as a minority law professor throughout the 1980s and 1990s. In the wake of the U.S. financial crisis, Warren served as chair of the Congressional Oversight Panel created to oversee the Troubled Assets Relief Program in 2008. She later served as Assistant to the President and Special Advisor to the Secretary of the Treasury for the Consumer Financial Protection Bureau under U.S. President Barack Obama.

Early life and education[link]

Elizabeth Herring^[1] was born June 22, 1949,^[2] in Oklahoma City, Oklahoma, to working class parents Pauline (née Reed) and Donald Jones Herring.^[3][4][5] She was the Herrings' fourth child, with three older brothers.^[6] When Warren was twelve, her father, a janitor, had a heart attack, which led to a pay cut, medical bills, and eventually the loss of their car. Her mother answered phones at Sears and Warren worked as a waitress.^[6][7]

At Northwest Classen High School she was named "Oklahoma's top high-school debater". She received a debate-team scholarship to George Washington University at the age of 16. Initially aspiring to be a teacher, she left GWU after two years to marry her high-school boyfriend Jim Warren.^[6][8] She moved to Houston to be with her husband, who was a NASA engineer. There she enrolled in the University of Houston where she graduated in 1970 with a degree in speech pathology and audiology.^[9] She taught children with disabilities for a year in a public school. However, she had not taken the required education courses to get a teaching certificate (she previously taught under an "emergency certificate"). After taking several graduate education courses, she decided she no longer wanted to pursue education as a career. She and her husband moved to New Jersey and since she was pregnant with their first child, she decided to stay at home for a few years.^[10][11][12]

After making a decision to study law, Warren enrolled at the Rutgers School of Law–Newark,^[10] where she served as an editor of the Rutgers Law Review, and was a summer associate at Cadwalader, Wickersham & Taft's.^[13] Shortly before her graduation in 1976, she became pregnant with her second child and she worked from home, writing wills and doing real estate closings.^[8][10]

She and Jim had two children before divorcing in 1978: Amelia Warren Tyagi, with whom Elizabeth would later coauthor two books and several articles, and a son, Alexander Warren. Today they have three grandchildren.^[14] In 1980, Warren married Bruce Mann, also a Harvard law professor. She cites Methodist founder John Wesley as an inspiration.^[15]

Academic career[link]

Throughout the 1980s and 1990s she taught law at several universities throughout the country, while researching bankruptcy and middle-class personal finance.^[10] In 1978 Congress had passed a law that made it easier for companies and individuals to declare bankruptcy and Warren decided "to set out to prove they were all a bunch of cheaters... I was going to expose these people who were taking advantage of the rest of us". However, she instead found that the vast majority of those in bankruptcy courts were from hardworking middle-class families: people who had lost their jobs or had family breakups or illnesses that had wiped out their savings. "It changed my vision," she said.^[6]

According to her CV, she taught at the Rutgers School of Law–Newark (1977–78), the University of Houston Law Center (1978–83), the University of Michigan (visiting, 1985), and the University of Texas School of Law (1981–87). She also worked as a research associate at the University of Texas at Austin (1983–87). She joined the University of Pennsylvania Law School in 1987, where she became the William A Schnader Professor of Commercial Law in 1990. She joined Harvard Law School in 1992 as the Robert Braucher Visiting Professor of Commercial Law, and began a permanent position as the Leo Gottlieb Professor of Law in 1995.^[16]

In 1995 Warren was asked to advise the National Bankruptcy Review Commission. She helped to draft the commission's report and then spent several years opposing legislation meant to severely restrict the right of consumers to file for bankruptcy. Warren and others opposing the legislation were not successful and in 2005 the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 was passed by Congress.^[17]

Warren appeared in the documentary film Maxed Out in 2006, has appeared several times on Dr. Phil to talk about money and families, has been a guest on The Daily Show,^[18] is interviewed frequently on cable news networks,^[19] appears in Michael Moore's Capitalism: A Love Story, has appeared on the Charlie Rose talk show,^[20] and has appeared on the Real Time With Bill Maher talk show.^[21] She has also appeared on the PBS show NOW.^[22]

Warren in 2010 at a Women in Finance symposium held at the U.S. Treasury.

From November 2006 to November 2010, Warren was a member of the FDIC Advisory Committee on Economic Inclusion, which advises the FDIC "on important initiatives focused on expanding access to banking services by underserved populations".^[23] She is a member of the National Bankruptcy Conference, an independent organization which advises the U.S. Congress on bankruptcy law.^[24] She is a former Vice-President of the American Law Institute and a member of the American Academy of Arts and Sciences. From 2005 to 2008, Warren and her law students wrote a blog called Warren Reports, part of Josh Marshall's TPMCafe.

Popular works[link]

In addition to writing more than 100 scholarly articles and six academic books, Warren has written several best-selling books, including All Your Worth: The Ultimate Lifetime Money Plan, coauthored with her daughter, Amelia Tyagi.

Warren and Tyagi also wrote The Two-Income Trap: Why Middle-Class Mothers and Fathers Are Going Broke. Warren and Tyagi point out that a fully employed worker today earns less inflation-adjusted income than a fully employed worker did 30 years ago. To increase their income, families have sent a second parent into the workforce. Although families spend less today on clothing, appliances, and other consumption, the costs of core expenses such as mortgages, health care, transportation, and child care have increased dramatically. The result is that even with two-income earners, families are no longer able to save and have incurred greater and greater debt.

In an article in The New York Times, Jeff Madrick said of Warren's book:

The upshot is that two-income families often have even less income left over today than did an equivalent single-income family 30 years ago, even when they make almost twice as much. And they go deeper in debt. The authors find that it is not the free-spending young or the incapacitated elderly who are declaring bankruptcy so much as families with children... their main thesis is undeniable. Typical families often cannot afford the high-quality education, health care and neighborhoods required to be middle class today. More clearly than anyone else, I think, Ms. Warren and Ms. Tyagi have shown how little attention the nation and our government have paid to the way Americans really live.^[25]

In an article in Time magazine by Maryanna Murray Buechner, "Parent Trap" (subtitled "Want to go bust? Have a kid. Educate same. Why the middle class never had it so bad"), Buechner said of Warren's book:

For families looking for ways to cope, Warren and Tyagi mainly offer palliatives: Buy a cheaper house. Squirrel away a six-month cash cushion. Yeah, right. But they also know that there are no easy solutions. Readers who are already committed to a house and parenthood will find little to mitigate the deflating sense that they have nowhere to go but down.^[26]

In 2005, David Himmelstein and Warren published a study on bankruptcy and medical bills,^[27] which said that half of all families filing for bankruptcy did so in the aftermath of a serious medical problem. The finding was particularly noteworthy because 75 percent of families who fit that description had medical insurance.^[28] This study was widely cited in academic studies and policy debates, though some have challenged the study's methods and offered alternative interpretations of the data.^[29]

TARP oversight[link]

On November 14, 2008, Warren was appointed by United States Senate Majority Leader Harry Reid to chair the five-member Congressional Oversight Panel created to oversee the implementation of the Emergency Economic Stabilization Act.^[30] The Panel releases monthly oversight reports that evaluate the government bailout and related programs.^[15] The Panel's monthly reports under Warren's leadership covered foreclosure mitigation, consumer and small business lending, commercial real estate, AIG, bank stress tests, the impact of the Troubled Asset Relief Program (TARP) on the financial markets, government guarantees, the automotive industry, and many other topics. The Panel has also released special reports on financial regulatory reform and farm loans. For each report, Warren released a video on the Congressional Oversight Panel's website explaining key findings.^[a]

In an interview at Newsweek, Warren commented, "To restore some basic sanity to the financial system, we need two central changes: fix broken consumer-credit markets and end guarantees for the big players that threaten our entire economic system."^[31]

On July 29, 2011, she left her role with the agency to return to academic life at Harvard Law School. Her departing address indicated how she first became involved:

Four years ago, I submitted an article to Democracy Journal that argued for a new government agency called the Financial Product Safety Commission. I threw myself into that piece because I felt strongly that a new consumer agency would make the credit markets work better for American families and strengthen the economic security of the middle class... I leave this agency, but not this fight... the issues we deal with – a middle class that has been squeezed and business models built on tricks and traps – are deeply personal to me, and they always will be.^[32]

Consumer Financial Protection Bureau[link]

Warren has long advocated for the creation of a new Consumer Financial Protection Bureau, a watchdog agency designed to "make basic financial practices such as taking out a mortgage or loan more clear and transparent while ferreting out unfair lending practices," according to CNN. In an interview with the Huffington Post, Warren said "My first choice is a strong consumer agency. My second choice is no agency at all and plenty of blood and teeth left on the floor".^[33] Through Warren's efforts, the bureau was established by the Dodd–Frank Wall Street Reform and Consumer Protection Act signed into law by Obama in July 2010. For the first year after the bill's signing, Warren worked on implementation of the bureau as a Special Assistant to the President in anticipation of the agency's formal opening. While liberal groups and consumer advocacy groups pushed for Obama to nominate Warren as the agency's permanent director, Warren was strongly opposed by financial institutions which had criticized Warren as overly aggressive in pursuing regulations, and by the Republican members of Congress. Furthermore, she did not have the strong support of the Obama administration, particularly Treasury Secretary Tim Geithner. In July 2011, Obama instead announced the nomination of former Ohio Attorney General Richard Cordray as the bureau's director, subject to Congressional approval.^[34] However, in December his nomination was blocked by a Republican-led filibuster in the Senate. Until a director is confirmed, the agency will not gain the full measure of its powers. It can supervise the compliance of banks with existing laws, but the Dodd-Frank financial legislation dictates that it cannot supervise other financial companies or write new rules. On 4 January 2012, President Obama named Ohio Attorney General Richard Cordray the Bureau's Director in a recess appointment.^[35]

2012 US Senate run[link]

The neutrality of this section is disputed. Please see the discussion on the talk page. Please do not remove this message until the dispute is resolved. (May 2012)

On September 14, 2011, Warren declared that she intended to run for the Democratic nomination for the 2012 election in Massachusetts for the United States Senate seat currently held by incumbent Scott Brown.^[36][37] On September 21, a video of Warren explaining the rationale of her economic policy received attention on the Internet.^[38]

Cherokee self-identification controversy[link]

An editor has expressed a concern that this section lends undue weight to certain ideas relative to the article as a whole. Please help to discuss and resolve the dispute before removing this message. (June 2012)

Warren listed herself as a minority in the Association of American Law Schools directory of law professors, from 1986 to 1995.^[39] The Brown campaign, the Native American Rights Fund, and a group of more than 150 Cherokees organized by Cherokee genealogist and activist David Cornsilk^[40][41] have questioned her motives for the claim and its propriety.^{[42][43][44][45][46]} The group, “Cherokees Demand Truth from Elizabeth Warren”, plans a protest at the Massachusetts Democratic Convention on June 2, 2012.^[47]

Genealogist Chris Child at the New England Historic Genealogical Society researched Warren's claimed native ancestry but found nothing conclusive. According to Child, “Once you go back further than 150 years the records are more complicated to go through,” and it may take weeks to months to make a determination.^[48][49][50] Warren said that she had heard family stories about her Cherokee ancestors her entire life ^[51] and had hoped it would create opportunities to meet people like her (even though the directory does not specify which minority professors belong to).^[39] But according to Warren, such opportunities never materialized and she eventually "stopped checking it off".^[52]

A month after the controversy began the Boston Globe discovered documents indicating that the Harvard University Law School had reported employing a Native American professor to the U.S. government in the years immediately before and after Warren left Harvard for a stint at the University of Pennsylvania.^[53] The most recent diversity census, for 2011, still shows one Native American professor. The census says that “Race/Ethnicity designations are from self-report data”.^[39] Warren, who does not meet the federal diversity definition of "Native American," admitted providing the information that she was a Native American to University of Pennsylvania and Harvard faculty in conversations after she was hired but denied that "there was [any] reporting for this".^[53] The Washington Post observed that she had "turned what could have been a small problem into a major story" by the way she had handled the issue.^[54]

According to a Suffolk University/7NEWS (WHDH-Boston) poll of 600 likely voters on May 20-22, 2012 there was 72 percent awareness of the controversy. 69 percent said Warren’s Native American heritage listing was not a significant story and 27 percent said it was.^[55][56]

Recognition[link]

Warren at the 2009 100 Most Influential People in the World reception.

Since about 2009, Warren has been recognized by several institutions as a major political figure. In 2009, the Boston Globe named her the Bostonian of the Year,^[9] and the Women's Bar Association of Massachusetts honored her with the Lelia J. Robinson Award.^[57] She was named one of Time Magazine's 100 Most Influential People in the World in 2009 and 2010.^[58] The National Law Journal has repeatedly named Warren as one of the Fifty Most Influential Women Attorneys in America,^[59] and in 2010 they honored her as one of the 40 most influential attorneys of the decade.^[60]

Warren has been recognized for her dynamic teaching style. In 2009, Warren became the first professor in Harvard's history to win the law school's teaching award twice. The Sacks-Freund Teaching Award was voted on by the graduating class in honor of "her teaching ability, openness to student concerns, and contributions to student life at Harvard."^[61] Warren also has won awards from her students at the University of Pennsylvania, the University of Michigan, and the University of Houston Law Center. She delivered the commencement address at the Rutgers School of Law–Newark in May 2011, where she was awarded an Honorary Doctor of Laws degree and was conferred membership into the Order of the Coif.^[62]

Publications[link]

Selected articles

• Warren, E. (1987). "Bankruptcy Policy". The University of Chicago Law Review 54 (3): 775–814. JSTOR 1599826. 
• Warren, E. (1992). "The Untenable Case for Repeal of Chapter 11". The Yale Law Journal 102 (2): 437–479. JSTOR 796843. 
• Warren, E. (1993). "Bankruptcy Policymaking in an Imperfect World". Michigan Law Review 92 (2): 336–387. JSTOR 1289668. 
• "Principled Approach to Consumer Bankruptcy". American Bankruptcy Law Journal 71: 483. 1997. http://heinonline.org/HOL/LandingPage?collection=journals&handle=hein.journals/ambank71&div=25&id=&page=. 
• "The Bankruptcy Crisis". Indiana Law Journal 73 (4): 1079. Fall 1998. http://www.law.indiana.edu/ilj/volumes/v73/no4/index.shtml. 
• Warren, Elizabeth; Westbrook, Jay Lawrence (January 2000). "Financial Characteristics of Businesses in Bankruptcy". SSRN Electronic Journal 73: 499. DOI:10.2139/ssrn.194750. http://papers.ssrn.com/sol3/papers.cfm?abstract_id=194750. 
• Himmelstein, DU; Warren, E; Thorne, D; Woolhandler, S (2005). "Illness and injury as contributors to bankruptcy". Health affairs (Project Hope) Suppl Web Exclusives: W5–63–W5–73. DOI:10.1377/hlthaff.w5.63. PMID 15689369. 
• "The Vanishing Middle Class". In Edwards, John, ed. (2007). Ending Poverty in America: How to Restore the American Dream. The New Press. ISBN 978-1-59558-176-1. 
• Himmelstein, David U.; Warren, Elizabeth; Thorne, Deborah; Woolhandler, Steffie J. (2005). "Illness and Injury as Contributors to Bankruptcy". SSRN Electronic Journal. DOI:10.2139/ssrn.664565. 
• Himmelstein, DU; Thorne, D; Warren, E; Woolhandler, S (2009). "Medical bankruptcy in the United States, 2007: Results of a national study". The American Journal of Medicine 122 (8): 741–6. DOI:10.1016/j.amjmed.2009.04.012. PMID 19501347. 

Books

• As We Forgive Our Debtors: Bankruptcy and Consumer Credit in America. Oxford University Press. 1989. ISBN 978-0-19-505578-8.  (with Teresa A. Sullivan and Jay Westbrook)
• The Fragile Middle Class: Americans in Debt. Yale University Press. 2001. ISBN 978-0-300-09171-7.  (with Teresa A. Sullivan and Jay Westbrook)
• The Two-Income Trap: Why Middle-Class Parents are Going Broke. Basic Books. 2004. ISBN 978-0-465-09090-7.  (with Amelia Warren Tyagi)
• All Your Worth: The Ultimate Lifetime Money Plan. Simon and Schuster. 2006. ISBN 978-0-7432-6988-9.  (with Amelia Warren Tyagi)
• Casenote Legal Briefs: Commercial Law. Aspen Publishers. 2006. ISBN 978-0-7355-5827-4.  (with Lynn M. LoPucki, Daniel Keating, Ronald Mann, and Normal Goldenberg)
• The Law of Debtors and Creditors: Text, Cases, and Problems (6th ed.). Aspen Publishers. 2008. ISBN 978-0-7355-7626-1.  (with Jay Westbrook)
• Chapter 11: Reorganizing American Businesses (Essentials). Aspen Publishers. 2008. ISBN 978-0-7355-7654-4. 
• Secured Credit: A Systems Approach. Wolters Kluwer. 2008. ISBN 978-0-7355-7649-0.  (with Lynn M. LoPucki)

See also[link]

Biography portal

• Social class in the United States

Notes[link]

References[link]

External links[link]

• Elizabeth Warren U.S. Senate campaign website
• Elizabeth Warren at Harvard Law School
  • Bibliography
• Biography at WhoRunsGov.com at The Washington Post
• Biography, voting record, and interest group ratings at Project Vote Smart
• Issue positions and quotes at On the Issues
• Campaign finance reports and data at the Federal Election Commission
• Appearances on C-SPAN programs
• Appearances on Charlie Rose
• Appearances at the Internet Movie Database
• Collected news and commentary at The New York Times
• Works by or about Elizabeth Warren in libraries (WorldCat catalog)
• Elizabeth Warren collected news and commentary at Salon.com
• Financial information at OpenSecrets.org

Interviews and articles

• Generation, Gap, and interview with Elizabeth Warrn in Guernica Magazine
• Elizabeth Warren: a tough sheriff in finance's Wild West, The Daily Telegraph
• Warren Winning Means You Won't Sell It If You Can't Explain It, Bloomberg
• In fight over credit rules, she wields a plan, Boston Globe
• "The TARP Queen: Why we should all bow before Elizabeth Warren (even if you've never heard of her)". Slate. Archived from the original on April 27, 2009. http://web.archive.org/web/20090427081845/http://www.thebigmoney.com/articles/judgments/2009/04/23/elizabeth-warren-my-hero. 
• Bank Buster, Mother Jones
• The Debt Crusader: Inspired by Dr. Phil, Harvard's Elizabeth Warren has gone to D.C. to change the way America borrows, Newsweek
• Elizabeth Warren on the Economy, NOW on PBS
• Video: Elizabeth Warren, New Yorker, Nov. 16, 2009
• Interview with Yahoo! Finance, Oct. 16, 2009
• Voices of Power Video: Elizabeth Warren, Washington Post, Oct. 8, 2009
• Interview with Elizabeth Warren from Frontline
• Elizabeth Warren on NPR link to full interview for show of May 8, 2009
• UCTV programs with Elizabeth Warren
  • The Coming Collapse of the Middle Class: Higher Risks, Lower Rewards, and a Shrinking Safety Net
  • Conversations with History: Law, Politics, and the Coming Collapse of the Middle Class with Elizabeth Warren
• Warren says Consumer Financial Protection Bureau is Obama's "Strongest Financial Reform" – video report by Democracy Now!