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nd the state retains the death penalty, including methods like the firing squad. The state contains the Idaho National Laboratory. Idaho's agricultural sector supplies many products, but the state is best known for its potato crop, which comprises around one-third of the nationwide yield. Its official state nickname is the "Gem State". Etymology In the early 1860s, when the U.S. Congress was considering organizing a new territory around Pikes Peak in the Rocky Mountains, the name "Idaho" was popular among the Congressional committee, as they believed it to be derived from a Shoshone term meaning "gem of the mountains." Realizing in January 1861 the name was quite possibly a fabrication and not Native American at all, the U.S. Congress ultimately decided to name the area Colorado Territory when it was created. But, by the time this decision was made in February 1861, the town of Idaho Springs, Colorado had already been named after their early frontrunner for a name, Idaho. In 1863, the Territory of Idaho was formed, though “Montana” was nearly its name. More than a decade after the name Idaho was first discussed for the eventual Colorado Territory, George M. Willing, a politician, claimed that he had been inspired by a little girl named Ida and that he coined the name in Washington at the time of the Congressional committee when he had been posing as an elected delegate to Congress. The same year Congress created Colorado Territory, a county called Idaho County was created in eastern Washington Territory. The county was named after a steamship named Idaho, which was launched on the Columbia River in 1860. It is unclear whether the steamship was named before or after the legitimacy of the Native American origins of “Idaho” came into question. Regardless, part of Washington Territory, including Idaho County, was used to create Idaho Territory in 1863. Idaho Territory would later change its boundaries to the area that became the U.S.

After the Civil War, many Midwestern and Southern Democrats moved to the Idaho Territory. As a result, the early territorial legislatures were solidly controlled by Democrats. In contrast, most of the territorial governors were appointed by Republican presidents and were Republicans. This led to sometimes-bitter clashes between the two parties, including a range war with the Democrats backing the sheepherders and the Republicans backing the cattlemen, which ended in the "Diamondfield" Jack Davis murder trial. In the 1880s, Republicans gained prominence in local politics. In 1864, Clinton DeWitt Smith removed the territorial seal and the state constitution from a locked safe and took them to Boise. This effectively moved the capital from where they were stored (Lewiston, Idaho) to the current capital, Boise. Since Idaho's statehood, the Republican Party has typically been the dominant party in the state. At one time, Idaho had two Democratic parties, one being the mainstream and the other called the Anti-Mormon Democrats, lasting into the early 20th century. In the 1890s and early 1900s, the Populist Party enjoyed prominence, while the Democratic Party maintained a brief dominance in the 1930s during the Great Depression. Since World War II, most statewide-elected officials have been Republicans, though the Democrats did hold the majority in the House (by one seat) in 1958 and the governorship from 1971 to 1995. Idaho's congressional delegation has also been generally Republican since statehood. Several Idaho Democrats have had electoral success in the U.S. House of Representatives over the years, but the Senate delegation has been a Republican stronghold for decades. Several Idaho Republicans, including current Senators Mike Crapo and Jim Risch, have won reelection to the Senate, but only Frank Church has won reelection as a Democrat. Church's 1974 victory was the last win for his party for either Senate seat, and Walt Minnick's 2008 victory in the 1st congressional district was the last Democratic win in any congressional race. In modern times, Idaho has been a reliably Republican state in presidential politics. It has not supported a Democrat for president since 1964. Even in that election, Lyndon B. Johnson defeated Barry Goldwater in the state by fewer than two percentage points, compared to a landslide nationally. In the 2004 United States presidential election, Republican George W. Bush carried Idaho by a margin of 38 percentage points and with 68.4% of the vote, winning in 43 of 44 counties. Only Blaine County, which contains the Sun Valley ski resort, supported John Kerry, who owns a home in the area. In 2008 Barack Obama's 36.1 percent showing was the best for a Democratic presidential candidate in Idaho since 1976. However, Republican margins were narrower in 1992 and 1976. In the 2006 elections, Republicans, led by gubernatorial candidate Butch Otter, won all the state's constitutional offices and retained both of the state's seats in the House. However, Democrats picked up several seats in the Idaho Legislature, notably in the Boise area. Idaho retains the death penalty. Pending the outcome of a legal challenge on a bill passed on March 20, 2023, authorized methods of execution include the firing squad.

gton and Oregon to the west; the state shares a small portion of the Canada–United States border to the north with the Canadian province of British Columbia. Idaho's state capital and largest city is Boise. With an area of 83,569 square miles (216,440 km2), Idaho is the 14th-largest state by land area. The state has a population of approximately two million people; it ranks as the 13th-least populous and the seventh-least densely populated of the 50 U.S. states. For thousands of years, and prior to European colonization, Idaho had been inhabited by natives. In the early 19th century, Idaho was considered part of the Oregon Country, an area which was disputed between the U.S. and the British Empire. Idaho officially became a U.S. territory with the signing of the Oregon Treaty of 1846, but a separate Idaho Territory was not organized until 1863, instead being included for periods in Oregon Territory and Washington Territory. The state was eventually admitted to the Union on July 3, 1890, becoming the 43rd state. Forming part of the Pacific Northwest (and the associated Cascadia bioregion), Idaho is divided into several distinct geographic and climatic regions. The state's north, the relatively isolated Idaho Panhandle, is closely linked with Eastern Washington, with which it shares the Pacific Time Zone—the rest of the state uses the Mountain Time Zone. The state's south includes the Snake River Plain (which has most of the population and agricultural land), and the southeast incorporates part of the Great Basin. Idaho is quite mountainous and contains several stretches of the Rocky Mountains. The United States Forest Service holds about 38% of Idaho's land, the highest proportion of any state. Industries significant for the state economy include manufacturing, agriculture, mining, forestry, science and technology, and tourism. Idaho has been a predominantly Republican state since statehood, with the Republican Party dominating in both state and national elections; abortion is severely restricted and the state retains the death penalty, including methods like the firing squad. The state contains the Idaho National Laboratory. Idaho's agricultural sector supplies many products, but the state is best known for its potato crop, which comprises around one-third of the nationwide yield.

cist (PharmD), physical therapist (DPT), or Medical Laboratory Scientist (Doctor of Medical Laboratory Science) who practices medicine or surgery, veterinary medicine, dentistry, optometry, podiatry, clinical pharmacy, physical therapy, or Clinical Laboratory Science, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant. The term residency is named as such due to resident physicians (resident doctors) of the 19th century residing at the dormitories of the hospital in which they received training. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. In the meantime, they practice "on" the license of their supervising physician. An individual engaged in such training may be referred to as a resident physician, house officer, registrar or trainee depending on the jurisdiction.

, optometry, podiatry, clinical pharmacy, physical therapy, or Clinical Laboratory Science, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant. The term residency is named as such due to resident physicians (resident doctors) of the 19th century residing at the dormitories of the hospital in which they received training. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. In the meantime, they practice "on" the license of their supervising physician. An individual engaged in such training may be referred to as a resident physician, house officer, registrar or trainee depending on the jurisdiction.

trainee depending on the jurisdiction. Residency training may be followed by fellowship or sub-specialty training. Whereas medical school teaches physicians a broad range of medical knowledge, basic clinical skills, and supervised experience practicing medicine in a variety of fields, medical residency gives in-depth training within a specific branch of medicine. Terminology A resident physician is more commonly referred to as a resident, senior house officer (in Commonwealth countries), or alternatively, a senior resident medical officer or house officer. Residents have graduated from an accredited medical school and hold a medical degree (MD, DO, MBBS, MBChB). Residents are, collectively, the house staff of a hospital. This term comes from the fact that resident physicians traditionally spend the majority of their training "in house" (i.e., the hospital). The similar term residency is named as such due to resident physicians of the 19th century residing at the dormitories of the hospital in which they received training. Duration of residencies can range from two years to seven years, depending upon the program and specialty. In the United States, the first year of residency is commonly called an internship with those physicians being termed interns. Depending on the number of years a specialty requires, the term junior resident may refer to residents who have not completed half their residency. Senior residents are residents in their final year of residency, although this can vary. Some residency programs refer to residents in their final year as chief residents (typically in surgical branches), while others select one or various residents to add administrative duties to the normal learning in the last year of residency. Alternatively, a chief resident may describe a resident who has been selected to extend his or her residency by one year and organize the activities and training of the other residents (typically in internal medicine and pediatrics). If a physician finishes a residency and decides to further his or her education in a fellowship, they are referred to as a "fellow". Physicians who have fully completed their training in a particular field are referred to as attending physicians, or consultants (in Commonwealth countries). However, the above nomenclature applies only in educational institutes in which the period of training is specified in advance.

ve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the nervous system, which comprises the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system, using various techniques of neurotherapy. A neurologist is a physician specializing in neurology and trained to investigate, diagnose and treat neurological disorders. Neurologists diagnose and treat myriad neurologic conditions, including stroke, epilepsy, movement disorders such as Parkinson's disease, brain infections, autoimmune neurologic disorders such as multiple sclerosis, sleep disorders, brain injury, headache disorders like migraine, tumors of the brain and dementias such as Alzheimer's disease. Neurologists may also have roles in clinical research, clinical trials, and basic or translational research.

ed to investigate, diagnose and treat neurological disorders. Neurologists diagnose and treat myriad neurologic conditions, including stroke, epilepsy, movement disorders such as Parkinson's disease, brain infections, autoimmune neurologic disorders such as multiple sclerosis, sleep disorders, brain injury, headache disorders like migraine, tumors of the brain and dementias such as Alzheimer's disease. Neurologists may also have roles in clinical research, clinical trials, and basic or translational research.

yriad neurologic conditions, including stroke, epilepsy, movement disorders such as Parkinson's disease, brain infections, autoimmune neurologic disorders such as multiple sclerosis, sleep disorders, brain injury, headache disorders like migraine, tumors of the brain and dementias such as Alzheimer's disease. Neurologists may also have roles in clinical research, clinical trials, and basic or translational research.

t an intervening health care provider." When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telemedicine may bridge the gap and can even improve retention in treatment as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration.

gration. EHealth encompasses a wide range of applications, including but not limited to the following: Two clinicians discussing a case via video conference; Robotic surgery performed through remote access; Physical therapy conducted using digital monitoring instruments, live feed, and application combinations; Diagnostic tests transferred between facilities for interpretation by a higher specialist; Home monitoring through continuous transmission of patient health data; Online consultations between patients and practitioners; Video remote interpretation services for clinical visits.

Telehealth versus telemedicine Telehealth is sometimes discussed interchangeably with telemedicine, the latter being more common than the former. Telehealth has been described as a disruptive innovation in healthcare because it enables medical services to be delivered remotely using communication technologies. The Health Resources and Services Administration distinguishes telehealth from telemedicine in its scope, defining telemedicine only as describing remote clinical services, such as diagnosis and monitoring, while telehealth includes preventative, promotive, and curative care delivery. This includes the above-mentioned non-clinical applications, like administration and provider education. The United States Department of Health and Human Services states that the term telehealth includes "non-clinical services, such as provider training, administrative meetings, and continuing medical education", and that the term telemedicine means "remote clinical services". The World Health Organization uses telemedicine to describe all aspects of health care including preventive care. The American Telemedicine Association uses the terms telemedicine and telehealth interchangeably, although it acknowledges that telehealth is sometimes used more broadly for remote health not involving active clinical treatments. eHealth is another related term, used particularly in the U.K. and Europe, as an umbrella term that includes telehealth, electronic medical records, and other components of health information technology. Methods and modalities Telehealth requires good Internet access by participants, usually in the form of a strong, reliable broadband connection, and broadband mobile communication technology of at least the fourth generation (4G) or long-term evolution (LTE) standard to overcome issues with video stability and bandwidth restrictions. As broadband infrastructure has improved, telehealth usage has become more widely feasible. Healthcare providers often begin telehealth with a needs assessment which assesses hardships that can be improved by telehealth such as travel time, costs or time off work. Collaborators such as technology companies can ease the transition. Delivery can come within four distinct domains: live video (synchronous), store-and-forward (asynchronous), remote patient monitoring, and mobile health. Audio-based telemedicine, primarily through telephone consultations, has been studied as a tool for managing chronic conditions.

urgical or non-surgical medical specialty, and also a specialty field within primary care. In other contexts, the field of sports medicine encompasses the scope of both medical specialists as well as allied health practitioners who work in the field of sport, such as physiotherapists, athletic trainers, podiatrists and exercise physiologists. Scope Sports medicine can refer to the specific medical specialty or subspecialty of several medical and research disciplines in sports. Sports medicine may be called Sport and Exercise Medicine (SEM), which is now well established in many countries. It can broadly also refer to physicians, scientists, trainers, and other paramedical practitioners who work in a broad setting. Sports medicine specialists include a broad range of professions. All sports medicine specialists have one main goal in mind, to heal and rehabilitate injuries for return to everyday life and return to play, as well as to prevent future injuries. They work with all different types of people, and not just athletes. The various sports medicine experts often work together as a team to ensure the best recovery plan for the individual. Team members can include orthopedic surgeons, certified athletic trainers, sports physical therapists, physical medicine and rehabilitation specialists, and specialty SEM physicians. Research within the field is also highly multidisciplinary. A 2023 systematic review noted a 12.1% increase in female authorship in major orthopedic sports medicine journals, with nearly 60% of this growth driven by professionals holding degrees other than an MD. Specializing in the treatment of athletes and other physically active individuals, SEM physicians have extensive education in musculoskeletal medicine. SEM doctors treat injuries such as muscle, ligament, tendon and bone problems, but may also treat chronic illnesses that can affect physical performance, such as asthma and diabetes.

Major scandals where doctors were prominent include: Bloodgate USA Gymnastics sex abuse scandal Operación Puerto doping case Biogenesis scandal Eva Carneiro scandal, involving Chelsea F.C. and José Mourinho Allied health team members Different medical professionals for sports injuries require different forms of training, but for sports injuries, they mainly all work with the diagnosis and treatment of these injuries. All sports medicine professionals work with people of all age ranges, professional athletes, or even adolescents playing any sport.

Allied health team members Different medical professionals for sports injuries require different forms of training, but for sports injuries, they mainly all work with the diagnosis and treatment of these injuries. All sports medicine professionals work with people of all age ranges, professional athletes, or even adolescents playing any sport. The main two allied health professions for sports injuries are athletic trainers (in the USA) and physical therapists (physiotherapists) in most other countries. Athletic trainer Athletic trainers are typically part of a sports medicine team in the US in particular, providing primary care, injury and illness prevention, wellness promotion, emergency care, therapeutic intervention and rehabilitation to injuries. When an athlete is injured, an athletic trainer is key to treatment and rehabilitation working closely with the athlete throughout rehabilitation.

Neonatal medicine, or neonatology, is a subspecialty of pediatrics concerned with the care, development, and diseases of newborn infants, particularly those born prematurely or in need of critical care. Neonatologists are medical doctors who specialize in the care of newborns, often working in neonatal intensive care units (NICUs). Neonatal care often involves a multidisciplinary team to provide intensive monitoring, respiratory and nutritional support, neonatal resuscitation and transport, and support for families facing complex medical decisions. Conditions commonly managed include complications of prematurity, respiratory disorders, neonatal infections, and congenital anomalies. The neonatal period is generally defined as the first 28 days of life, during which newborns are especially vulnerable. Advances in neonatal medicine, including incubator technology, mechanical ventilation, phototherapy, and pulmonary surfactant therapy, have contributed to substantially improved survival and outcomes for premature and critically ill infants. Modern neonatal care is delivered in a range of settings, including delivery rooms, newborn nurseries, and NICUs. Neonatology is also an academic discipline that includes clinical and basic science research.

ogy, mechanical ventilation, phototherapy, and pulmonary surfactant therapy, have contributed to substantially improved survival and outcomes for premature and critically ill infants. Modern neonatal care is delivered in a range of settings, including delivery rooms, newborn nurseries, and NICUs. Neonatology is also an academic discipline that includes clinical and basic science research.

suffering, and disability. Historical developments Though high infant mortality rates were recognized by the medical community at least as early as the 1860s, advances in modern neonatal intensive care have led to a significant decline in infant mortality in the modern era, falling from 5.0 million deaths globally in 1990 to 2.3 million in 2022. This has been achieved through a combination of technological advances, enhanced understanding of newborn physiology, improved sanitation practices, and development of specialized units for neonatal intensive care. Around the mid-19th century, the care of newborns was in its infancy and was led mainly by obstetricians; however, the early 1900s, pediatricians began to assume a more direct role in caring for neonates. The term "neonatology" was coined by Dr. Alexander Schaffer in 1960. The American Board of Pediatrics established an official sub-board certification for neonatology in 1975. In 1835, the Russian physician Georg von Ruehl developed a rudimentary incubator made from two nestled metal tubs enclosing a layer of warm water. By the mid-1850s, these "warming tubs" were in regular use at the Moscow Foundling Hospital for the support of premature infants. 1857, Jean-Louis-Paul Denuce was the first to publish a description of his own similar incubator design, and was the first physician to describe its utility in the support of premature infants in medical literature. By 1931, Dr.

Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists. It focuses on promoting, maintaining, or restoring health through patient education, physical interventions, disease prevention, and health promotion. The term physical therapist or physiotherapist is used to represent the trained person providing physical therapy. The profession has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services.

physical therapy. The profession has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services.

both public and private. In addition to clinical practice, other aspects of physical therapy include research, education, consultation, and health administration. Physical therapists provide primary care patient management in conjunction with other medical services. In some jurisdictions, such as the United Kingdom, physical therapists may have the authority to prescribe medication. Overview Physical therapy addresses illnesses or injuries that limit a person's ability to move and perform functional activities in their daily lives. PTs use an individual's history and physical examination to arrive at a diagnosis and establish a management plan and, when necessary, incorporate the results of laboratory and imaging studies like X-rays, CT scans, or MRIs. Physical therapists can use sonography to diagnose and manage common musculoskeletal, nerve, and pulmonary conditions. Electrodiagnostic testing (e.g., electromyograms and nerve conduction velocity testing) may also be used. PT management commonly includes the prescription of, or assistance with, specific exercises, manual therapy, and bodily manipulation. Additional treatments include mechanical devices such as traction; education; electrophysical modalities which include heat, cold, electricity, sound waves, and radiation; assistive devices; prostheses; and orthoses. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness-oriented programs for healthier and more active lifestyles, and providing services to individuals and populations to develop, maintain, and restore maximum movement and functional ability throughout life. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease, or environmental factors. Functional movement is central to what it means to be healthy. Physical therapy is a profession which has many specialties including musculoskeletal, orthopedics, cardiopulmonary, neurology, endocrinology, sports medicine, geriatrics, pediatrics, women's health, wound care and electromyography. PTs practice in many settings, such as privately owned physical therapy clinics, outpatient clinics or offices, hospitals, health and wellness clinics, rehabilitation hospitals, skilled nursing facilities, extended care facilities, private homes, education and research centers, schools, hospices, industrial workplaces or other occupational environments, fitness centers and sports training facilities. Physical therapists also practice in non-patient care roles such as health policy, health insurance, health care administration, and as health care executives. Physical therapists are involved in the medical-legal field serving as experts, performing peer review and independent medical examinations. Education varies greatly by country. The span of education ranges from some countries having little formal education to others having doctoral degrees and post-doctoral residencies and fellowships. Regarding its relationship to other healthcare professions, physiotherapy is typically one of the allied health professions.

occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement." Occupational therapy is classified as an allied health profession in many countries. In the United Kingdom, occupational therapists are regulated by the Health and Care Professions Council as part of a group of professions that form the third-largest clinical workforce in the National Health Service. In England, allied health professions (AHPs) are the third largest clinical workforce in health and care.

tional therapists are regulated by the Health and Care Professions Council as part of a group of professions that form the third-largest clinical workforce in the National Health Service. In England, allied health professions (AHPs) are the third largest clinical workforce in health and care.

e regulated by the Health and Care Professions Council in the United Kingdom. Etymology In Europe, occupational therapy is also known as ergotherapy in Europe, derived from the Greek ergon which is allied to work, to act and to be active. History The earliest evidence of using occupations as a method of therapy can be found in ancient times. In c. 100 BCE, Greek physician Asclepiades treated patients with a mental illness humanely using therapeutic baths, massage, exercise, and music. Later, the Roman Celsus prescribed music, travel, conversation and exercise to his patients.

O degree who undergoes specialty training in medical and surgical eye care. In the United States, following graduation from medical school, one must complete a four-year residency in ophthalmology to become an ophthalmologist. Following residency, additional sub-specialty training (or fellowship) may be sought in a particular aspect of eye diseases. Ophthalmologists prescribe medications to treat eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists provide both primary and specialty eye care—medical and surgical.

India In India, after completing MBBS degree, postgraduate study in ophthalmology is required. The degrees are doctor of medicine, master of surgery, diploma in ophthalmic medicine and surgery, and diplomate of national board. The concurrent training and work experience are in the form of a junior residency at a medical college, eye hospital, or institution under the supervision of experienced faculty. Further work experience in the form of fellowship, registrar, or senior resident refines the skills of these eye surgeons. All members of the India Ophthalmologist Society and various state-level ophthalmologist societies hold regular conferences and actively promote continuing medical education. Nepal In Nepal, to become an ophthalmologist, three years of postgraduate study is required after completing an MBBS degree. The postgraduate degree in ophthalmology is called medical doctor in ophthalmology. Currently, this degree is provided by Tilganga Institute of Ophthalmology, Tilganga, Kathmandu, BPKLCO, Institute of Medicine, TU, Kathmandu, BP Koirala Institute of Health Sciences, Dharan, Kathmandu University, Dhulikhel, and National Academy of Medical Science, Kathmandu. A few Nepalese citizens also study this subject in Bangladesh, China, India, Pakistan, and other countries. All graduates have to pass the Nepal Medical Council Licensing Exam to become a registered ophthalmologists in Nepal. The concurrent residency training is in the form of a PG student (resident) at a medical college, eye hospital, or institution according to the degree providing university's rules and regulations.

Nepal In Nepal, to become an ophthalmologist, three years of postgraduate study is required after completing an MBBS degree. The postgraduate degree in ophthalmology is called medical doctor in ophthalmology. Currently, this degree is provided by Tilganga Institute of Ophthalmology, Tilganga, Kathmandu, BPKLCO, Institute of Medicine, TU, Kathmandu, BP Koirala Institute of Health Sciences, Dharan, Kathmandu University, Dhulikhel, and National Academy of Medical Science, Kathmandu. A few Nepalese citizens also study this subject in Bangladesh, China, India, Pakistan, and other countries. All graduates have to pass the Nepal Medical Council Licensing Exam to become a registered ophthalmologists in Nepal. The concurrent residency training is in the form of a PG student (resident) at a medical college, eye hospital, or institution according to the degree providing university's rules and regulations.

Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing taxpayer-funded health insurance to 85 million low-income and disabled people as of 2022; in 2019, the program paid for half of all U.S. births. In 2023, the total (federal and state) annual cost of Medicaid was $870 billion, with an average cost per enrollee of $7,600 for 2021. 37% of enrollees were children, but they only accounted for 15% of the spending, ($3,000 per person) while seniors and disabled persons accounted for 21% of enrollees and 52% of spending (more than $18,000 per person). In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities. Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets. Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid. Along with Medicare, Tricare, ChampVA, and CHIP, Medicaid is one of the several Federal Government-sponsored medical insurance programs in the United States. Medicaid covers healthcare costs for people with low incomes; Medicare is a universal program providing health coverage for the elderly; and the CHIP program covers uninsured children in families with incomes that are too high to be covered by Medicaid. Medicaid offers elder care benefits not normally covered by Medicare, including nursing home care and personal care services. There are also dual health plans for people who have both Medicaid and Medicare. Research shows that existence of the Medicaid program improves health outcomes, health insurance coverage, access to health care, and recipients' financial security and provides economic benefits to states and health providers.

2025 Medicaid cuts in the second Trump administration In 2025, Republican Congressional leaders John Thune and Mike Johnson announced goals of cutting 1.5 to 2 trillion dollars of the US federal budget, with President Donald Trump stating that cuts to Medicaid would only include "abuse or waste". The 2025 budget resolution, which was passed by the House of Representatives with only Republicans votes, proposed cutting $880 billion from the Standing Committee for Energy and Commerce, which includes many areas, such as Medicaid and Medicare. On July 4, 2025, President Donald Trump signed the One Big Beautiful Bill Act, intended in part to implement this resolution. The act cut Medicaid in a number of ways: while it did not repeal the ACA's Medicaid expansion, it mandated work requirements for able-bodied Medicaid recipients. It also requires Medicaid recipients above the federal poverty line to pay more fees for coverage; adds new verification requirements; increases the number of times states need to check the eligibility of their Medicaid expansion recipients; prohibits Medicaid from funding nonprofits that provide abortion care; makes it harder for illegal immigrants to use Medicaid; bans pharmacy benefit managers from using spread pricing; and puts limits on so-called "provider taxes" that states impose on healthcare providers to fund their portion of Medicaid spending. The non-partisan Congressional Budget Office (CBO) estimated that it will reduce the number of people on Medicaid by several million.; the CBO estimates that the work requirements in particular will lead 11 million to lose their Medicaid coverage, many of whom already work or qualify for exemptions but will not be able to get through the red tape. The bill prompted claims that undocumented immigrants are on Medicaid. Undocumented immigrants are already ineligible for full Medicaid benefits, and many undocumented immigrants access state-funded health programs rather than federal Medicaid. According to a CBO analysis, the bill's provisions could lead some states to cut back those state-funded health programs, potentially causing an estimated 1.4 million people to lose state-level health coverage, including undocumented immigrants. When commenting on the Trump administration's One Big Beautiful Bill Act and the impact of the Medicaid provisions on the economy, USDA Secretary Brooke Rollins stated that 34 million able-bodied adults on Medicaid should be working.

Arizona: AHCCCS California: Medi-Cal Connecticut: HUSKY D Illinois: HealthChoice Illinois Iowa: Hawk-i Healthy and Well-Kids in Iowa Maine: MaineCare Massachusetts: MassHealth New Jersey: NJ FamilyCare Oregon: Oregon Health Plan Oklahoma: Soonercare Tennessee: TennCare Washington: Washington Apple Health Wisconsin: BadgerCare As of January 2012, Medicaid and/or CHIP funds could be obtained to help pay employer health care premiums in Alabama, Alaska, Arizona, Colorado, Florida, and Georgia. Differences by state While states have significant autonomy in implementing the Medicaid program, their flexibility is bounded by federal requirements designed to ensure a baseline of coverage and access. For example, federal law mandates that certain services, such as inpatient and outpatient hospital services, laboratory and X-ray services, and physician services, must be covered by all state Medicaid programs. Additionally, states must adhere to federal guidelines regarding beneficiary protections and quality standards.

graduates a medical degree, a physician typically may not legally practice medicine until licensed by the local government authority. Licensing may also require passing a test, undergoing a criminal background check, checking references, paying a fee, and undergoing several years of postgraduate training.

tudents after the completion of their degree program, which typically lasts five or more years for the undergraduate model and four years for the graduate model. Many modern medical schools integrate clinical education with basic sciences from the beginning of the curriculum (e.g.). More traditional curricula are usually divided into preclinical and clinical blocks. In preclinical sciences, students study subjects such as biochemistry, genetics, pharmacology, pathology, anatomy, physiology and medical microbiology, among others. Subsequent clinical rotations usually include internal medicine, general surgery, pediatrics, psychiatry, and obstetrics and gynecology, among others. Although medical schools confer upon graduates a medical degree, a physician typically may not legally practice medicine until licensed by the local government authority. Licensing may also require passing a test, undergoing a criminal background check, checking references, paying a fee, and undergoing several years of postgraduate training.

or the graduate model. Many modern medical schools integrate clinical education with basic sciences from the beginning of the curriculum (e.g.). More traditional curricula are usually divided into preclinical and clinical blocks. In preclinical sciences, students study subjects such as biochemistry, genetics, pharmacology, pathology, anatomy, physiology and medical microbiology, among others. Subsequent clinical rotations usually include internal medicine, general surgery, pediatrics, psychiatry, and obstetrics and gynecology, among others. Although medical schools confer upon graduates a medical degree, a physician typically may not legally practice medicine until licensed by the local government authority. Licensing may also require passing a test, undergoing a criminal background check, checking references, paying a fee, and undergoing several years of postgraduate training.

ssion usually occur within minutes to hours of the injury, usually within 72 hours. However, symptoms may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Symptoms of a concussion may make it difficult to return to work, school, sports (in cases of sports related concussions) or prior level of functioning, with disability usually lasting days to weeks. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness. Common causes include motor vehicle collisions, falls, sports injuries, and bicycle accidents. Risk factors include physical violence, drinking alcohol and a prior history of concussion. The mechanism of injury involves either a direct blow to the head or forces elsewhere on the body that are transmitted to the head. This is believed to result in neuron dysfunction, as there are increased glucose requirements, but not enough blood supply. A thorough evaluation by a qualified medical provider working in their scope of practice (such as a physician or nurse practitioner) is required to rule out life-threatening head injuries, injuries to the cervical spine, and neurological conditions and to use information obtained from the medical evaluation to diagnose a concussion. Glasgow coma scale score 13 to 15, loss of consciousness for less than 30 minutes, and memory loss for less than 24 hours may be used to rule out moderate or severe traumatic brain injuries. Diagnostic imaging such as a CT scan or an MRI may be required to rule out severe head injuries. Routine imaging is not required to diagnose concussion and is, by definition, normal after concussions. Prevention of concussion approaches includes the use of a helmet and mouth guard for certain sporting activities, seatbelt use in motor vehicles, following rules and policies on body checking and body contact in organized sport, and neuromuscular training warm-up exercises. Treatment of concussion includes relative rest for no more than 1–2 days, aerobic exercise to increase the heart rate and gradual step-wise return to activities, school, and work. Prolonged periods of rest may slow recovery and result in greater depression and anxiety. Paracetamol (acetaminophen) or NSAIDs may be recommended to help with a headache. Prescribed aerobic exercise may improve recovery. Physiotherapy may be useful for persisting balance problems, headache, or whiplash; cognitive behavioral therapy may be useful for mood changes and sleep problems. Evidence to support the use of hyperbaric oxygen therapy and chiropractic therapy is lacking. Worldwide, concussions are estimated to affect more than 3.5 per 1,000 people a year. Concussions are classified as mild traumatic brain injuries and are the most common type of TBIs. Males and young adults are most commonly affected. Outcomes are generally good. Another concussion before the symptoms of a prior concussion have resolved is associated with worse outcomes.

Worldwide, concussions are estimated to affect more than 3.5 per 1,000 people a year. Concussions are classified as mild traumatic brain injuries and are the most common type of TBIs. Males and young adults are most commonly affected. Outcomes are generally good. Another concussion before the symptoms of a prior concussion have resolved is associated with worse outcomes.

Signs and symptoms Concussion symptoms vary between people and include physical, cognitive, and emotional symptoms. Signs and symptoms of a concussion usually appear within 72 hours of the injury, most commonly within the first several minutes to hours after the injury. However, symptoms may be delayed by 1–2 days. Delayed onset of symptoms may still be serious and require a medical assessment. Up to one-third of people with concussion experience longer or persisting concussion symptoms, also known as post concussion syndrome or persisting symptoms after concussion, which is defined as concussion symptoms lasting for 4 weeks or longer in children and adolescents, and symptoms lasting for more than 14 days in an adult. The severity of the initial symptoms is the strongest predictor of recovery time in adults. Physical Headaches are the most common mTBI symptom. Others include dizziness, vomiting, nausea, lack of motor coordination, difficulty balancing, or other problems with movement or sensation. Visual symptoms include light sensitivity, seeing bright lights, blurred vision, and double vision. Tinnitus, or a ringing in the ears, is also commonly reported. In one in about seventy concussions, concussive convulsions occur, but seizures that take place during or immediately after a concussion are not "post-traumatic seizures", and, unlike post-traumatic seizures, are not predictive of post-traumatic epilepsy, which requires some form of structural brain damage, not just a momentary disruption in normal brain functioning. Concussive convulsions are thought to result from temporary loss or inhibition of motor function and are not associated either with epilepsy or with more serious structural damage.

Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It started in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS). Medicare is divided into four parts: A, B, C, and D. Part A covers hospital, skilled nursing, and hospice services. Part B covers outpatient services. Part C is an alternative that allows patients to choose private plans with different benefit structures that provide the same services as Parts A and B, usually with additional benefits. Part D is for self-administered prescription drugs. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees cover most of the remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries.

rts A and B, usually with additional benefits. Part D is for self-administered prescription drugs. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by Congress' MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees cover most of the remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries.

t of the remaining costs by taking additional private insurance (medi-gap insurance), by enrolling in a Medicare Part D prescription drug plan, or by joining a private Medicare Part C (Medicare Advantage) plan. In 2022, spending by the Medicare Trustees topped $900 billion per the Trustees report Table II.B.1, of which $423 billion came from the U.S. Treasury and the rest primarily from the Part A Trust Fund (which is funded by payroll taxes) and premiums paid by beneficiaries.

ern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

The Treasure Valley is a valley in the western United States, primarily in southwestern Idaho, where the Payette, Boise, Weiser, Malheur, and Owyhee rivers drain into the Snake River. It includes all the lowland areas from Vale in rural eastern Oregon to Boise, and is the most populated area in Idaho. Historically, the valley had been known as the Lower Snake River Valley or the Boise River Valley. Pete Olesen, president of the valley's association of local Chambers of Commerce, coined the name "Treasure Valley" in 1959 to reflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas.

eflect the treasure chest of resources and opportunities that the region offered. The valley has a very diverse terrain, from sage flatlands, to mesas, agricultural areas, and urbanized areas. As the Boise Metropolitan Area grows, more and more undeveloped and agricultural land is being urbanized. History Settling the region The tribes that roamed the area, specifically, were the Northern Paiute and Shoshone. In 1834, Thomas McKay built the original Fort Boise, in the area near present-day Parma, which was run for a time by Francois Payette. It later was moved because of flooding troubles and was abandoned in 1854. The Oregon Trail runs through the Treasure Valley. The valley was settled for the most part by ranchers and farmers, initially to supply the gold and silver mining communities in the higher elevations nearby: Idaho City in the Boise Basin and Silver City in the Owyhees. A new Fort Boise was constructed by the U.S. Army in 1863 in present-day Boise, from which the city grew.

om endocrine + -ology) is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events proliferation, growth and differentiation, and the psychological or behavioral activities of metabolism, growth and development, tissue function, sleep, digestion, respiration, excretion, mood, stress, lactation, movement, reproduction, and sensory perception caused by hormones. Specializations include behavioral endocrinology and comparative endocrinology. The endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Therefore, endocrine glands are regarded as ductless glands.

by hormones. Specializations include behavioral endocrinology and comparative endocrinology. The endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Therefore, endocrine glands are regarded as ductless glands.

in different parts of the body, that secrete hormones directly into the blood rather than into a duct system. Therefore, endocrine glands are regarded as ductless glands. Hormones have many different functions and modes of action; one hormone may have several effects on different target organs, and, conversely, one target organ may be affected by more than one hormone. The endocrine system Endocrinology is the study of the endocrine system in the human body. This is a system of glands which secrete hormones. Hormones are chemicals that affect the actions of different organ systems in the body. Examples include thyroid hormone, growth hormone, and insulin. The endocrine system involves a number of feedback mechanisms, so that often one hormone (such as thyroid stimulating hormone) will control the action or release of another secondary hormone (such as thyroid hormone). If there is too much of the secondary hormone, it may provide negative feedback to the primary hormone, maintaining homeostasis. In the original 1902 definition by Bayliss and Starling (see below), they specified that, to be classified as a hormone, a chemical must be produced by an organ, be released (in small amounts) into the blood, and be transported by the blood to a distant organ to exert its specific function. This definition holds for most "classical" hormones, but there are also paracrine mechanisms (chemical communication between cells within a tissue or organ), autocrine signals (a chemical that acts on the same cell), and intracrine signals (a chemical that acts within the same cell).

ther information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information. For several decades, EHRs have been touted as key to increasing quality of care. EHR combines all patients' demographics into a large pool, which assists providers in the creation of "new treatments or innovation in healthcare delivery" to improve quality outcomes in healthcare. Combining multiple types of clinical data within electronic health records has enabled clinicians to identify and stratify patients with chronic conditions. EHR systems may also support improvements in quality of care through the use of data and analytics to help prevent hospitalizations among high-risk patients. EHR systems are designed to store data accurately and to capture a patient's state across time. It eliminates the need to track down a patient's previous paper medical records and assists in ensuring data is up-to-date, accurate, and legible. It also allows open communication between the patient and the provider while providing "privacy and security." EHR is cost-efficient, decreases the risk of lost paperwork, and can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date. Due to the digital information being searchable and in a single file, EMRs (electronic medical records) are more effective when extracting medical data to examine possible trends and long-term changes in a patient.

Terminology The terms electronic health record (EHR), electronic patient record (EPR), and electronic medical record (EMR) have often been used interchangeably, but "subtle" differences exist. The EHR is a more longitudinal collection of the electronic health information of individual patients or populations. The EMR, in contrast, is the patient record created by providers for specific encounters in hospitals and ambulatory environments and can serve as a data source for an EHR. EMRs are essentially digital versions of the paper documents used in a clinician's office, typically functioning as an internal system within a practice. An EMR includes the medical and treatment history of patients treated by that specific practice. In contrast, a personal health record (PHR) is an electronic application for recording individual medical data that the individual patient controls and may make available to health providers. Comparison with paper-based records While there is ongoing debate regarding the advantages of electronic health records compared with paper records, the research literature presents a more nuanced view of their benefits and limitations. Increasing discontent and burnout among healthcare professionals is well documented as of 2023, with several studies finding that a leading cause of job frustration and increasing stress for most doctors and nurses is the increasing burden of increasingly complex record-keeping, paperwork, and administrative workloads.. Proponents of EHR note that these systems can substantially reduce such burdens, for example cutting time spent on insurance eligibility tasks by more than 80%. But along with increased convenience, transparency, portability, and accessibility, there is also an increased risk that sensitive information may be accessed by unauthorized persons or unscrupulous users (versus paper medical records). This is acknowledged by the increased security requirements for electronic medical records included in the Health Insurance Portability and Accountability Act (HIPAA) and by large-scale breaches in confidential records reported by EMR users. Meanwhile, handwritten paper medical records may be poorly legible, which can contribute to medical errors. Pre-printed forms, standardization of abbreviations, and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn a person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies," and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require specific steps to avoid these errors. Electronic records may help with the standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If the ability to exchange records between different EMR systems were perfected ("interoperability"), it would facilitate the coordination of health care delivery in non-affiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.

Comparison with paper-based records While there is ongoing debate regarding the advantages of electronic health records compared with paper records, the research literature presents a more nuanced view of their benefits and limitations. Increasing discontent and burnout among healthcare professionals is well documented as of 2023, with several studies finding that a leading cause of job frustration and increasing stress for most doctors and nurses is the increasing burden of increasingly complex record-keeping, paperwork, and administrative workloads.. Proponents of EHR note that these systems can substantially reduce such burdens, for example cutting time spent on insurance eligibility tasks by more than 80%. But along with increased convenience, transparency, portability, and accessibility, there is also an increased risk that sensitive information may be accessed by unauthorized persons or unscrupulous users (versus paper medical records). This is acknowledged by the increased security requirements for electronic medical records included in the Health Insurance Portability and Accountability Act (HIPAA) and by large-scale breaches in confidential records reported by EMR users. Meanwhile, handwritten paper medical records may be poorly legible, which can contribute to medical errors. Pre-printed forms, standardization of abbreviations, and standards for penmanship were encouraged to improve the reliability of paper medical records. An example of possible medical errors is the administration of medication. Medication is an intervention that can turn a person's status from stable to unstable very quickly. With paper documentation it is very easy to not properly document the administration of medication, the time given, or errors such as giving the "wrong drug, dose, form, or not checking for allergies," and could affect the patient negatively. It has been reported that these errors have been reduced by "55-83%" because records are now online and require specific steps to avoid these errors. Electronic records may help with the standardization of forms, terminology, and data input. Digitization of forms facilitates the collection of data for epidemiology and clinical studies. However, standardization may create challenges for local practice. Overall, those with EMRs that have automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs. EMRs can be continuously updated (within certain legal limitations: see below). If the ability to exchange records between different EMR systems were perfected ("interoperability"), it would facilitate the coordination of health care delivery in non-affiliated health care facilities. In addition, data from an electronic system can be used anonymously for statistical reporting in matters such as quality improvement, resource management, and public health communicable disease surveillance.

Together with amendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act remains in effect. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

o constrain healthcare costs and improve quality. After it came into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

expansion of Medicaid eligibility and changes to individual insurance markets. Both received new spending, funded by a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office (CBO) reports stated that overall these provisions reduced the budget deficit, that repealing ACA would increase the deficit, and that the law reduced income inequality. The act largely retained the existing structure of Medicare, Medicaid, and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a monetary penalty) and that insurers cover a list of "essential health benefits". Young people were allowed to stay on their parents' insurance plans until they were 26 years old. Before and after its enactment the ACA faced strong political opposition, calls for repeal, and legal challenges. In the Sebelius decision, the U.S. Supreme Court ruled that Congress cannot use the Commerce Clause to compel individuals to buy health insurance but upheld the individual mandate by recharacterizing the penalty as a tax. The Court also held that states could opt out of the ACA's Medicaid expansion without losing existing federal Medicaid funding, while otherwise upholding the law. This led Republican-controlled states to not participate in Medicaid expansion. Polls initially found that 43% of Americans wanted to see the law repealed or scaled back and 49% wanted to see it expanded or enacted as is. By 2017, the law had majority support.

Boise (locally also ) is the capital and most populous city in the U.S. state of Idaho. It is the county seat of Ada County. The population of the city was 235,685 at the 2020 census. The Boise metropolitan area, located in the Treasure Valley, includes five counties of Idaho with an estimated population of 846,000, the most populous metropolitan area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

an area in Idaho and 95th-most populous in the United States. Located on the Boise River in southwestern Idaho, it is 41 miles (66 km) east of the Oregon border and 110 miles (177 km) north of the Nevada border. Downtown Boise's elevation is 2,704 feet (824 m) above sea level. Boise is home to major employers in the technology, manufacturing, and service sectors, including companies such as Micron Technology and Hewlett-Packard.

...that the military should continue killing Indians 'until the last Indian in the Territories was either on his reservation or enriched the sagebrush with his decaying carcass.' ...if the Indians refused to move there, 'they will be killed or put on the reservation by force, and certainly shot if they don't stay there.' Furthermore, the editor continues, 'The idea that the Indians have any right to the soil is ridiculous. ...They have no more rights to the soil of the Territories of the United States than wolves or coyotes...' This would be our plan of establishing friendship upon an eternal basis with our Indians: Let all the hostile bands of Idaho Territory be called in (they will not be caught in any other manner) to attend a grand treaty; plenty of blankets and nice little trinkets distributed among them; plenty of grub on hand; have a real jolly time with them; then just before the big feast put strychnine in their meat and poison to death the last mother's son of them. At the same time, native warriors around the valley, under the leadership of Howluck also known as "Bigfoot" among white settlers, among others, waged an escalating and intensified guerrilla campaign of harassment of passerby caravans along the Oregon Trail. The United States Army also escalated and intensified "punitive expeditions" against formations of warriors and against civilian communities as well. This marked the start of the "unofficial" Snake War in 1866. This war lasted until 1868, and is statistically the deadliest of the Indian Wars in the West in terms of casualties. In the end, 1,762 men were counted as the casualties of this war from both sides. In 1868, Fort Hall Indian Reservation was established in Southeastern Idaho, about 220 miles upstream, according to the terms of Fort Bridger Treaty. The Boise Valley Shoshone and Bannock Tribes were not party to this treaty. Nevertheless, in April 1869, the United States Military embarked on a campaign of "Removal, rounding up of natives in the region including in and around Boise, and expelling them with cavalry escort to Fort Hall Indian Reservation. This period is known among the Shoshone and Bannock people as Idaho's Trail of Tears. Some of the natives managed to escape, and they ran to either Duck Valley or Fort McDermitt in Nevada. Incorporation and growth Boise's early growth was significantly driven by its role in supplying the nearby gold towns that sprung up in the 1860s northeast and then southwest of the town. Miners sometimes wintered in Boise and a number of early prominent businessmen were miners who settled in town in the years after the gold rush waned. By 1864 substantial agricultural production was underway on easily irrigated lands near the river and three canal companies had been incorporated. Early transportation improvements were largely a result of toll road franchises awarded by the territorial legislature starting in the 1860s. These first ran from Fort Boise to the mining centers in the Boise Basin and east to Rocky Bar and to Rattlesnake Station where they connected to the Oregon Trail. Territorial census records from a special 1864 enumeration list the population of Boise as 1,658, and an act of December 12, 1864, was the first attempt by the Idaho Territorial Legislature to incorporate the city. This was rejected by voters the following March. Two more unsuccessful attempts were made to organize a city administration by election before the 1866 version of the city charter was approved by voters on January 6, 1868. The growing number of homes and businesses, for which owners wanted proper legal title, may have contributed to the eventual success of incorporation. All of these rejected efforts to incorporate the city came after Boise had been controversially made the state capital in 1864 over strong opposition from northern Idaho interests. This decision reflected the rapid shift of population growth from north to south after the discovery of gold in southern Idaho. By 1868 Boise had over 400 permanent buildings with a wide range of commercial services. 1868 also marked the formal beginning of a long advocacy for railroad connections to other Idaho communities and, just as importantly, to other growing cities in the west such as Portland, Oregon. Competing railroad and western state government interests frustrated these efforts for many years. Designed by Alfred B. Mullett, the U.S. Assay Office at 210 Main Street was built in 1871 and today is a National Historic Landmark. It first began accepting gold and silver for purchase on March 2, 1872, largely eliminating the need to transport ore to the mint in San Francisco. A territorial penitentiary, now known as the Old Idaho State Penitentiary, opened the same month several miles east of town. Mining continued to be important to Boise's economic growth and periodic booms contributed to population growth as well, though production of gold and silver probably peaked in the 1860s. 1882's gold and silver production of $3,500,000 declined to $1,488,315 (including lead) by 1899. Boise began to earn its City of Trees nickname in this period with a popular focus on a range of tree planting projects. Thomas J. Davis planted several thousand fruit trees in 1864 and several other early businessmen either founded nurseries or orchards of their own. In the 1870s tree planting began in earnest in downtown Boise led by prominent hotels as well as businessmen and residents. In 1907 Davis donated 43 acres of his orchard property to the city for use as a park in the name of his wife Julia. Commercial agriculture continued to expand, but was slowed by the lack of reliable rail links to regional and national markets and by a lack of large scale irrigation projects, which themselves were often tied to hoped-for railroad projects for financing. A.D. Foote, a successful mining engineer, drew up plans to irrigate up to 500,000 acres immediately south of Boise in 1882, but progress was halting and smaller farms were the norm until after the turn of the century with most located near to the river bottom where soil was productive and irrigation more easily achieved. Fruit orchards proliferated and sugar beets, still an important agricultural industry in Idaho, began to be widely cultivated in the 1890s. Cattle and sheep farming became increasingly important as the century closed. With the exception of dairy, most livestock products were exported from Idaho, unlike other agricultural products which were still largely scaled to support local markets. The timber industry also increasingly thrived in the Boise market in the 1880s and 1890s. Large quantities of timber were exported from elsewhere in Idaho, but a growing Boise supported the expansion of Alexander Rossi's sawmill, first established in 1865. Prominent early Boisean William Ridenbaugh had inherited control of the canal now bearing his name from his uncle William Morris in 1878 and later partnered with Rossi to expand the sawmill capacity under the name Rossi and Ridenbaugh Lumber Company. Their materials supported bridge building and the rapid expansion of Boise in the 1890s. As with many early infrastructure ventures, electrification succeeded only after at least one false start. July 4, 1887, marked the start of electrical transmission from a plant located on the Bench. William Ridenbaugh provided expertise and manpower for the water supply and several months were spent rigging poles and lines from the Bench to the service area across the river. Additional electrical supplies allowed the building of an electric streetcar line in 1891. This ran without interruption until buses replaced the lines in 1927, tracking—and sometimes driving—the development of Boise and nearby communities. This system expanded over several decades, reaching into the North End, South Boise and across the river on Front St. A loop line, completed in 1912, ran as far as Caldwell and Nampa, providing transport throughout the valley. Three early trolley companies merged in 1912 to form the Idaho Traction Company with a depot at 7th and Bannock Streets downtown. Additional services and urban amenities arrived in the 1890s as Boise grew. Exploratory drilling for hot water was successful in 1890 and by the end of the decade many homes along Warm Springs avenue were being heated by this source. A natatorium was built in 1892 close to the source of the hot water near the Idaho State Penitentiary. Churches serving several denominations, a Jewish synagogue, a major hardware store and department store, a Masonic hall, the Columbia Theater, Saint Alphonsus' Hospital, a number of parochial and secular schools, a City Hall and a new Union Pacific passenger station, constructed when service was finally extended to downtown, were all built during the 1890s. Falk's Department Store sponsored a semi-professional baseball team representing Boise from at least 1892 and the city supported other organized sports as they became popular.

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States.

ams, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States.

commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States.

decision support systems. The use of AI in healthcare has also raised ethical, technical, and regulatory concerns, including related to issues such as data privacy, automation of jobs, and amplifying already existing algorithmic bias.

Disease diagnosis Accurate and early diagnosis of diseases is still a challenge in healthcare. Recognizing medical conditions and their symptoms is a complex problem. AI can assist clinicians with data processing capabilities to save time and improve accuracy. Through the use of machine learning, artificial intelligence can substantially aid doctors in patient diagnosis through the analysis of mass electronic health records (EHRs). AI can help early prediction, for example, of Alzheimer's disease and dementias, by looking through large numbers of similar cases and possible treatments. In 2023 a study reported higher satisfaction rates with ChatGPT-generated responses compared with those from physicians for medical questions posted on Reddit's r/AskDocs. Evaluators preferred ChatGPT's responses to physician responses in 78.6% of 585 evaluations, noting better quality and empathy. The authors noted that these were isolated questions taken from an online forum, not in the context of an established patient-physician relationship.

Telehealth Telehealth is the treatment of patients remotely. Pivovarov and Elhada (2015) propose using wearable devices to allow for constant monitoring of a patient and the ability to notice changes via AI that may be less distinguishable by humans.

Kassebaum Act) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information and stipulated guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The law does not restrict patients from accessing their own information, except in limited cases.

Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information and stipulated guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The law does not restrict patients from accessing their own information, except in limited cases.

Title I protects health insurance coverage for workers and their families if they change or lose their jobs. Title II, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Title III sets guidelines for pre-tax medical spending accounts. Title IV sets guidelines for group health plans. Title V governs company-owned life insurance policies.

training, pursued after receipt of the M.D. or D.O. degree in the United States. This education includes internship, residency, subspecialty and fellowship programs, and leads to state licensure and board certification. Physicians must complete GME training before they can practice medicine independently. Graduate medical education is part of what's known as the continuum of medical education, following undergraduate medical education (UME)—the training that leads to the M.D. or D.O. degree—and preceding continuing medical education (CME). The federal government significantly invests in GME, primarily through Medicare payments administered by the Centers for Medicare & Medicaid Services (CMS). The federal government also supports physician GME training through the Medicaid program, the children's hospital GME program, the teaching health center GME program, the Department of Defense, and the Department of Veterans Affairs. Total federal GME funding was about $15 billion per year as of 2012 and 2018.

Medicare funding The Social Security Amendments of 1983 authorized Medicare indirect GME (IME) funding as add-ons to inpatient prospective payment system (IPPS) payments. The Consolidated Omnibus Budget Reconciliation Act of 1985 authorized Medicare direct GME (DGME) funding. The Balanced Budget Act of 1997 capped payments because of an anticipation of a surplus of physicians and a concern that the IME adjustment overpaid hospitals relative to their additional teaching costs. The Medicare administrative contractor (MAC) calculates funding using the hospital's cost report data (intern/resident counts, FTE caps, per resident amounts, Medicare patient load, rotations, provider agreements). Disputes are preserved in the MAC cost report audit and settlement process, and if unresolved the provider appeals to the Provider Reimbursement Review Board (PRRB), which has jurisdiction over factual, legal, and methodological disputes, including cap-building, redistribution, and regulatory interpretation.

ng that leads to the M.D. or D.O. degree—and preceding continuing medical education (CME). The federal government significantly invests in GME, primarily through Medicare payments administered by the Centers for Medicare & Medicaid Services (CMS). The federal government also supports physician GME training through the Medicaid program, the children's hospital GME program, the teaching health center GME program, the Department of Defense, and the Department of Veterans Affairs. Total federal GME funding was about $15 billion per year as of 2012 and 2018.

cheology and Roman medical literature also indicate that many types of medical devices were in widespread use during the time of ancient Rome. In the United States, it was not until the Federal Food, Drug, and Cosmetic Act (FD&C Act) in 1938 that medical devices were regulated at all. It was not until later in 1976 that the Medical Device Amendments to the FD&C Act established medical device regulation and oversight as we know it today in the United States. Medical device regulation in Europe as we know it today came into effect in 1993 by what is collectively known as the Medical Device Directive (MDD). On May 26, 2017, the Medical Device Regulation (MDR) replaced the MDD. Medical devices vary in both their intended use and indications for use. Examples range from simple, low-risk devices such as tongue depressors, medical thermometers, disposable gloves, and bedpans to complex, high-risk devices that are implanted and sustain life. Examples of high-risk devices include artificial hearts, pacemakers, joint replacements, and CT scans. The design of medical devices constitutes a major segment of the field of biomedical engineering. The global medical device market was estimated to be between $220 and US$250 billion in 2013. The United States controls ≈40% of the global market followed by Europe (25%), Japan (15%), and the rest of the world (20%). Although collectively Europe has a larger share, Japan has the second largest country market share. The largest market shares in Europe (in order of market share size) belong to Germany, Italy, France, and the United Kingdom.

A global definition for medical device is difficult to establish because there are numerous regulatory bodies worldwide overseeing the marketing of medical devices. Although these bodies often collaborate and discuss the definition in general, there are subtle differences in wording that prevent a global harmonization of the definition of a medical device, thus the appropriate definition of a medical device depends on the region. Often a portion of the definition of a medical device is intended to differentiate between medical devices and drugs, as the regulatory requirements of the two are different.

Japan Article 2, Paragraph 4, of the Pharmaceutical Affairs Law (PAL) defines medical devices as "instruments and apparatus intended for use in diagnosis, cure or prevention of diseases in humans or other animals; intended to affect the structure or functions of the body of man or other animals." Rest of the world Canada The term medical device, as defined in the Food and Drugs Act, is "any article, instrument, apparatus or contrivance, including any component, part or accessory thereof, manufactured, sold or represented for use in: the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, in a human being; the restoration, correction or modification of a body function or the body structure of a human being; the diagnosis of pregnancy in a human being; or the care of a human being during pregnancy and at and after the birth of a child, including the care of the child. It also includes a contraceptive device but does not include a drug." The term covers a wide range of health or medical instruments used in the treatment, mitigation, diagnosis or prevention of a disease or abnormal physical condition. Health Canada reviews medical devices to assess their safety, effectiveness, and quality before authorizing their sale in Canada.

Outpatient surgery, also known as ambulatory surgery, day surgery, day case surgery, or same-day surgery, is surgery that does not require an overnight hospital stay. The term “outpatient” arises from the fact that surgery patients may enter and leave the facility on the same day. The advantages of outpatient surgery over inpatient surgery include greater convenience and reduced costs. Outpatient surgery may occur in an inpatient facility, in a self-contained unit within a hospital (also known as a hospital outpatient department), in a freestanding self-contained unit (also known as an ambulatory surgery center), or in a physician's office-based unit. Between the late 20th century and early 21st century, outpatient surgery has grown in popularity in many countries. In the United States, 65% of surgeries at hospitals in 2012 were conducted on an outpatient basis, compared with 54% in 1992. Studies have shown that outpatient surgery is as safe as or safer than inpatient surgery. For instance, complication rates and post-surgical hospitalization or readmission rates are comparable, and pain and infection rates are lower after outpatient surgery than inpatient surgery.

atient surgery may occur in an inpatient facility, in a self-contained unit within a hospital (also known as a hospital outpatient department), in a freestanding self-contained unit (also known as an ambulatory surgery center), or in a physician's office-based unit. Between the late 20th century and early 21st century, outpatient surgery has grown in popularity in many countries. In the United States, 65% of surgeries at hospitals in 2012 were conducted on an outpatient basis, compared with 54% in 1992. Studies have shown that outpatient surgery is as safe as or safer than inpatient surgery. For instance, complication rates and post-surgical hospitalization or readmission rates are comparable, and pain and infection rates are lower after outpatient surgery than inpatient surgery.

nt surgery. Nevertheless, articles in the newsmedia (such as some discussing the 2014 death of Joan Rivers after an outpatient procedure) have questioned the safety of outpatient surgery performed at ambulatory surgery centers. Ambulatory surgery centers Ambulatory surgery centers, also known as outpatient surgery centers, same day surgery centers, or surgicenters, are health care facilities where surgical procedures not requiring an overnight hospital stay are performed. Such surgery is commonly less complicated than that requiring hospitalization. Avoiding hospitalization can result in cost savings to the party responsible for paying for the patient's health care. These centers specialize in providing surgery, including certain pain management and diagnostic (e.g., eye muscle surgery services) in an outpatient setting. Overall, the services provided can be generally called procedures. These can be considered procedures that are more intensive than those done in the average doctor's office but not so intensive as to require a hospital stay. An ambulatory surgery center and a specialty hospital often provide similar facilities and support similar types of procedures. The specialty hospital may provide the same procedures or slightly more complex ones and the specialty hospital will often allow an overnight stay.

pa ( ) is the most populous city in Canyon County, Idaho, United States. The population was 100,200 at the 2020 census. It is Idaho's third-most populous city. Nampa is about 20 miles (32 km) west of Boise along Interstate 84, and 6 miles (9.7 km) west of Meridian. It is the second principal city of the Boise metropolitan area. The name "Nampa" may have come from a Shoshoni word meaning 'moccasin' or 'footprint'. According to toponymist William O. Bright, the name comes from the Shoshoni word /nampai/, meaning "foot".

History Nampa had its beginnings in the early 1880s when the Oregon Short Line Railroad built a line from Granger, Wyoming, to Huntington, Oregon, that passed through Nampa. In Nampa there is a history museum that marks the railroad's significance. More railroad lines sprang up through Nampa, making it an important railroad town. Alexander and Hannah Duffes established one of the town's first homesteads, eventually forming the Nampa Land and Improvement Company with the help of their friend and co-founder, James McGee. Despite the name, many early settlers called the town "New Jerusalem" because of its citizens' strong religious focus. After only a year the town grew from 15 homes to 50. As amenities were added, Nampa continued to grow, and it was incorporated in 1891. Downtown Nampa's street grid is oriented with the railroad tracks, which run northwest–southeast; this was done intentionally by Alexander Duffes to prevent accidents like one that occurred earlier in a town he had platted near Toronto, where a woman and her two children were killed by a train when their buggy wheel got stuck as they crossed the tracks. As the Oregon Short Line railroad originally bypassed Boise, Nampa has the fanciest of many railroad depots built in the area. Nampa gained attention in 1889 due to a purported archaeological discovery known as the Nampa figurine. George Frederick Wright wrote up details that year for the Boston Society of Natural History. The first elementary school was built in the 1890s. Lakeview School was on a hill on 6th Street and 12th Avenue North, with a view of Lake Ethel. Just after the school's centennial celebration, it was condemned as a school and sold to the First Mennonite Church. In 2008 the building was refurbished, and it is now used by the Idaho Arts Charter School. Lake Ethel, an irrigation reservoir, had long been the site of community picnics, and many citizens fished, swam, boated, and even hunted on it and its surrounding property. But the hunting didn't last long, as O. F. Persons, owner of the adjoining homestead, took offense when local hunters started shooting his pet ducks. The city later auctioned off the lake. E. H. Dewey (a former Nampa mayor) was the only bidder. But occasional flooding led to a series of lawsuits from neighbors. Dewey eventually drained Lake Ethel. Not long after, the city council became interested in buying back the Fritz Miller property as well as the Dewey home. Pressure had been building for more than four years. Nampa citizens wanted another park. On August 7, 1924, the city council passed an ordinance to purchase the Miller property and name it Lakeview Park. A bandstand was completed in 1928, and the municipal swimming pool opened on August 13, 1934. It is Nampa's largest park and many community celebrations are held there. Colonel William H. Dewey, a man who made a fortune mining in Silver City, built the Dewey Palace Hotel in 1902 for $250,000. He died in his hotel in 1903, leaving his son $1 million. The hotel survived the great fire of 1909, which burned several blocks of downtown Nampa, but was razed in 1963 after redevelopment plans failed. Relics from the hotel such as the chandelier and the hotel safe can be found at the Canyon County Historical Museum, which is in the old train depot on Front Street and Nampa City Hall. After demolition the location on First Street between 11th and 12th Ave. South was sold to private enterprise, including a bank and tire store, replacing this building with modern structures. A public-use postage stamp sized park was later placed across the street from the old palace property as a collaboration between the Downtown Alliance of Nampa (the local business council) and an Eagle Scout Project for the Boy Scouts of America. The park includes a large mural/wall sculpture of running horses commissioned for the project. A Carnegie library was built downtown in 1908; it burned down after the library moved in 1966. Nampa Public Library was then on the corner of 1st Street and 11th Avenue South in the old bank building. A new library, on 12th Avenue South, opened in 2015. Deer Flat Reservoir, an offstream irrigation storage reservoir, was constructed by the United States Bureau of Reclamation between 1906 and 1911. Known locally as Lake Lowell, it is surrounded by the Deer Flat National Wildlife Refuge, established in 1909 by President Theodore Roosevelt. The refuge is administered by the U.S. Fish and Wildlife Service. Lake Lowell is filled by the concrete New York Canal; the water is diverted from the Boise River a few miles below Lucky Peak Dam. In 1910, the Idaho State School and Hospital was built northwest of Nampa for the state's developmentally challenged population. It opened in 1918. The institution was largely self-sufficient, with a large farm staffed by the residents. The higher-functioning residents also cared for residents who could not care for themselves. The land for the farm was sold and is now golf courses (Centennial and Ridgecrest), and the residents no longer give primary care to other residents. The institution is modernized and remains in operation, though a few of the oldest buildings now house juvenile offenders. Nampa held an annual harvest festival and farmers' market from about 1908, a time of celebration and community fun. From this festival emerged the Snake River Stampede Rodeo in 1937, which continues to this day. It is one of the top 12 rodeos in the pro rodeo circuits. In 1913, a local congregation of the Church of the Nazarene built a small elementary school, which became to Northwest Nazarene College in 1915 and finally Northwest Nazarene University. As of 2025, the university has approximately 1,800 undergraduate and graduate students. Karcher Mall opened in 1965, the first enclosed shopping mall in the Treasure Valley. It was "the place to gather" for several decades until the Boise Towne Square mall was built in Boise in 1988, drawing business away. Karcher Mall was renamed District 208 in 2022. The Idaho Press-Tribune is the local newspaper for the Canyon County area.

Idaho Hispanic Community Center (IH2C) In 2003, the Hispanic Cultural Center of Idaho (HCCI) opened thanks to community support. It has recently transitioned back to the City of Nampa and was renamed the Idaho Hispanic Community Center (IH2C) and is home to the Idaho Hispanic Foundation. It hosts events, classes, and festivals, including Día de los Muertos, Hispanic Heritage Month, and Día Internacional de la Mujer. It serves as a meeting place for associations and groups. Displays of cultural history are available to the public. Nampa Train Depot Museum The Nampa Train Depot Museum is a historical depot with displays and archives of the area's railroad and cultural history. The Canyon County Historical Society saved the depot from demolition in 1972. Annual Festival of the Arts Nampa's Festival of the Arts, which began in 1987, is held in Lakeview Park every year and includes local art, music, dance, and food.

Ada County is located in the southwestern part of Idaho, United States. As of the 2020 census, the county had a population of 494,967, which by 2025 was estimated to have risen to 546,141. Ada County is by far the state's most populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

populous county; it is home to 26.8% of the state's population. The county seat and largest city is Boise, which is also the state capital. Ada County is included in the Boise metropolitan area. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads.

ea. The Ada County Highway District has jurisdiction over all the local county and city streets, except for private roads and state roads. In the interior Pacific Northwest east of the Cascade Range, Ada County ranks second in population, behind Spokane County, Washington. History Ada County was created by the Idaho Territory legislature on December 22, 1864, partitioned from Boise County. It is named for Ada Riggs, the daughter of H. C. Riggs, a member of the legislature; he established the county and was a co-founder of Boise.

the county seat of Canyon County, Idaho, United States. Caldwell is the 5th most populous city in Idaho. As of the 2020 census, Caldwell had a population of 59,996. Caldwell is considered part of the Boise metropolitan area, and is the location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

location of the College of Idaho. The city is located approximately 24 miles (39 km) west of Boise, and approximately 17 miles (27 km) east of the Oregon border. History The present-day location of Caldwell is along a natural passageway to the Inland and Pacific Northwest. Native American tribes from the west coast, north Idaho and as far away as Colorado came to the banks of the Boise River for annual trading fairs, or rendezvous. European and some Hawaiian explorers and traders soon followed the paths left by Native Americans and hopeful emigrants later forged the Oregon Trail and followed those paths to seek a better life in the Oregon Territory. Pioneers of the Trail traveled along the Boise River to Canyon Hill and forded the river close to the Silver Bridge on Plymouth Street. During the Civil War, the discovery of gold in Idaho's mountains brought a variety of new settlers into the area. Many never made it to the mines but settled along the Boise River and run ferries, stage stations, and freighting businesses. These early entrepreneurs created small ranches and farms in the river valleys. Caldwell's inception occurred largely as a result of the construction of the Oregon Short Line Railroad, which connected Wyoming to Oregon through Idaho. Robert E. Strahorn came to the Boise River Valley in 1883 to select a route for the railroad. He rejected the grade into Boise City as too steep and chose a site 30 miles to the west. He drove a stake into an alkali flat of sagebrush and greasewood and the City of Caldwell was platted. Caldwell was named after one of Strahorn's business partners, Alexander Caldwell, a former senator from Kansas. When Caldwell was platted in August 1883, its founder, the Idaho and Oregon Land Improvement Company, started persuading settlers and businessmen to move to the area. Within four months, Caldwell had 600 residents living in 150 dwellings, 40 businesses, a school, a telephone exchange, and two newspapers. On January 15, 1890, the Board of Commissioners of Ada County issued a handwritten order incorporating the City of Caldwell. The College of Idaho was founded in Caldwell in 1891. In 1892, Canyon County was established from a portion of Ada County, and Caldwell was named the county seat. Irrigation canals and waterways were constructed throughout Canyon County, providing the foundation for an agricultural economy. The Oregon Short Line Railroad became part of the larger Union Pacific Railroad network and in 1906 the Caldwell freight and passenger depot was constructed. Caldwell experienced moderate growth as an agricultural processing, commercial retail and educational center during the 20th century. In 2009, the City of Caldwell completed a revitalization project to restore Indian Creek, which runs through downtown Caldwell, but had been used for sewage disposal by local industries and been covered over.

105, which by 2025 was estimated to have risen to 275,123, making it the second-most populous county in Idaho. The county seat is Caldwell, and its largest city is Nampa. Canyon County is part of the Boise metropolitan area. History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

History Hudson's Bay Company established Fort Boise in 1834 near what is now Parma, but abandoned it in 1855. Emigrants traveled through Canyon County on the Oregon Trail. Discovery of gold in the Boise Basin in 1862 brought settlement to the region again. The lower Boise River was fully contained within Boise County from 1863 until the formation of Ada County in 1864. Settlement of the lower Boise River west of Boise City was limited prior to the completion of the Oregon Short Line Railroad. Middleton was the first European settlement of Canyon County, starting in 1863. The 1870 Census for Ada County listed 76 residents of the Boise Valley, excluding Boise City and the 1880 Census listed 44 residents at Middleton. The arrival of the railroad at Caldwell led to the establishment of a town there as of August 1883. Businessmen James A. McGee and Alexander Duffes filed the plat for nearby Nampa in 1886. Parma was settled around the same time, with the Old Fort Boise post office being moved to the town's location; it was incorporated in 1904. Ada County established precincts for each of the settlements with a combined 1890 Census population of 2,311. Significant settlement of Greenleaf and Notus started around 1904 with the two settlements listed as precincts at the 1910 census. Notus was incorporated in 1921 while Greenleaf was incorporated prior to 1980. Melba was incorporated in 1912 while Wilder was incorporated in 1919. The City of Star annexed a portion of territory in northeast Canyon County prior to 2007, becoming the county's ninth incorporated city. The majority of Star is located within Ada County. The Idaho Legislature created Canyon County from Ada County in an act approved March 7, 1891, effective at the November 26, 1892, election. Caldwell was established as the county seat. The county originally contained all of Canyon and Payette counties and part of Gem; Gem County formed in 1915 and Payette County in 1917.

2000 census As of the 2000 census, there were 131,441 people, 45,018 households and 33,943 families living in the county. The population density was 223 people per square mile (86 people/km2). There were 47,965 housing units at an average density of 81 units per square mile (31 units/km2). The racial makeup of the county was 83.10% White, 0.32% Black or African American, 0.85% Native American, 0.80% Asian, 0.13% Pacific Islander, 12.17% from other races, and 2.62% from two or more races. Hispanic or Latino of any race were 18.61% of the population. 15.9% were of German, 12.7% English, 10.3% American and 7.6% Irish ancestry. There were 45,018 households, of which 39.80% had children under the age of 18 living with them, 60.70% were married couples living together, 10.10% had a female householder with no husband present, and 24.60% were non-families. 19.80% of all households were made up of individuals, and 8.40% had someone living alone who was 65 years of age or older. The average household size was 2.85 and the average family size was 3.28. 30.90% of the population were under the age of 18, 10.70% from 18 to 24, 28.30% from 25 to 44, 19.10% from 45 to 64, and 11.00% who were 65 years of age or older. The median age was 30 years. For every 100 females, there were 98.70 males. For every 100 females age 18 and over, there were 96.30 males. The median household income was $35,884 and the median family income was $40,377. Males had a median income of $29,418 compared with $22,044 for females. The per capita income for the county was $15,155. About 8.70% of families and 12.00% of the population were below the poverty line, including 14.50% of those under age 18 and 10.70% of those age 65 or over. Communities Cities Unincorporated communities Bowmont Huston Roswell Sunnyslope Walters Ferry, Idaho Politics Like the majority of Idaho, Canyon County is reliably Republican by comfortable margins. The last time a Democratic candidate carried the county was in 1936 by Franklin D. Roosevelt.

Meridian is a city located in Ada County, Idaho, United States. The population was 117,635 at the 2020 census, making it the second most populous city in the county and Idaho, after Boise, the state capital.

Rail transportation (1908–28) Following the raising of $4,000 to lay the Interurban rail line from Onweiler (Meridian and Ustick Roads), the tracks were completed into the village center. Turning east on Broadway and ending at East Second, the last car would spend the night in Meridian before returning to Boise early the next morning with passengers and freight. The interurban Station and Generator building (west one-third of the old library at Meridian and Idaho Streets) was built in 1912, and the line continued on to Nampa via Meridian. The tracks down Broadway were not used after 1912. The Interurban Company entered into receivership and closed in 1928 after 20 years of providing continuous transportation to neighboring towns. It was Meridian's main connection to the area outside the local community. The Union Pacific Railroad spur opened in 1900 and is currently operated by the Boise Valley Railroad. Many industrial customers continue to ship forest, agricultural, and chemical products along this corridor. Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

Creamery (1929–70) The city's official website describes the history of the Ada County Dairymen's cooperative creamery as follows:The lowest days of the Great Depression brightened for area dairymen when the Ada County Dairymen's cooperative creamery began operation in 1929. It provided milk checks to those who were members of the cooperative, enabling them to pay their taxes and provide food for their families. Other community members hauled milk to the creamery and were employed by the creamery, whose product was Challenge Butter. The creamery ran seven days a week for 40 years. Additions and improvements were made while the plant was in full operation. Later years saw the Wyeth Laboratories affiliate with the creamery to manufacture SMA baby formula.

Eagle is a city in Ada County, Idaho, ten miles (16 km) northwest of downtown Boise. The population was 30,346 at the 2020 census. History 19th century Eagle Island in Idaho was settled in 1863 by Truman Coe Catlin, who later shifted from crop farming to dairy farming, starting the island's dairy tradition. He also pioneered irrigation in the area by constructing a wide irrigation ditch. The most notable early community developer was Thomas Hugh Aiken, a Canadian surveyor, who helped establish the Eagle community in the 1870s.

Parks and recreation The city features numerous parks, including Arboretum Park, Friendship Park, Heritage Park, Orval Krasen Park, Reid W. Merrill Sr. Community Park, and Stephen C. Guerber Park, among others. The Parks and Recreation department offers youth sports leagues, camps, special events (such as Eagle Fun Days), and maintains extensive trails. Nearby Eagle Island State Park provides a swimming beach, trails, disc golf, and winter sports. Education Most of Eagle is in the West Ada School District, with a small portion in the Boise School District.

20th century The Eagle Fish Hatchery, established in the late 1940s in Idaho, was originally part of a trout program until the 1980s. In 1991, it was restructured to support the conservation of Snake River sockeye salmon, an endangered species listed that year. The hatchery's mission shifted to preserving the species and its genetic diversity through the development of eight broodstocks derived from smolts, anadromous adults, and residual populations.