History of the U.S. Health Care Delivery System
Over the course of our countries history, the delivery of our health care system has tried to meet the needs of our growing and changing population. However, we somehow seem to fall short in delivering our goals of providing quality, affordable and accessible healthcare to our citizens. The history of our delivery system will show we continuously changed the delivery of our system however never mange to control cost. If we can come up with efficient ways to cut cost, the delivery of quality care will follow. The delivery of the U.S. healthcare system has changed drastically over the years from the inception of organized healthcare to today’s underdeveloped system. Prior to the 1920’s, most Americans would only seek medical attention to treat chronic illnesses which would shortly result in death. Hospital centers were scarce and early patients were mostly treated by private physicians in their homes. Because of the scarcity of hospitals and the underdevelopment of medical technology at the time, doctors could do little to help patients. This resulted in minimal medical cost for patients receiving care. However, families did purchased sickness insurance, or what we know today as disability insurance, to cover cost of lost wages due to long term sickness. At this time, the cost of loss wages and/or the sickness insurance premiums exceeded the cost of the medical care itself. Because of this, organized health care was not seen as essential. At the start of the twentieth century, the increase in medical advancements and growth of hospitals changed the need for organized health care. (Add Quote) Private doctors began to shift medical care to hospitals in order to take advantage of new medical technologies which in turn increased the costs for such care. From this point on, health care cost would continuously rise as science and medicine would proved to stabilize chronic diseases, physicians licensures became standardized and specialty services became popular. As a result, peoples urge to live longer increased and the demand for quality physicians drove cost even more. We would see early on how quickly changes in service delivery would raise cost. Rosenberg (1987) notes that "by the 1920s… prospective patients were influenced not only by the hope of healing, but by the image of a new kind of medicine -- precise, scientific and effective" (p. 150). In the late 1920’s, a committee called the Costs of Medical Care, or CCMC, was formed to track the medical expenses of American families. The CCMC found that in 1929 the average American family spent $108 on medical expenses with 14% being hospital cost (Falk, Rorem, and Ring 1933, p. 89). Just five years later, medical cost would rise almost 40% for U.S. families (Davis 1934, p. 211). Add references for quotes. As a result of rising cost and the coping of the Great Depression, health care cost began to become un-affordable for most U.S. families. In the early 1930’,s we would see the first pre-paid medical services offered to families to help cope with rising medical cost and prepare for unexpected treatments and hospitalizations. The first known medical insurance company, Blue Cross, was piloted in a local hospital in Dallas, Texas. Earlier known as “the blues” (add quote), the company started off as a nonprofit health insurer who served local community organizations and charged a flat premium for everyone needing their services. For the exchange of tax break incentives, the organizations kept premiums reasonably low. This company would become a model and give rise to the major for-profit insurance companies we know today as they began to see profit in capitalizing insurance as a profitable service industry. As private companies entered the market and insurance became competitive, Blue Cross along with other on-profit companies shifted their focus to a for-profit approach to catch up with market. From the 1940 to...
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