History of US Health Care System

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History of US Health CareSystem

Inthe colonial era, the US health system was dominated by traditionalmedicine.

Medicalprofessionalism emerged in the mid 18thcentury.

Mortalityrate was high due to numerous incidences of infectious diseases.

Establishmentof medical facilities, professional health workers and technologydevelopment played an important role in the evolution.

Characteristicsof the Health Care System

TheUS health care system is characterized by facilities and processesthat facilitate the accessibility of health care services.

Ithas a variety payment methods and insurance programs which areintegrated.

Althoughmarket conditions have an impact, the government has authority andcontrol over all aspect of health through relevant healthy carepolicies and reforms.

Emerginginformation and medical technologies have revolution the quality andaccessibility of services.

Basic Subsystems

TheUS health care system has four important subsystems. They include:

Managedcare: It isfinanced by public and private insurance program and focus onefficiency, cost and accessibility of medical services.

Militarymedical care:Includes TRICARE and VA. It provides comprehensive cover for militaryofficers, veterans and their dependants.

Vulnerablepopulation: Aims atproviding medical care to disadvantaged communities, who are mainlypoor and uninsured.

Integrateddelivery system: Thisis a network that links all the players in the health care system toenhance the delivery of service.

Health care professionals

Thereare numerous professionals who have a direct or indirect contributionto the system.

Mainhealth care professionals include

  • General physicians

  • Nurses

  • Specialized doctors such as pediatricians, gynecologists, dentists, surgeons among others.

  • Pharmacists

  • Medical laboratory technologists

  • Community health and social workers

  • Medical engineers

  • Administrators and managers s

  • Radiologists

  • Medical information specialists

  • Therapists

  • Psychiatrists

  • Dietitians

Health care setting

Thereis several setting in the American health care system. They include

  • General hospitals which provide basic diagnosis and treatment services.

  • Specialized hospitals such as psychiatric facilities.

  • Nursing homes and hospices providing long term care.

  • Ambulatory centers and outpatient clinics that deal with patients who do not require hospitalization.

  • Home health care where the medical worker, mainly nurses, attends the patient’s needs at home.


Thereare numerous challenges in the health care system.

  • High cost of medical services and prescribed drugs.

  • Large number of uninsured citizens.

  • Increased shortage of health care workers.

  • An aging population which has evolved into a critical health determinant.

  • High prevalence of terminal diseases.

  • Unhealthy lifestyles and obesity.

  • Globalization and immigration


  • Advanced medical technologies, which have been developed in the recent past.

  • A comprehensive health insurance program under Obamacare, which increases coverage.

  • Corroboration with other health care systems.

Health care policy

Throughouthistory, health care reforms have been an important social andpolitical issue.

Thehealth care policy aims at regulating and coordinating variousplayers in the health care industry.

In2010, the “Patient Protection and Affordable Care Act” commonlyknown as Obamacare introduced major changes in the health caresystem.

Itmainly focused on increasing affordability and accessibility ofhealth services.


Niles, N. (2014). Basicsof the U.S. health care system.Sudbury, Mass.: Jones and Bartlett.

Barton, P. (2016).Understanding theU.S. health services system.Chicago, IL: Health Administration Press.

Barr, D. (2016). Introductionto US health policy : the organization, financing, and delivery ofhealth care in America.Baltimore, Maryland: Johns Hopkins University Press.

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