In the history of the United States there have been an overall transformation of the way the public experiences health care. Paul Starr eloquently explains trends that have affected the health care system in his books The Social Transformation of American Medicine and Remedy and Reaction. An in depth overview of the history of medicine gives a greater understanding of the trends that shape the system we experience today. The first major trend that shaped medicine is the delivery of medicine to the public from the 1800’s to present. In the early 1800’s individuals received medical care by individuals that were not properly trained and did not have proper knowledge of sanitary care for patients.
In the 1850’s the invention of the stethoscope, ophthalmoscope, laryngoscope, microscope x-ray, and EKG provided a transforming medical community that began relying on technology of care to provide better diagnoses and care. With the invention of these medical devices, patients moved from caring for individuals in their homes to the hospital facilities and contributed to a higher survival rate. With the development of more hospitals to care for the sick, we also began to see the formation of multiple hospitals to tailor to multiple religious denominations.
The next major trend discussed in the trend in the way we finance health care. Financing for health care in the private sector began to change in 1929 when Blue Cross was formed at Baylor University for school teachers in Dallas, TX. There was a dual purpose for this program. It provided coverage for individuals so that there would not be financial consequences as a result of hospital care. In essence it was a safety net to also ensure hospitals received payment for services rendered.
The insurance company assumed the risk, based on the profitability of a claim. In 1939 another program was developed called Blue Shield. Blue Shield was designed by a group of physicians as a way of reimbursing physicians’ services and medical and surgical services.
The coverage did not include coverage for pharmaceuticals. Monetary payment was made to an insured which could be assigned to a provider. We also saw the development of the Federal Government third party payers such as Medicaid or Medicare. Especially today we are seeing the move toward more regulation and the possibility of requiring health coverage for all with a penalty if the coverage is not purchased.
The third trend we see in health care is the utilization of health care. In the early 1800’s care was primarily provided to patients who were likely facing a detrimental condition for which there was no care. Methods were not in place to provide surgeries that were sanitary and technology had yet to provide equipment to diagnosis conditions. In the 21st century we see a trend to move toward preventative care. More and more health insurance companies are offering incentives on deductibles as a way to encourage annual visits so as to possibly lower health care costs for major illnesses that could arise and could possibly be prevented in identified earlier.
Health care is a field that is forever changing, and it could not be truer than when we turn on the news to see the latest headlines regarding “Obamacare.” There has long been a struggle on how to best provide coverage availability to Americans without infringing on their freedom of choice. Health care continues to be one of the most costly challenges we face, and as we have seen in the past decades, it is a topic that is ever transforming.
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