Evolution Of U.S. Healthcare System Essay
Abstract
Nowadays the health care system is utterly complex and versatile, it is radically different from what it used to be long time ago. Most of the changes are related to the significant transition from indemnity plan, which was made up on the basis of the patients’ desires, towards managed health care system. The last two generations of American citizens had to go through serious changes and moreover the system of health care continues to evolve. There is a number of factors, having impact upon these changes and serving the driving forces for introduction of them. At the same time a number of challenges appeared, they are related to the increase of costs in the sphere of healthcare, increasing the number of people, who do not have insurances, increase of treatment costs, etc. Researching and understanding the factors, which force the changes along with predicting of their outcomes, are important for supporting of the process of evolution in health care sphere in the United States.Evolution Of U.S. Healthcare System Essay
Historically the system of health care in America has evolved significantly between the years 1750 and 2000, people were used to itinerant doctors and home remedies. Certainly the doctors were not well-trained and experienced, they lacked strong scientific and technological base, in addition the situation was worsened by the general bureaucratic system. Development of medical science and technologies, revealing and acceptance of “germ theory”, explaining the causes of the diseases, were the major driving sources for this evolution. Doctors received the opportunity to utilize various technological advancements in order to be more successful in treating the diseases. Institutions of medical training started to prepare well-trained and skillful specialists in various medical spheres; the system of medical insurance was introduced. This was also the period of evolvement of governmental institutions, working out of health care programs, drug regulations and insurance systems. The private sphere was marked with the growth of corporations, which utilized health care as a business.Evolution Of U.S. Healthcare System Essay
The medicine in America used to be based upon families. In other words women were expected to take care of the sick members of the family and only in those situations, when the disease was serious, doctors were contacted. This system of “domestic medicine” was practiced till 1800. Such issues as baby deliveries were also managed by women at homes. “Until the mid- eighteenth century Western medicine was based on the ancient Greek principle of “four humors”—blood, phlegm, black bile, and yellow bile. Balance among the humors was the key to health; disease was thought to be caused by too much or too little of the fluids. The healing power of hot, cold, dry, and wet preparations, and a variety of plants and herbs, were also highly regarded.” (Fillmore 2009, p. 1). Only during the late colonial period the first physicians with medical degrees and corresponding training started to appear. During the same period physicians started to research the problem of germs and the meaning of social conditions, as influential factors for spreading of the diseases.
Urbanization brought corresponding changes into the sphere of health care in America. Doctors did not travel to their patients’ homes any more, they started to treat them under their roof. After the Civil War hospitals were divided into private and public. At the same time there appeared the first schools for nurses, acknowledging this profession in the society.Evolution Of U.S. Healthcare System Essay
By the end of the nineteenth century medical science was supported by great advancements in chemistry and biology, as well as other medicine related sciences. This breakthrough allowed doctors fight with such diseases as cholera, yellow fever, tuberculosis. Prevention practices brought their results and the diseases stopped to spread so easily and quickly. This fact led to increase of the general level of public health. At the beginning of the twentieth century doctors started to receive better salaries and their positions became much stronger. In 1899 the American Hospital organization was founded. Workers received a number of benefits through their labor unions and were able to get certain paid services as well. However the concept of national health insurance, which was widely spread in most of the European nations, was not accepted in America. Health care costs started to grow and there appeared a lot of health insurance plans. Doctors received payments according to the system “free-for-service”.
After World War II the period of great advancements in medical care and science started, which led to increase of the costs. The levels of medical care and preventive care were rather high during this period. Such innovations as x rays, diagnostic approaches, and penicillin became the basis for the future scientific culture in medicine. The American government launched such programs as the National Institutes of Health and the Centers for Disease Control. Starting from the 1960s the social programs were launched, aiming at provision of medical care to aged people and poor people. The U.S. Public Health Services, the Food and Drug Administration were also founded at this moment of time.Evolution Of U.S. Healthcare System Essay
In the 1980s the meaning of Health Maintenance Organizations grew and these organizations occupied the dominating positions in the sphere of health care. Decades later these organizations made the free-for-service practice almost disappear and doctors turned out to be in less control of their practice. The system changed and the doctors were to take care of all patients, this system was also known as “managed care”. Managed care brought significant changes into the meaning of preventive care, consumer choice. Individual patients had to acknowledge the portion of their own responsibility for their health and timely healthcare. In the 1990s communication technologies were rapidly developed. Internet had its impact upon the sphere of medical care, as much more information became available to the consumers. The practice of “telemedicine” was also enabled with development of computer and communication technologies.
Health care of the 21st century continues to change and develop further, health care sphere becomes more complex and the costs are changing. “Just as the impact of new technologies, such as x rays, antibiotics, vaccines, and surgical advances changed early and mid-twentieth-century medicine socially and scientifically, scientific and medical innovations, as well as social movements and economic realities, will continue to shape twenty-first-century medicine and health care.” (Fillmore 2009, p. 5).
Generally the historic experience shows that according to the approach of public interest there has also been the conflict between reformers, who were concentrated upon their interests in health care and those experts, who insisted upon consideration of public interests, as the major aims. Healthcare organizations in America are rather complex and they need properly organized and conducted management approaches and supervision. This is the reason, why healthcare managers are appointed to their positions and take huge responsibility for important decisions. According to systems approach the whole health care system could be split into four key levels: the individual patient, the care team, the organization and the political and economic environment.
Critical approach in healthcare underlines the important of the quality of health care. This approach considered the connection between social inequities and reproduction of health care. It is necessary to admit that there are really disparities in health care.
Health care is definitely under the impact of various factors, including social situation in the country, economic development of the country, development of innovations and technologies in medical science and demographic changes. Demographic shifts and ageing society have strong impacts upon health care in America. “Like the rest of the world, the US is an ageing society. Between 2000 and 2050, the number of older people is projected to increase by 135%. Moreover, the population aged 85 and over, which is the group most likely to need health and long-term care services, is projected to increase by 350%.” ( Wiener, Tilly, 2002, p. 3). According to the current forecasts the number of the population over 85 would grow from 1.6% till 4.8% by 2050. Consideration of demographic change is important, because first of the high proportion of elderly citizens in America and secondly there are predictions of future strains of population ageing, as the growth of the working age population is said to be rather slow. This fact would mean that there would be less people, able to pay taxes, which are important for development and realization of the public programs for older population and providing the needed services, including medical care for them.
Generally the health care system of the United States is considered to be unique in comparison to other countries of the world. It has great resources at its disposal, including medical personnel and specialists and highly developed technological innovations and at the same time there are a lot of troubles and challenges in this system. “The U.S. spends per capita on healthcare more than twice the Organization for Economic Cooperation and Development (OECD) average. The U.S. healthcare system, however, ranks poorly relative to its OECD peers in some basic measures like quality, access, efficiency, equity, and life expectancy” (Golalic, 2013, p. 2).Evolution Of U.S. Healthcare System Essay
President Obama introduced his healthcare reform, known as the Patient Protection and Affordable Care Act (PPACA). This was the latest attempt of the government to improve the system of health care. This act was signed in 2010. It was expected to expand the healthcare coverage for those individuals, who were not able to pay for insurance. The Managed care companies were not allowed to use “pre-existing” conditions any more and reject insurance coverage to people and neither did they have dollar limits on coverage.
Overall, upon the transition of the healthcare in America towards managed care, there is a need to introduce further improvements and approaches in order to secure well-organized management and support of this sphere, on the basis of consideration of all economic, social and technological factors.Evolution Of U.S. Healthcare System Essay