Healthcare Essay example

Words: 18329
Pages: 74

Chapter 3

The Evolution of Health Services in the United States
Learning Objectives
To discover historical developments that have shaped the nature of the US health care delivery system
To evaluate why the system has been resistant to national health insurance reforms
To explore developments associated with the corporatization of health care
To speculate on whether the era of socialized medicine has dawned in the United States

“Where’s the market?”

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CHAPTER 3

The Evolution of Health Services in the United States

Introduction
The health care delivery system of the United States evolved quite differently from the systems in Europe. American values and the social, political, and
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This chapter traces the evolution of health care delivery through three major historical phases, each demarcating a major change in the structure of the delivery system. The first phase is the preindustrial era from the middle of the 18th century to the latter part of the 19th century. The second phase is the postindustrial era beginning in the late 19th century. The third, most recent and current phase, is marked by the growth of managed care, organizational integration, the information revolution, and globalization, called the corporate era.

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Medical Services in Preindustrial America
The practice of medicine is central to the delivery of health care; therefore, a major portion of this chapter is devoted to tracing the transformations in medical practice from a weak and insecure trade to an independent, highly respected, and lucrative profession. Delivery of medical services through managed care and the corporatization of physician practices, however, have made a significant impact on practice styles and have compromised the autonomy that physicians have historically enjoyed. The medical profession has also consolidated into larger organizational units, away from the solo practice of medicine that had once prevailed. Medical Services in Preindustrial America
From Colonial times to the beginning of the
20th century, American medicine lagged behind the advances in medical science, experimental research, and medical