RUNNING HEAD: HEALTH CARE GROWTH 1
Historical Transitioning and Growth of the U.S. Health Care System
Luis Raffo Carlin
Dr. Crystal Russell
HSA500
January, 2015

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Introduction
The study is about “Historical Transitioning and Growth of the U.S. Health Care System”. First,
the paper will summarize key milestones involved in the past and present shaping and transitional
dynamics behind changes in the present health care industry. Second, it will evaluate the importance of
financing and technology in health care. Third, it will analyze the primary complexities and integrated
social dynamics associated with changing demographics and emergent diseases. Fourth, the paper will
examine the major fluctuating and daunting challenges in health care management that mortality trends
and an aging Baby Boom generation predicate.
Milestones involved in the past and present shaping and transitional dynamics behind
changes in the present health care industry.
In the nineteenth century different types of practitioner competed to provide care in the United States,
much of which was of poor quality. This practice of the health care system continues until the end of
19th century after that medical reform started in the beginning of the 20th century due to the factors like
scientific basis for medicine, improvement in medical training, and quality of hospitals.
As the nineteenth century ended, advancements in biology, chemistry and related medical sciences
meant that the great diseases were practically eliminated with the development of diagnostic tests and
vaccines. Extensive public health projects, aimed at fighting the causes of disease or to prevent their
spreading, raised the levels of public health.

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In the beginning of 20th century medical practitioner showed the interest in the local and state medical
societies and nationally through the American Medical Association (AMA).
The year of 1910, represented health care system turning point for the country because from poor
quality of the medical practice being used and poor quality of medical colleges and training the country
experience many reforms taken place which closed many medical schools, improved medical
curriculum, quality of student being entered and training facilities.
Private health insurance in the United States had its beginnings around the early 1930s, with the
establishment of non-profit Blue Cross plans for hospital care, and soon thereafter Blue Shield plans for
physician care” (Rice, Rosenau, Unruh, Barnes, 2013, 34). First hospital insurance plan began in the
1929 in Dallas, Texas. After that Blue Cross and Blue shield started getting competition from the
private insurer, mainly after the Second World War. Private insurer was using the “experience rating”
which means expenses will depend on the previous health status of the insured group.
After the tough competition from the private insurer, Blue Cross also started to implement the
“experience rating”. Tremendous growth in the private insurance during this period was because
employer contribution to personal health care insurance was not considered as the taxable income for
employees. Until the 1960, there was no government program to help and promote the health care in the
country. “Medicare and Medicaid were created in 1965 under Lyndon Johnson’s presidency and run
by the US federal Department of Health and Human Services (HHS)” (Irvine, 2013, 2). Medicare is
medical program which serves the American over the age of 65. Medicaid program which was the joint
program of the federal and state government intended to serve the poor.

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Both provide the care for the disabled American. Doctors did not apparently notice, however, the
growth of Health Maintenance Organizations (HMOs). By the mid 1980s, HMOs began to dominate
both the organization of health care and reimbursement to physicians. In the 1990s, HMOs and their
varieties would revolutionize the organization of health care in the United States and provoke
controversy among recipients of healthcare as well as doctors, who came to find themselves in less
control of their practices. Fee-for-service began to fade as doctors increasingly found themselves
working for corporations that made profits from pre-paid healthcare by reducing the costs of healthcare,
carefully restricting services, and focusing on preventive healthcare.
So now health care field is being served by the government programs, non-profit organizations and
the private organization to provide the best in class medical solution. Twenty-first-century technology
promises to continue changing the nature, complexity, and costs of healthcare. As knowledge increases
about the genetic bases of disease, the healthcare system will make greater use of gene therapies,
developing ways to prevent genetically caused diseases. The impact of new technologies advances
innovations, as well as social movements and economic realities, will continue to shape twenty-first-
century medicine and health care.
Evaluate the importance of financing and technology in health care
Financing and the technology are very important for the advancement of the medical care in the
country. If one health care provider is not having sufficient funding then it cannot afford the technology
for the advancement of the medical care. On the other hand if medical care provider is not having
sufficient technological involvement and proper road map for the medical care then it will not get the
investor or funding.

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Health financing is important to ensure social protection in health (WHO, 2010). Without proper
financing the provider will not be able to reach to long term car or new technology equipment. The
other aspect of the health care system is technology. Technology means having the equipment to give
the patient a diagnosed and treatment efficiently. Technology also involved on keeping electronic
medical records of the patient. Technology helps the flow of information of all the medical history of the
patient so that effective medical care can be provided.
Primary complexities and integrated social dynamics associated with changing
demographics and emergent diseases
Globalization of the world has allow information to flow without boundaries and also has contribute
that people migrate from country to country. So these benefits have also challenges such as culture and
disease. Demographics changes means increasing the risk for providers to not be able to provide in the
short term services according to the disease or culture. For instance the population of the U.S. has all
kind of different culture and the population has changed in age, sex, and race. The health care provider
must study society so that appropriate healthcare can be offered. Among the example we can mention
the investment in nursery homes (baby boomers aging) and the preventive measurements to have an
effective care against virus that can be transmitted through population migration (Ebola).
Major fluctuating and daunting challenges in health care management that mortality trends
and an aging Baby Boom generation predicate
Between 2012 and 2050, the United States will experience considerable growth in its older
population.

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In 2050, the population aged 65 and over is projected to be 83.7 million almost double its estimated
population of 43.1 million in 2012. The baby boomers are largely responsible for this increase in the
older population, as they began turning 65 in 2011.3 By 2050, the surviving baby boomers will be over
the age of 85. The aging of the population will have wide-ranging implications for the country. By
“aging,” demographers often mean that the proportion of the population in the older ages increases. As
the United States ages over the next several decades, its older population will become more racially and
ethnically diverse. The projected growth of the older population in the United States will present
challenges to policy makers and programs, such as Social Security and Medicare. It will also affect
families, businesses, and health care providers. “The rapid aging of the U.S. population is being driven
by two realities: Americans are living longer lives than in previous decades and, given the post-World
War II baby boom, there are proportionately older adults than in previous generations (CDC, 2013, 9).
Conclusion
The U.S. is among the best medical care in the world. Technology has made a difference in health
care but not all people of United States can afford the health care system. Therefore, U.S. health care
system reflects its wider context having the non-profit group, profitable group and private sector. The
United States also have a demographic that is changing in age, sex and race. The amount of investment
and expenditures per capita is more than any other country (Rice, Roseau, Unruh, Barnes, 2013, xxi). In
conclusion the US health care has move to give more and better service to all Americans but the need
for a reform to give affordability is needed.

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References
Centers for Disease Control and Prevention. The State of Aging and Health in America (13). Atlanta,
GA:
Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013.
Dranove, D. (2000). The evolution of American health care. Princeton, NJ: Princeton University Press.
Irvine, B. (2013). Healthcare Systems: The USA (E. Clarke & E. Bidgood, Eds.).
Roberts, A. (2010). The Emergence of Disease in Early World-Systems. A Theoretical Model of World-
System and Pathogen Evolution.
Rice, T., Rosenau, P., Unruh, L., & Barnes, A. (2013). Health Systems in Transition. United States of
America Health System Review, 15(3).
Sulfaro, S. B. (2013). Triage Evolution: From Labeling to Streaming. Journal of Emergency
Nursing, 39(6), 667-668.
U.S. Census Bureau. International Data Base. Washington, DC.
2012 National Population Projections. Washington, DC. 2012b. , accessed January 23, 2013.
2012 Population Estimates. Washington, DC. 2012c. , accessed January23,2015.