The intent in the following pages is to provide a brief overview and analysis of the U.S. health care system, with a particular focus on unresolved problems within the system and current trends. This system, unlike the former Soviet system, is a polyglot arrangement of diverse institutions and providers that is oriented to care after a problem occurs, rather than prevention.
The U.S. health care system followed the basic Western model of development, with a reliance on individual providers for most health care. Nurses were a development of the 19th century, along with hospitals, while the concept of insurance coverage for health care was a development of the 20th century. For the most part, the emphasis in this analysis is on the development of health care during the 20th century in the United States.
According to Andrews (1995), physicians were the supreme economic power in the health field during the early part of the 20th century. Individuals did not think of hospitals as a regular or standard part of their health care; most women, for example, had their children at home attended only by physicians, midwives, or nurses. Hospitals were repositories for the dying and the incurable. Most people did not want to enter them.
However, there were some beginnings of the powerful insurance/hospital coalition at that time. The major railroads actually provided medical coverage for their workers beginning in the 19th century. Another 500,000 individuals had coverage for nonoccupational ailments. However, 97 percent of the population had no source of assistance for their medical needs by the year 1930.
It was in 1930 that the Blue Cross Hospital insurance system was developed, starting with Baylor University Hospital in Dallas, Texas. Their initial plan was for public school teachers, in which a fee of six dollars per year provided the teacher with up to three weeks of care in the hospital if ordered there by a physician. ...