Historical Overview Flashcards
What are the 3 phases of evolution of health/medical services?
Preindustrial
Post industrial
Corporate Era
What were the medical services like in preindustrial america?
Primitive medical procedures.
limited surgery/Dx
In preindustrial america, who paid for services? what was a problem in this time?
the consumer
too much demand and lack of affordability
Postindustrial america brought growth of
medical/professional sovereignty..
licensing/more organization
What was the initial role of private health insurance?
income protection during sickness and temporary disability
What happened to pts and hospitals after Great depression?
patients: loss of income
Hospitals: forced to charge fee instead of donations
Federal aid to the states for public health and welfare assistance, maternal and child health, children with disability services
Social security act 1935
alliance of insurers and providers:
examples
who had control?
provider-insurer pact
Blue cross
Blue shield
providers
in 1954, who determined that employer contributions to health insurance was non-taxable?
IRS
in 1948, who ruled that employee benefits, including health insurance, was a legitimate part of union bargaining
Supreme court
What came to rise in 1945? and who was it primarily available to?
Private health insurance
middle-class workers.
cost of private insurance in 1950 vs 1965
1 billion
8.7 billion
What did others rely on when they couldn’t get private health insurance?
“charity” care
a cost shift to private payers.
Partial national health insurance for elderly and poor?
medicare
medicaid
When did Gov become involved in health insurance?
1965
in the 1970s the government had increasing regulation to monitor care.. for what?
to attempt to reduce cost because business concern was cost of health care
in 1972 blue cross had legal separation from
AHA
the 80s brought the beginning of which cost-control measures?
why?
Medicare prospective payment systems
selective contracting
managed care
cost of employer sponsored health plans increased.
Because of fragmentation of hospitals in 90s, what was the government action in 1997?
Balanced budget act
What aided healthcare reform in 2010
?
patient protection and affordable care act
Why was ACA installed?
increase in cost as well as increased amount of uninsured ppl. offered payment reforms, and alternatives to fee-for-service.
