It is critical to understand where and how health care started and its journey if we intend to ensure access to health care for everyone. It’s interesting that physicians at one point in history were not held in high esteem as compared to today where people proudly announce that “they are a doctor.”

One of the leading forces in the changes in health care is that it is influenced by our values and beliefs. In the bible, people who were ill with diseases like leprosy was often separated from others and left to suffer from their diseased body. Healing was considered to be a miracle, and during that phase of our history, it was. Some of the first instances of holistic healing came from the bible. Jesus often healed the whole person, not just their disease, but their soul through teaching. In Luke 9:2(KJV) it says “And he sent them to preach the kingdom of God, and to heal the sick.” To me this supports treating the whole person is the answer to sound health care. We have to have an understanding of the history of medicine if we want to understand the tenets of health care. History helped define ways of classifying conditions as well as describing them. Terms like acute and chronic are the foundational language for those in health care roles.

Another factor to consider is how the determinants of health (Sig & Sing 2019), suggests that we cannot put our trust just in treating the physical, but look at other issues like mental health, obesity as part of disease prevention and treatment. The progress of medical care delivery has an impact on future strategies; we can see a time in medical history where hospitals were not a success, where medical care was only for the wealthy or those who could afford it. Social changes had a significant impact on medical history. History of health care can be divided into three sub-segments, Preindustrial, Postindustrial and the Corporate Era. In the Preindustrial health care was not organized, no formal training and it was considered a trade. In the Postindustrial is where medicine starts to develop into the recognized profession it is. During this period, medical education became more formalized, different types of medical institutions were formed and need for organized medical insurance. Discoveries like penicillin, radiology, hand washing, and vaccines gave health care credibility. Develop of professional organizations like the American Medical Association forced to change through policy development and created guidelines for its members becoming an entity for all medical professionals. In the Corporate era, the focus was on how to make health care accessible through new technology and organized health care systems.

Several factors have helped shaped U. S. health care. One that sticks out to me is the development of Medicare and Medicaid. They were needed as there was very little access for the elderly and the poor. Many believe this was an attempted at a government based health care as fail-safe that over time has become a guide on how health care is billed and delivered. (Altman et al. 2015) Corporate based systems is a factor that should be addressed as an indicator of our health system changed. Manage Care Organizations and integrated delivery systems have taken over health care delivery and forced changes in how physicians practice and partnerships are form.

Information management has taken medicine and patient/physician relationships to places it could not go before. Telemedicine allows patient and physicians to connect from miles away. The electronic medical record is a source for documentation of care and enables the patient to have immediate access to their health records. Globalization, allows patients to go to other places outside of their country for care. These cities where the advancements in practice for disease management that would enable open access to new types of treatment, as well as relationships that shared research, can absolve some diseases. But the most significant factor is health care reform, perhaps tag line for politicians, but recognized that health care is not available to every citizen and health reform is the prequel for real health care for all. With rising health care cost, it was inevitable that people would realize we need a change. In walks, the first real attempt, not talk, the Affordable Care Act. While the subject of much scrutiny, finally someone did something. While there is disparity about its viability, the average citizen now can access some health care at a minimum preventative. Blumenthal et al. (2015) research “…. show that the newly insured are pleased with their coverage”.

Altman D, Frist WH. Medicare and Medicaid at 50 Years: Perspectives of Beneficiaries, Health Care Professionals and Institutions, and Policy Makers. JAMA. 2015;314(4):384–395. doi:10.1001/jama.2015.7811

Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years. The New England Journal of Medicine, 372(25), 2451-2458. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1056/NEJM…

Shi, L., & Singh, D. A. (2019). Essentials of the U. S. health care system. Burlington, MA: Jones & Bartlett Learning