Institute: ONC | Component: 1 | Unit: 1 | Lecture: a | Slide: 20
Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Introduction and History of Modern Health Care in the U.S.
Lecture:Components of Health Care Delivery and Finance
Slide content:Brief History of Health Care Finance - 1 Mid-20th century Introduction of health insurance Growth of open-ended spending Late 20th century Efforts to control costs, culminating in managed care Empowerment of patients/consumers and growth of Internet 20
Slide notes:Health care finance has evolved over the last half-century. Starting in the middle of the 20th century was when many medical technologies first came to the fore, and it became clear that people could not just pay for the services that they used. So in the middle of the 20th century, health insurance was introduced, with the notion that everyone paid into a pool, and those who needed it, used it. This was the beginning of what some call open-ended spending with the fee-for-service model, in which insurance would just pay the bills, with little restriction based on quality-ensuring criteria such as the cost-effectiveness or the evidence basis of treatments being offered. Towards the latter part of the 20th century, this system started to become increasingly expensive, with no ability to control costs. This led to efforts that aimed to control costs, and to what we now call managed care, where constraints are put on spending. At the same time, the late 20th century saw the empowerment of patients and consumers to play a more active role in health care, aided in part by the growth of the Internet, which made information more widely available. Health IT Workforce Curriculum Version 4.0 20