Since the postindustrial period, health care in the US has evolved from a simple system of itinerant doctors with relatively little training to a complex system. Medical science, technology, and authority of the medical professionals undergird the complex system. This paper examines how health care in the US has evolved since the post-industrial period. It will also explore how the evolution of medical technology, graduate medical education, and professionalization of medical and nursing staff have influenced the delivery of care. Lastly, the paper investigates why the US has been unsuccessful in evolving the current health care system into a national health care system.
Evolution of the US Health Care Since Postindustrial Period
In the pre-industrial era (the 1700s to 1800s), home remedies and itinerant physicians characterized health care in the US. Medical practice was in disarray as it was viewed as a trade rather than a profession. Additionally, health care involved primitive medical practices such as emetics and purgatives. The health care system also missed institutional core whereby hospitals served social welfare and custodial function. Substandard medical education also characterized health care, whereby medical education was via apprenticeship and not universities (Magner & Kim, 2017). Since the postindustrial era, health care in the US has significantly evolved, whereby it has morphed from a simple system to a complex system.
The post-industrial period (the late 1800s to mid-1900s) saw American physicians gain professional sovereignty. The physicians started many of the early hospitals in the US, with financial support from philanthropists. Various factors including urbanization, advancements in science and technology, institutionalization, licensing, and educational reform fueled the transformation of health care in the post-industrial period. Since the postindustrial era, health care in the US has also seen the introduction of public health, health insurance, the birth of patient safety and quality improvement, patient-centered care, et cetera. Today, three main features define the US healthcare system: (1) corporatization, (2) professionalism, and (3) reliance on science and technology (Magner & Kim, 2017). Health care has become a domain of large corporations, which provide professionalized care and rely on science and technology to provide the best care to patients.
How has the evolution of medical technology, graduate medical education, and the professionalization of medical and nursing staff affected the delivery of care?
The evolution of medical technology, graduate medical education, and professionalization of medical and nursing staff have tremendously affected the delivery of health care. Besides directly improving the delivery of health care, advancements in technology have influenced other factors such as the growth of institutions, medical education, and urban development allowing health care in the US to evolve to a professional entity (Salmon, 2020). According to Salmon, health care in the US did not emerge as a professional entity until the beginning of the 20th century. Notably, technological advancements characterizing the 20th century fueled the evolution. Some of the groundbreaking medical discoveries of the 20th century include aseptic techniques, sterilization techniques, X-ray imaging, et cetera. Thus, technology made advanced treatment available.
Before the postindustrial period, physicians received their education via apprenticeship. The post-industrial era saw physicians receive graduate education, which led to the professionalization of health care delivery. The evolution improved the standard of care by requiring that medical practices require science-based education, skills, and expertise. This allowed for the institutionalization of the hospital whereby it became the institution core of health care delivery (Salmon, 2020). Thus, graduate education improved physicians’ competence leading to improved patient outcomes.
The professionalization of medical and nursing staff influenced the delivery of care by facilitating the legitimacy and acceptance of professional care. Consequently, this improved the demand for professional services. The professionalization also affected medical education by information reforms such as laboratory instruction and science addition to the curriculum. Moreover, the professionalization facilitated organized medicine through licensure (Salmon, 2020). Therefore, professionalization enhanced the desirability of medical treatments.
Why the US has Been Unsuccessful in Evolving the Current Health Care System into a National Health Care System
Since the 20th century, the US has been striving to evolve its health care system into a national health care system. However, it has not succeeded due to the increased rise of private insurance since the mid-1990s. The private insurance coverages have proven costly for low-income Americans. Efforts to implement national health insurance have faced challenges ranging from public resistance to problems with receiving services. Polls conducted in the 1980s pointed out significant fear of loss of coverage and problems with receiving services as the main reasons why the US has been unsuccessful in evolving its current health care system to a national health care system. The main impediment to the evolution of the US health care system into a national health care system in the 20th and 21st century is the ever-rising cost of care which makes medical care unaffordable to all Americans (Dickman, Himmelstein, & Woolhandler, 2017). Thus, the federal government needs to devise ways to lower the cost of care and cultivate public trust to make the national healthcare system successful.