US Health Care System History

What was healthcare like before 1875?

Not effective, relied on the pure market system and charity hospitals

Why were health outcomes so uncertain pre-1875?

There was disagreements about technology, variation in provider ability, and many competing practitioner types

What was medical school like pre 1875?

Licensure was rejected, and entry into schools was easy because they were for profit

What happened in between 1875-1900?

Real advances in healthcare arose from the civil war, and methods from all provider types began to converge on effective therapies 

What started during 1875-1900 in medical schools?

A movement toward medical licensure, and states were beginning to require education and licensing for physicians 

What is all licensing always?

It is always rent seeking, seeking above profits

What happened to schools and students during 1875-1900?

An increase in both students and schools

Why did medical professional organizations began to become frustrated in 1875-1900?

Diploma mills still existed, and the income for licensed professionals was not rising substantially

What did AMA create in 1904?

Council on Medical Education, CME, to develop minimum standards for medical schools and grade them

• reports of schools were not made public

What occurred to medical schools during 1900-1915?

CME grading caused many schools to voluntarily raise standards or close

What did Abraham Flexner do in 1910?

He produced Bulletin #4, it graded medical schools based on AMA standards and teaching resources 

What occured by 1912?

Several states licensing boards formed the federation of state medical boards, which accepted the AMA ratings as authoritative

What happened when state licensing boards made AMA ratings authoritative?

The number of medical schools drops and so did the number of graduates

What happens as a result of many schools closing during 1900-1915?

Access to medical care and medical training falls, with fewer women and minority graduates

What happened to the medical organizations after many schools closed?

They gained a lot of power, with both the quality of medical care and prices rising significantly 

What happened when prices rose in 1900-1915?

Healthcare became too expensive, so unions/fraternal/firms organizations provided health/disability benefits to members

Why did insurance markets arise?

Severe illness is random and rare

Future healthcare needs are uncertain

Healthcare services are expensive

What happened when wages were frozen during WII?

Since companies could not offer more money to workers to fix the labor shortage, they added healthcare benefits instead

What happened post WII?

Changes in tax allowed firms to provide health insurance as a cheap benefit