Vocabulary Flashcards: History and Structure of U.S. Health Care (Video Notes)

A set of vocabulary-style flashcards covering key terms, institutions, reforms, and eras described in the lecture notes on the history and structure of U.S. health care.

Affordable Care Act (ACA)

U.S. health reform enacted in 2010 aimed at expanding health insurance coverage; sparked extensive litigation; upheld the individual mandate as a tax in 2012; mandate later repealed in 2019; expanded Medicaid in many states and faced ongoing debates.

Preindustrial era (Medical Services in Preindustrial America)

Period from colonial times to the late 1800s when medical practice was primitive, with few hospitals, no health insurance, and a free market approach to care.

Almshouse (poorhouse)

Government-run institutions for the destitute that served as precursors to hospitals and nursing homes; often housed the elderly, homeless, and disabled.

Asylum (lunatic asylum)

State-run institutions for patients with untreatable, chronic mental illness; early inpatient psychiatric facilities.

Pesthouse

Local government facility established to isolate people with contagious diseases to contain outbreaks.

Dispensary

Outpatient clinics providing free or charity care to the urban poor and dispensed drugs; staff often early in medical careers.

Apprenticeship-based medical training

Early medical education mostly through apprenticeship; few formal scientifically grounded programs; low standards and limited formal degrees.

American Medical Association (AMA)

Founded in 1847; organized medicine movement; controlled medical education and licensing; opposed national health insurance; promoted private practice.

Flexner Report (1910)

Carnegie Foundation review that standardized medical education, leading to closing of substandard schools and raising professional standards.

Johns Hopkins model (1893)

Graduated medical education with university affiliation and resident training; established the model of modern medical education.

Blue Cross

Hospital insurance plan originated in 1929 (Baylor teachers); nonprofit; later expanded and merged into a nationwide network.

Blue Shield

Plan started in 1939 to cover physicians’ fees; complemented hospital-based Blue Cross; later merged with Blue Cross plans.

Kerr-Mills Act (1960)

Federal grants to states to extend health services to low-income elderly; precursor to broader public programs; ultimately less effective in implementation.

Medicare

Part of the Social Security Act (1965) providing health insurance for the elderly and certain disabled individuals; Parts A (hospital), B (physician), later C (managed care) and D (prescription drugs).

Medicaid

Means-tested, state-administered health program (Title 19, 1965) financed with federal matching funds; varies by state in eligibility and benefits.

Employment-based health insurance

Health coverage tied to employment, accelerated by WWII wage controls, 1948 bargaining rights, and 1954 tax exclusion for employer-provided coverage.

Postindustrial era

Historical period marked by urbanization, rise of a professional medical class, organized medicine, hospital centralization, and growth of private and public insurance.

Corporate era

Recent period characterized by growth of managed care, large hospital/health systems, consolidation, and physicians’ partial or full employment by large corporations.

Telemedicine

Delivery of medical care at a distance through telecommunications, enabling real-time exams and procedures like telesurgery.

E-health

Health information and services delivered over the Internet, expanding access to medical knowledge and online consultations.

Globalization in health care

Cross-border health activities including telemedicine, medical tourism, foreign direct investment, and physician migration.

Medical tourism

Patients traveling to other countries for medical procedures at lower cost or with access to advanced facilities.

Olmstead v. L.C. (1999)

Supreme Court decision directing states to provide community-based services for people with mental illness, promoting deinstitutionalization.

Repeal of the individual mandate (2019)

Tax Cuts and Jobs Act partially repealed the ACA’s individual mandate starting January 1, 2019, influencing later legal challenges to the ACA.

Era of reform (ACA era)

Phase beginning with the ACA aiming to reform health policy and expand coverage, though with ongoing political and legal debates and flux in implementation.