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Evolution of the United States Health Care System

The United States has experienced numerous changes over its long history, which has resulted in an essential impact on all spheres of life, including medicine. Before the Civil War, the American health care system was almost absent, and thousands of people suffered from different health issues. However, the gradual social, industrial, and scientific development of the nation brought particular improvements to American medicine. That process has resulted in the fact that there is a significant difference between the US health care system during various historical epochs. Thus, the principal purpose of this paper is to describe how the US health care system has evolved since the early 1900s and what two unique characteristic features this evolution has brought.

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Difference Between the 1900s and the Modern Era

As has been mentioned above, the Civil War became a push for the American health care industry to emerge. However, its original features were far from ideal, and the absence of universal medical coverage was among them. Manchikanti et al. (2017) stipulate that Theodore Roosevelt was one of the first politicians to take efforts to create comprehensive coverage. Franklin D. Roosevelt and Harry S. Truman also tried to create this phenomenon, but multiple private insurers opposed their actions. Significant success was achieved by President Lyndon B. Johnson, who signed into law Medicare and Medicaid in 1965 (Manchikanti et al., 2017). It was an initial step to improve the health care industry, while Obama’s term in office contributed to more significant enhancements. ObamaCare and the Affordable Care Act stipulated that insurance companies could not deny coverage to individuals with pre-existing conditions and that people who earned less than 400% of the poverty level qualified for subsidies (Manchikanti et al., 2017). This information demonstrates that it took 100 years for America to make its health care industry more accessible to the population.

Unique Characteristics of US Health Care

This section will explain what characteristic features make the American health care industry unique. On the one hand, it refers to the fact that the US has a predominantly private health care system that receives a substantial amount of government subsidies (Shi & Singh, 2018). The explanation of this state of affairs lies in the fact that many private insurance companies oppose universal medical coverage because it will result in financial losses for them. On the other hand, the private nature of the industry means that medical services are not accessible to everyone. Even though various programs and acts emerge to solve this issue, there are still many citizens who cannot afford themselves medical service, and Native Americans are among them (Kamimura et al., 2018). It is so because a patient may not obtain treatment if they do not have health insurance. These unique features stipulate that the US policymakers should take specific efforts to make their health care industry better and more accessible for the population.


The US health care system was not the same over its long period of existence. When it emerged after the Civil War, various politicians took their efforts to make the industry universal to the nation. One of the most significant improvements occurred in the 1960s when Medicare and Medicaid appeared. In addition to that, Obama introduced the Affordable Care Act and ObamaCare and made medical services better in the early 21st century. However, these efforts did not cancel the existing challenges that could also be described as unique features of US health care. They include the predominance of private health providers and people’s limited access to medical service. These characteristic features are not present in most developed countries because their governments usually control medical systems. This fact means that the US policymakers should do their best to eliminate the existing issues.


Kamimura, A., Panahi, S., & Weaver, S. (2018). Global healthcare issues and proposed solutions. Diversity and Equality in Health and Care, 15(2), 93-94.

Manchikanti, L., Li, S. H., Benyamin, R. M., & Hirsch, J. A. (2017). Evolution of the US health care reform. Pain Physician, 20(3), 107-110.

Shi, L., & Singh, D. A. (2018). Essentials of the U.S. health care system (5th ed.). Jones & Barnett Learning.

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