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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Introduction to Health Services Research : A Self-Study Course

Module 2: Brief History of Health Services Research (Page 15 of 40)

Political, Economic and Health Care Expansion in the United States

Political Expansion Post WWII

A period of U.S. political expansion followed World War II with a corresponding improvement in the economy.

The health care arena was marked with advances in technology and medical research, a shortage of physicians, and an increase in the number of hospitals, demand for health services, and the cost of these services (MLA, 1995).

National Institutes of Health

The National Institutes of Health (NIH) expanded during this period as did the voluntary health agencies, like the American Cancer Society (http://www.cancer.org/docroot/home/index.asp).

HMOs Develop in New York and California

For middle class and wealthy families, private health insurance developed as the ticket to health care services. Many pre-paid health plans developed, including the Health Insurance Plan of Greater New York (HIP) in 1947 and the Permanente Foundation in California (1945).

Health Care Coverage a Problem

However, for working class and poorer families, the cost of coverage blocked adequate access. Unions included demands for health benefits in their contract negotiations (Starr, 1982).

View Key Projects and Milestones in Health Services Research.

Discussion Questions

  1. Why did the NIH and voluntary health agencies, like the American Cancer Society expand during this time period? Discuss.
  2. Unions began including demands for health benefits in their contract negotiations in the late 1940s. Did this affect the health of that population? How do we know?
  3. Does everyone who wants or needs health care have access to it today? Has anything changed since the late 1940s? Please explain what has or has not changed and the implications to today's society.
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