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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 22 of 40)

The Vietnam War and Its Aftermath

Competition

During the decades after the Vietnam War (1954-1975), the economic supremacy of U.S. business interests declined due to increased competition from Japan and Germany.

The Nixon and Reagan Administrations attacked government responsibility for the population's health.

The "Crisis in Health Care"

Snapshot of table 3: Per Capita Expenditures on Health Care 1970-1998. This image will open in a new window. Close the window to return to this page.The "crisis in health care" grabbed headlines as medical care expenditures rose from $69 billion in 1970 to $230 billion in 1980. Health services research documented excessive surgery and hospitalization (Huber, 1999). The table to the right shows the per capita expenditures for health care between 1970 and 1998.

Note the increase in expenditures from $357 to $4,095 per person per year between 1970 and 1997.

Health Planning Movement

A movement developed for rational planning in medical care to reduce duplication of facilities and technology; promote the use of physician assistants and nurse practitioners in order to improve access; increase peer review to decrease over-utilization of services; and support a national health insurance plan to ease inequities in access to health services.

More Social Activism

Social activists demanded health as a human right.

Social activists demanded health as a human right. At the same time, the feminist movement questioned medical authority over personal health; generated interest in self-care and holistic medicine; and asked for the de-medicalization of childbirth and death.

View Key Projects and Milestones in Health Services Research.

Discussion Questions

  1. Did the feminist movement and its demands change health care? How can you tell? How has this movement affected how you get health care? How research is done?
  2. Has the use of physician assistants and nurse practitioners reduced the cost of medical care? Has their use increased quality? How do health services researchers measure this?
  3. Excessive surgery and hospitalization is said to have led to a "crisis in health care." How did surgery and hospitalizations get so out of control? Explain.
  4. Is government responsible for the public's health? Give reasons for and against the idea.
  5. Health care expenditures increased from $357 to $4,095 per person per year between 1970 and 1997. Have health care expenditures increased or decreased since 1997? What is driving today's costs? Is everyone insured? If many are uninsured, does this lack of insurance drive up costs for health insurance for those who wish to purchase insurance?
  6. Compare health care expenditures in the United States with other countries. Are expenditures higher or lower in the United States? Why does the United States spend so much more money on providing health care than other countries?
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