How did employer-based health insurance emerge in the U.S.?
During World War II, wage controls led employers to offer health benefits; the IRS made these tax-exempt, cementing employer-sponsored coverage.
What was the significance of the 1965 Medicare and Medicaid legislation?
It institutionalized government responsibility for the elderly and low-income, creating public insurance pillars within a predominantly private system.
What were key reforms introduced by the Affordable Care Act (ACA) of 2010?
Expanded Medicaid, created health insurance exchanges, introduced individual and employer mandates, and prohibited pre-existing-condition exclusions.
How has technology influenced U.S. health-care evolution?
Advanced diagnostics, procedures, and pharmaceuticals improved outcomes but drove costs and specialization, shaping provider organization.
What major trends characterize contemporary U.S. health care?
Aging population, chronic-disease burden, emphasis on value-based care, integration, telehealth, and workforce shortages.
Name and briefly describe the four main health-care models.
Beveridge (tax-funded, public delivery); Bismarck (payroll insurance, private providers); National Health Insurance (single public payer, private delivery); Out-of-Pocket (direct payment).
Which model best describes the Veterans Health Administration?
Beveridge—government finances and provides care through publicly owned facilities.
Which model resembles employer-based insurance in the U.S.?
Bismarck—funded by payroll contributions and delivered by private providers.
How does the U.S. combine multiple models?
VA = Beveridge; Employer = Bismarck; Medicare = National Health Insurance; Uninsured = Out-of-Pocket.
Key contrasts between U.S. and peer countries.
U.S. spending ≈ 17 % GDP (vs ~9–12 %).
No universal coverage.
Higher administrative cost.
Lower life expectancy, higher infant/maternal mortality.
