Historical Transitioning and Growth of the US Health Care System

Many have come to believe the only way to provide health care for all Americans is to have a universal health care system. While many claim this will only increase costs, they do not have anything to compare a single payer healthcare system to other than the failed current system that costs more than the health care system of any other industrialized country in the world. The use of technology, despite its difficulty in adoption by health care organizations, can help to make single-payer health care effective, efficient and less expensive. It will also help to address the issues of changing demographics and health care management system.

Milestones in Health Care Industry

Beginning in the early days of the twentieth century, healthcare reform efforts have often called for universal healthcare coverage. Manchikanti, Helm, Benyamin, and Hirsch (2017) of Pain Physician explain that President Theodore Roosevelt, a progressive Republican, first suggested it. Then Franklin Roosevelt included a publicly funded healthcare program in the Social Security legislation that congress passed after eliminating the universal healthcare program. Since then Presidents Truman, Johnson, Nixon, Carter, Clinton and Obama have all advocated for universal healthcare in some form or other. President Obama came the closest to achieving it with the Affordable Care Act (ACA) in 2010. Portions of the ACA are still in effect although it has been largely gutted by the Trump administration (Manchikanti, Helm, Benyamin, & Hirsch, 2017, p. 107). However, many of the Democratic presidential contenders for 2020 are calling for universal healthcare policies.

Financing and Technology in Health Care

Financing is the main feature of most discussions about the U.S. health care system. Gooch (2019) of Becker’s Hospital Review found, “Cost reduction and management is the biggest priority for senior finance executives this year, followed by predicting and managing changing payment models” (Gooch, 2019). Other top concerns of a financial nature regarding the U.S. healthcare system include “cost management and efficiency, reporting and analysis to support decision-making, operational budgeting and forecasting, [and] profitability measurement across specific dimensions” (Gooch, 2019). Most Americans are aware of the fact that the United States pays more per person in healthcare costs than all other industrialized nations, and yet have worse outcomes.

Currently, health care in the United States is paid for with government programs such as Medicaid (expanded through the ACA) and Medicare, private health insurance and out-of-pocket for Americans who do not have health insurance. Schreck (2019) of Merck Manual notes that the high cost of healthcare in the United States is considered to be unsustainable by many. He says that health care costs reached $3.3 trillion dollars in 2016, and for decades, the cost of health care in the United States has increased more than the economy has grown. “According to the Organization for Economic Cooperation and Development (OECD), in 2016 the United States spent 17.9% of GDP on health care compared to the next highest countries, including Switzerland (12.4% of GDP) and Sweden, Germany, France, and Japan (each about 11%) (Schreck, 2019). Schreck notes that U.S. health care is also technologically advanced, which accounts for some of the costs.

Technology is another area of the healthcare industry that gets a great deal of focus. In recent years there has been a great many advancements in healthcare information technology (HIT). However, there have also been numerous problems. For instance, part of the ACA was a requirement that healthcare organizations switch from paper health records to electronic health records (EHRs). This was difficult for many healthcare professionals who were not as comfortable with computer systems. Other issues have come about because of new technology such as many user errors, system failures and other issues some of which have diminished the quality of patient care. There have also been numerous breaches affecting personal and private information through HIT systems. Yet, to be able to have universal health care and lower the costs, HIT is vital to the U.S. healthcare system. Changing technologies can also help to deal with the changing demographics in the United States, which also affects health care.

Changing Demographics

One trend in demographics is that the United States will soon be no longer have a majority of white people. Instead, blacks, Hispanics, and mixed race people will be the largest demographic in the population. The largest age group in the population will continue to be the Baby Boomers, who by 2020 will all be nearing 60 with many of them well into retirement and their senior years. This means that the highest costs in the health care industry will come from caring for this large older demographic who often have chronic diseases such as diabetes, congestive heart failure, and cancer. This could become expensive without innovative ways to deal with the issue such as using telemedicine. Also, young people have been encouraged to go into the health care field so that they will have a sustainable career and so that there will be enough health care workers to care for the aging population.

Challenges in Health Care Management

With people living longer, a rapidly increasing elderly population, and the push to universalize healthcare in the United States, healthcare management is facing many changes in the future. Figueroa, Harrison, Chauhan, and Meyer (2019) of BMC Health Services Research explain, “Key themes of achieving high quality care and sustainable service delivery were . . . often evidenced through health reforms. The influence of technological innovation in both its opportunities and complexities is evident” (Figueroa, Harrison, Chauhan, & Meyer, 2019, p. 8). Health care management as a healthcare industry sector will have to professionalize to meet the demands of healthcare in the future.


While there are many issues affecting the future of healthcare in the United States that cannot be controlled such as the changing demographics and aging population, there are solutions to the challenges that U.S. healthcare will face. Those solutions involve technology and professional healthcare managers, but they also involve policies. Unless healthcare is universalized, the cost will continue to rise and soon become unsustainable.


Figueroa, C. A., Harrison, R., Chauhan, A., & Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Services Research, 19(1), 1-11. Retrieved from https://bmchealthservres.biome...

Gooch, K. (2019, January 31). Cutting costs top 2019 priority for healthcare finance execs & other survey findings. Becker's Hospital Review. Retrieved from beckershospitalreview.com/finance/cutting-costs-top-2019-priority-for-healthcare-finance-execs-other-survey-findings.html

Manchikanti, L., Helm, S., Benyamin, R., & Hirsch, J. (2017). Evolution of US Health Care Reform. Pain Physician, 20(3), 107-110. Retrieved from https://www.ncbi.nlm.nih.gov/p...

Schreck, R. L. (2019). Oveview of Health Care Financing. Merck Manual. Retrieved from https://www.merckmanuals.com/h...