ABSTRACT
Municipal water purification is a system. Criminal justice is a system. Each comprises a set of planned parts and their interrelationships, which is how people generally think of a system. By the end of World War II, Blue Cross had 19 million hospitalization subscribers, a number that quadrupled by 1950. Fifty-four million workers also had surgery coverage by then. The revolution in health care did not originate, nor does it receive its primary continuing impetus, as a spontaneous business strategy. Spiraling health care expenditures by private employers and governments, federal and state, did the job. Capitation has more recently been extended in the private sector from the subscribers to the professionals who provide the actual services. Medicare, Medicaid, the Indian Health Service, veterans hospitals, and health services in the active military are all areas of financing or direct provision of medical services by government.
