ABSTRACT
Prior to the Affordable Care Act, almost all knowledgeable analysts agreed that US health-care system, at its best, was an innovative system that provides effective, high-technology care that is among the world’s finest. At the same time, the health care system was generally recognized as being extremely expensive, inefficient and wasteful, grounded in profit making, and leaving tens of millions of Americans lacking the resources to obtain basic health care. In the first decade of the 2000s, a major research effort was undertaken to systematically evaluate the overall quality of the US health care system. The foundation of today’s US health care system largely originated in a series of events that occurred between 1850 and the early 1900s. Advances in the scientific understanding of disease and illness and in effectiveness of medical procedures, the expansion and elaboration of hospitals, and the growth of commercial health insurance companies contributed to an increasingly complex system of health care delivery and financing.
