Improvements in Health and the Organization and Development of Health Care and Health Insurance Markets

This chapter describes the gains in health in the twentieth century and the development of the markets of health care and health insurance. It first provides an overview of the literature documenting the gains in public health that led to mortality transition in the United States in the late nineteenth and early twentieth centuries. Clean water, sanitation and electrification helped reduce mortality, as did food and milk inspection, the elimination of parasites such as malaria and hookworm, and food fortification. As the century progressed, advances in science and technology, combined with reforms in physician education and licensing led to improvements in medical care and health. These changes increased the cost of medical care and led to the development of health insurance markets.