Introduction:
In order to understand current health delivery services changes and formulate predictions, one must thoroughly comprehend the three developmental eras of the health care system. The evolution of our current health care system began in 1850, and has metamorphosed in three time periods, 1850 to 1900, 1900 to World War II (WW II), and WW II to 2009. Significant distinct and overlapping trends in disease prevalence, availability of health care resources, social organizations, and the public's knowledge and perception of health and illness and technology.
Disease Prevalence
1850 - 1900: Epidemics of Acute Infections
These public health disasters were related to the congested and unsanitary food supply, sewage disposal,
Research and development grants produces immediate war related benefits in trauma, transportation, pharmaceuticals, and medical education. Hospitals grow in size, number, and reputation as leading centers of medical care and research. Physician and nursing education programs and practice centered on the hospital and the hospitalized patient. The era of specialization is in full gear with 80% of physicians claiming to be specialists. (Saltman, 2002, 45-49)
Social Organizations
1850 - 1900: Self-sufficiency
The lack of public services and the paucity of hospitals and medical care therein necessitated a strong reliance on self-sufficiency. The predominant ethic dictated pride in self-sufficiency and if dependency prevailed, then gratitude for the various charities and services was indicated. (Ranade , 1998)17-19)

1900 - World War II: A New Deal
The ingrained philosophy of the first stage persisted until the Great Depression, at which time reality meant dependency for the majority of people. This was the beginning of a national health effort to provide medical services to those previously denied access to medical care. Local city and county hospitals flourish as government attempts to improve the health status of the people. The health insurance industry is born. (Ranade , 1998)17-19)
World War II - 2009: Health Care as a Right
Tremendous government involvement in providing and assuring access to medical