The Western journal of medicine
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During the 20th century, medicine has confronted a series of problems threatening health care delivery in the United States. Historically, crises developed related first to quality of care, later to access and finally to the current issue of cost. ⋯ Additionally, economy-wide inflation, advanced medical technologies, an aging population, the growth of health care facilities, expansion of third-party payment systems including Medicare and Medicaid and rising incomes per capita have occurred. Programs now exist, and others are being planned, through which physicians, individually in private practice and collectively through organized medicine, may confront this major challenge now threatening the very foundations of health care delivery in the United States.