The Health Services Establishment is Becoming an Independent Variable: A Life of its Own

Abstract

Until recently, the health services establishment was assumed to be a product of the social, economic, and scientific medical developments since the turn of the century. It consumed a modest and relatively constant percentage of the gross national product (GNP). It was a dependent variable. Since the 1950s, sparked by labor-management negotiations for health insurance coverage and Medicare and Medicaid, plus the dazzling high medical technology such as organ transplants, the health services establishment took off. It grew faster than the GNP and the Consumer Price Index. It competes with other priorties for goods and services. It became an independent variable having an impact on society. This essay attempts to demonstrate conceptually and empirically how and why this transformation took place.