How Did We Get Here?

Abstract

Chapter 3 traces the development of health systems in middle- and high-income countries since the Second World War and notes the trends that have led to the development of contemporary health systems. The authors summarize the major trends in healthcare—the benefits, costs, public attitudes and beliefs, and consumer responses to medical care. Health has improved, more citizens are able to access healthcare, standards of care have risen, and the advance of scientific medicine is stunning. The authors reflect on the forces that have led to the current successes and raise upcoming challenges in improving health and healthcare. Foremost among these are concerns about rising costs and value-for-money of health systems, which pose sustainability challenges to health systems in all countries.