title: A perspective of health care in the past--insights and challenges for a health care system in the new millennium.
abstract: Health care has been in a state of perpetual change over the past decade. The swirl of activity includes: mergers and acquisitions, downsizing, shortages of nurses, unionizing of physicians, health care cost increases, escalation of pharmaceutical prices, consumerism, managed care, high-tech-low-touch services, the Balanced Budget Act of 1997, declining reimbursement, alternative medicine, Web-based shopping for health care, medicine moving into cyberspace, nanotechnology, advances in digital technology, and a diagnostic boon in high-tech imaging. What this demonstrates is that the broad-based landscape of changes affecting health care in the United States is extensive and incredibly complex. This article provides a perspective of health care in the past, discusses issues and concerns impacting health care today, and articulates some of the challenges and opportunities that are and will continue to shape the future of our health care system in the new millennium.
authors.forename: J S
authors.initials: JS
authors.lastname: Cicatiello
mesh_terms: D020811:Biomedical Technology / Q000639:trends; D003695:Delivery of Health Care / Q000639:trends*; D005544:Forecasting; D006285:Health Planning; D006280:Health Workforce; D006801:Humans; D007857:Leadership; D011157:Population Dynamics; D014481:United States