History of Health Policy: Explaining Complexity through Time

Abstract

History can be a powerful tool for teaching health policy. Particularly in the United States, with its complex system of public and private payers and providers of health services, understanding the historical origins of policies, programs, and institutions makes the system’s contours legible. Historical analysis may also help health care providers to navigate this system and to advocate for changes within it. The US Medical Licensing Examination (USMLE) and the Accreditation Council on Graduate Medical Education (ACGME) have curricular standards for students to understand specific aspects of health policy and “systems-based practice,” and historians working within the curricular structures of US medical education may find reference to these standards useful in explaining and justifying their role in preparing medical students and resident physicians for practice. This paper explores some examples of how to use history to teach health professions students about the historical development of the US health care system, the constraints that defined how it came to be, and possibilities for reform.