Soon after, the American Medical Association began producing a standardized curriculum for medicine across America by establishing the council on Medical Education in 1904. Majority of these institutions were owned and operated by private physicians with no connection to a University. In the act to standardized health care education Abraham Flexner was appointed by the Carnegia foundation. (Zinner 2009) Flexner had influential impact on improving the medical education standards across the country by his evaluations conducted in the …show more content…
In 1929 group of teachers located in Dallas contracted with the local hospital to establish monthly premiums exchanged for medical services. (Zinner 2009). These principles were later built upon by Sidney Garfield who laid the platform for insurance based care leading to an establishment known as Kaiser Permanente in Oakland, California. Simultaneously one of the biggest medical insurance plan was built, known as Blue Cross. The fee for service and HMO plans that we know of today started to take form. The HMO’s started to take power ran by big for profit corporations that made money by focusing on lowering health care cost and reducing medical services. Alongside came the government state wide plans known as Medicaid fee for service plans for the elderly. The fee for service started to die out leading to capitation a system that paid doctors a set fee from which they had to care for all of their patients, the sick and the well, known as managed care plans. (Fillmore, 2009) Throughout evolution U.S. remains the highest per capita in the world, ranking lower amongst other countries in access, quality, efficiency, and