Health Care Marketplace in the United States

As the twenty-first century begins, the United States healthcare system has endured a turbulent, unremitting change cycle for over two decades. It is truly a system in motion, configuring and reconfiguring itself on a regular basis. The Self-Regulatory Era in health care lasted from the late nineteenth century until the late 1930s and was a time when healthcare evolved naturally in the marketplace. That era was overturned by providers in the late 1930s, when they organized to create the Fee-for-Service/Third-Party Payer system, which gave the era its name. The present-day Cost-Containment Era has resulted from the revolts of purchasers against increasingly higher healthcare costs. Today the healthcare system has been restructured around free market principles: there has been a dramatic shift in the way healthcare services are organized, delivered, and financed. Healthcare is now treated like other commodities. Behavioral health care has felt these changes keenly, and practicing psychologists are in a very different health care world than existed through the mid-1980s. Keywords: behavioral; care; competition; health; healthcare; managed; marketplace