An Historical Perspective on Home Care Policy

home care and the character of its public and private support have changed significantly over time, the history of home care in the United States suggests continuity as well. Barely a century ago virtually all medical care was provided in the home, first by family members and other "natural" caregivers, and later by physicians making house calls. With the emergence of modern scientific medicine and the hospitals in which it is practiced, the importance of home care waned as people sought care in hospitals and physicians' offices. The rise in chronic illness attracted attention to the idea of caring for persons in their homes, and models of organized home care were developed in a few cities. Not until the marketing of private health insurance after World War II, and especially the passage of Medicare and Medicaid in 1965, was home care again to be considered a part of mainstream health