Examines the evolution of health policies in the United States and their possible impact on public health. Reviews four periods of U.S. history (1776-1861, 1861-1931, 1931-1981, and 1981 to the present) with special emphasis on the significant increase in the federal role and the current attempts to reduce the federal role. (SK)

This integrated review of national trends affecting the health care system is primarily intended to facilitate the planning efforts of health care providers and consumers, Government agencies, medical school administrators, health insurers, and companies in the medical market. It may also be useful to educators as a textbook to give their students…