The first Almshouse was established. Almshouses are known to be the ancestors of Hospitals because they provided care to the sick and poor.(Shi,&Singh,2019,p.228)
Pro Almshouses provided care to indigent people whose families could not provide care.(Shi,&Singh,2019,p.228)
Con- Conditions in Almhouses were unsanitary. (Shi,&Singh,2019,p.228)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Medicine was considered more of a trade than a profession.
Pro- Midwives, clergymen, and naturalists had a lot of autonomy and could practice medicine and healing techniques.(Shi,&Singh,2019,p.226)
Con- They did not have anyone to govern them and often cause harm to patients without having to deal with consequences. (Shi,&Singh,2019,p.226)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Pro- This initiates the establishment of an organized governing body to oversee the practice of medicine.(Shi,&Singh,2019,p.226)
Con-Standards were minimum and because of lack of training medicine was considered weak and unorganized. (Shi,&Singh,2019,p.226)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

State care Acts were passed centralizing the financial responsibility of the mentally ill to every state.(Shi,&Singh,2019,p.227)
Pro Families of the mentally ill patients had fewer burdens.(Shi,&Singh,2019,p.228)
Cons- The quantities of patients in mental asylums were high, therefore the quality of care tremendously suffered.(Shi,&Singh,2019,p.228)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Pro After the civil war the establishment of physicians as a profession emerged along with their increase in income.(Shi,&Singh,2019,p.234)
Con- Physicians were still not easily accessible to all patients.(Shi,&Singh,2019,p.234)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Pro-The development of telephones, automobiles, and roads made healthcare and physicians more accessible. (Shi,&Singh,2019,p.234)
Con- This trend causes physicians to move away from house calls, and some people who did not relocate to urban areas still lack the ability to travels long distances. Therefore healthcare was not accessible to them.(Shi,&Singh,2019,p.234)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Federal funding was made available under the National Mental Health Act for Psychtriact Education and research.(Shi,&Singh,2019,p.244)
Pro Mental health was available for veterans who suffered battles fatigue. (Shi,&Singh,2019,p.244)
Cons- Although it was available many veterans did not receive treatment for their mental illness partially because community centers were not yet established.(Shi,&Singh,2019,p.244)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Congress passed the amendments to the social security act and establish Medicare and Medicaid.(Shi,&Singh,2019,p.261)
Pro- This made health care affordable to two venerable groups those living in poverty and the elderly.(Shi,&Singh,2019,p.261)
Cons- Medicaid was stigmatized as public welfare.(Shi,&Singh,2019,p.263)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

Consumers travel abroad to receive elective, nonemergency and medical procedures.
Pro- Consumers are able to receive treatments at a cheaper cost with minimum regulation.(Shi,&Singh,2019,p.268)
Con- Globalization has brought new health concerns. Infectious disease such as HIV and HepC has increased worldwide.(Shi,&Singh,2019,p.271)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.

On March 21, 2010, the U.S House of Represenative passed the patient Protection and Affordable Care Act.(Shi,&Singh,2019,p.271)
Pro- The ACA reduced the number of uninsured Americans. Pre ACA 43 million Americans were uninsured. Post ACA the number of uninsured Americans was reduced to 26 million.(Shi,&Singh,2019,p.275)
Cons- Many middle-class Americans who had insurance prior to the ACA received cancellations from their health insurance because it did not meet standards.(Shi,&Singh,2019,p.276)
Shi, L. & Singh D.A. (2019). Delivering Healthcare in America: A Systems Approach (7th Ed.). Burlington, MA: Jones and Bartlett Learning.