The healthcare system in the United States has been in a constant state of change throughout the 20th century due to rising costs, quality of care and unequal access. As there have been rapid changes in the landscape of managed care, there have also been exponential increases in the cost of national healthcare expenditures. In 2007 national healthcare costs had reached 16.2% of the GDP, an increase from 8.6% in 1977. The cost of rising healthcare has continued to become a focus of politics and the economic landscape due to the amount of government spending with Medicare and Medicaid and the increased costs and reduced affordability of private insurance. (Kongstvedt) Past cost control efforts have focused on changes from the payer and supplier side of healthcare, whereas current efforts place increased focus on patient preference and wellness. The most recent changes in the healthcare system have resulted from quality care measures and the guidelines within the Affordable Care Act.
On a national level, increased focus on prevention and wellness has the ability to both improve overall health, but also control the rising costs of healthcare. According to the US Department of Health and Human Services, chronic diseases – such as heart disease, cancer, stroke, and diabetes – are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation’s health spending. Often due to economic, social, and physical factors, too many Americans engage in behaviors – such as tobacco use, poor diet, physical inactivity, and alcohol abuse—that lead to poor health. The ACA creates a National Prevention, Health Promotion, and Public Health Council, composed of senior officials across the government, to elevate and coordinate prevention activities and design a focused strategy across Departments to promote the nation’s health. In addition, the Affordable Care Act