The nurse studying the development of the American health care system understands that before the 1990s, health care funding was primarily:

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Before the involvement of the federal government in health care financing in the 1990s, physicians (and health care facilities)charged a fee for services, which was generally paid for either out of pocket by the individual or by private health insurance companies.There has always been some charitable health care, but this has not been the primary method of payment.Entitlement programs, such as Medicare, cover health care expenses for certain designated groups.States are involved in some health care financing but certainly not the majority of it.

The Nurse Studying the Development of the American Health Care