5 1960s In the 1950s, the price of 1970s hospital care doubled. Now in the President Richard Nixon renames early 1960s, those outside the workplace, especially the elderly, have difficulty affording insurance. Over 700 insurance companies selling health insurance. Concern about a "doctor shortage" and the need for more "health manpower" leads to federal measures to expand education in the health professions. Major medical insurance endorses high-cost medicine. President Lyndon Johnson signs Medicare and Medicaid into law. "Compulsory Health Insurance" advocates are no longer optimistic'. The number of doctors reporting themselves as full-time specialists grows from 55% in 1960 to 69%. prepaid group health care plans as health maintenance organizations (HMOs), with legislation that provides federal endorsement, certification, and assistance. Healthcare costs are escalating rapidly, partially due to unexpectedly high Medicare expenditures, rapid inflation in the economy, expansion of hospital expenses and profits, and changes in medical care including greater use of technology, medications, and conservative approaches to treatment. American medicine is now seen as in crisis. President Nixon's plan for national health insurance rejected by liberals & labor unions, but his "War on Cancer" centralizes research at the NIH. The number of women entering the medical profession rises dramatically. In 1970, 9% of medical students are women; by the end of the decade, the proportion exceeds 25%. World Health Organization declares smallpox eradicated. 1980s Corporations begin to integrate the hospital system (previously a decentralized structure), enter many other healthcare-related businesses, and consolidate control. Overall, there is a shift toward privatization and corporatization of healthcare. Under President Reagan, Medicare shifts to payment by diagnosis (DRG) instead of by treatment. Private plans quickly follow suit. Growing complaints by insurance companies that the traditional fee-for-service method of payment to doctors is being exploited. 1990s Health care costs rise at double the rate of inflation. Expansion of managed care helps to moderate increases in health care costs. Federal health care reform legislation fails again to pass in the U.S. Congress. By the end of the decade there are 44 million Americans, 16 % of the nation, with no health insurance at all. Human Genome Project to identify all of the more than 100,000 genes in human DNA gets underway. "Capitation" payments to doctors By June 1990, 139,765 people in become more common. the United States have HIV/AIDS, with a 60 percent mortality rate.. 2000s Health care costs are on the rise again. Medicare is viewed by some as unsustainable under the present structure and must be "rescued". Changing demographics of the workplace lead many to believe the employer-based system of insurance can't last. Human Genome Project to identify all of the more than 100,000 genes in human DNA is expected to be completed a full two years ahead of schedule, in 2003. Direct-to-consumer advertising for pharmaceuticals and medical devices is on the rise.