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Municipal and county public health departments provide limited primary care services through public health clinics and regulate sanitation, water supply, and environmental hazards. Most hospitals are owned by private non-profit institutions; the remainder are owned by governments or private for-profit corporations.
The federal government plays a number of different roles in the American health care arena, including regulator; purchaser of care; provider of health care services; and sponsor of applied research, demonstrations, and education and training programs for health care professionals.
The U.S. healthcare system developed largely through the private sector. The first health plan started in 1929 to serve teachers. This model served as the blueprint for the first Blue Cross plans available in the U.S. (Raffel, 1980).
Examples of PHSM include hand washing, mask-wearing, physical distancing, school and business measures, modifications of mass gatherings and international travel and trade measures.