The U.S. system of healthcare insurance began in 1929 in Dallas, Texas. The non-profit Blue Cross insurance company was established to provide 21 days of future hospital care to a group of 1,500 Dallas-area teachers in exchange for prepaying premiums to Baylor Hospital. Blue Shield was later established on the same principles to provide outpatient care. Today, we know of this insurance company as Blue Cross/Blue Shield. The next major development was during the post-World War II era, a time of strong economic growth and the penetration of for-profit health insurance companies and employer health insurance. Companies paid for part or all of the employees’ health insurance. The for-profit health insurance companies provided coverage based on actuarial data and were highly profitable. This system created two vulnerable groups – the unemployed and employees who worked for small companies that did not provide health insurance. The result was millions of Americans who were unable to afford health insurance, which is still the plight of millions of working Americans today. The majority of health insurance companies were for-profit and operated on capitalistic principles. There was no intent to provide coverage for all Americans. The intent was profitability. The system was designed based on the American economic value system of independence and a strong personal work ethic. This resulted in the concept that health insurance being a privilege rather than a right. Every other developed country developed the reverse of the concept; health insurance is a right, not a privilege. Ultimately, a deeply entrenched medical industrial complex developed in the U.S., in which profit is the primary motivation. Therefore, the structural components of the system are difficult to modify or replace.