When the first formally trained clinical engineers came into the work force, the industrialized
world was in the midst of a post-war health care boom. That boom eventually
ended as the cost of health care reached the point where businesses and governments
sought to control it. The result has been a plethora of systems including state-sponsored
health care, single-payer systems, Health Maintenance Organization (HMO)-based care,
capitated payment schemes, systems of hospitals, both for- and nonprofit, and in some
cases, rationed care.