In terms of how the industries have changed over the years, the similarities between the US agriculture system and the US healthcare delivery system are striking. In the early 1900s, the agriculture industry was composed of thousands of small-scale and subsistence farms that provided food for their local communities, and in many cases these small farms generated only slightly more food than was required by the family who grew it. During this time period, over 40% of the US population was involved at some stage of the farming process, from planting to harvesting to transport and distribution. The changes in the US agricultural industry since that time have been nothing less than radical: farming now employs less than 2% of the US workforce, and hundreds of thousands of small farms have given way to far fewer, massive commercial farms. Rather than the mules and horses of the past, these farms use gigantic combines and planters to expedite the process, as well as to compensate for the drastically reduced amount of human labor available.
Farm subsidies (or rather, the scale on which they are administered) have also changed significantly. These farm subsidies were distributed to small farms to provide financial stability, given that a small farm could collapse if a drought or flood ruined their crops. As one might expect, small farms are far less capable than large commercial farms in terms of absorbing financial losses. Massive economic scaling, fewer competitors, and advances in crop durability mean that commercial farmers’ income is much more stable than their rural counterparts of the past. Yet these farm subsidies persist, and consequently small farms are under tremendous pressure to scale up to maximize their benefit. Mirroring the trend in American agriculture, small healthcare providers are under a similar kind of pressure. Bonds between large private health insurance companies and large area hospitals mean that smaller clinics (both public and private) often cannot compete and are forced to either find a possible merger or go out of business.
Through massive scaling, increased technological availability, and partnerships with local health insurance providers, hospitals are becoming full-fledged economies unto themselves, much like large commercial farms. These medical centers often have the available capital to expand even during a larger economic recession, given that they can demonstrate convince their funding sources of suitable local need. Although the healthcare industry presently does not receive subsidies in the same way that farms do, they do receive significant portions of taxpayer revenue through Medicare and Medicaid, which are social health insurance programs that assist the elderly and low-income individuals, respectively.