often contemplated during this period and stalled once an infectious disease outbreak such as influenza in 1918, tuberculosis in the early 1900s, and the polio epidemic in the 1950s hit the U.S.. At this time, with the goal to improve people's health and welfare by allowing for effective health planning and the creation of neighborhood health centers, health policies like the Social Security Act were enacted. This was followed by Medicare and Medicaid Act in 1965 that gave poor people in the U.S., access to inpatient and outpatient medical care from public hospitals after racial segregation ended in the South. With their mandate to care for low income patients, the public hospital started engaging in leadership roles in the communities they care for since the 1980s. There was a 14% decrease in public hospitals in the United States from 2008 to 2018, compared to 4% of the total number of hospitals. In 2021 there were 965 public hospitals in the United States, compared to 5,198 hospitals total. Repercussions of accumulated uncompensated care In the U.S., public hospitals receive significant funding from local, state, and/or federal governments. Currently, many urban public hospitals in the U.S. playing the role of safety-net hospitals, which do not turn away the under insured and uninsured, may charge Medicaid, Medicare, and private insurers for the care of patients. Public hospitals, especially in urban areas, have a high concentration of uncompensated care and graduate medical education as compared to all other American hospitals. 23% of emergency care, 63% of burn care and 40% of trauma care are handled by public hospitals in the cities of the United States. Many public hospitals also develop programs for illness prevention with the goal of reducing the cost of care for low-income patients and the hospital, involving Community Health Needs Assessment and identifying and addressing the social, economic, environmental, and individual behavioral determinants of health. For-profit hospitals were more likely to provide profitable medical services and less likely to provide medical services that were relatively unprofitable. Government or public hospitals were more likely to offer relatively unprofitable medical services. Not-for-profit hospitals often fell in the middle between public and for-profit hospitals in the types of medical services they provided. For-profit hospitals were quicker to respond to changes in profitability of medical services than the other two types of hospitals. Public hospitals in America are closing at a much faster rate than