The article is dedicated to the transformation of U.S. public health. The author examines the key features of market mechanisms in the industry that determine the inevitability of government regulation on the sphere. The author conceptually analyses the main institutions of the US national health care model, their main characteristics and features. The main stages of the evolution of public health care in the USA are analyzed and identified. Created to address economic, social and demographic problems that affect the health of the population, it has significantly expanded its mandate in the provision medical services and today is formally subordinated to the task of providing affordable insurance and medical care. However, the issue remains a hotly contested political battle, and the outcome of the election race could change the intended trajectory of development.