This book centers on the persistent problems in present-day healthcare and the transition to a more sustainable healthcare in the future. As the previous historical chapter highlighted, such a transition poses quite a number of challenges. The Dutch health system has been contested since the 1970s, without a clear resolution being in sight. This chapter takes the reader further back in time, to the preceding one-and-ahalf centuries (1820–1970), when the last major transition in the Dutch health system took place.