Paying the Doctor’s Bill

American health care has become a big business, but as our archives show, medical professionals were typically more concerned about care than costs.

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The United States may not have the best health care system in the world, but it is the most expensive. Currently, health care spending is 17 percent of our Gross Domestic Product and predicted to be 20 percent by 2018. Since 1960, this spending has skyrocketed, reflecting a major socioeconomic change in the way the U.S. delivers health care. Historically, though, doctors and hospitals were expected to serve the needs of others, even if they didn’t get paid. It was considered morally and ethically wrong to profit from medical service or inventions, a far cry from today’s lucrative marketplace for investors and investor-owned corporations. The following articles from the Post archives put this transition into perspective.

You can read the full original articles by downloading the below PDF files.

“Peeps Into Professional Ledgers: Dollar Secrets of Doctors and Dentists”
by Forrest Crissey, August 29, 1914.

If the business side of professional life were placed on an efficiency basis the scientific side of medical practices would receive an uplift that would be felt from one end of the country to the other: and it would not be evidenced in higher fees, either. One result would be that the honest, conscientious debtor to the doctor would not have to pay for the delinquencies of the dead beat. And that is about what he has been doing under the old system for many years—especially in family practice.

Does the physician deserve his undoubted reputation for business inefficiency?

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“The High Cost of Sickness”
November 6, 1926.

Dr. C. C. Burlingame, in addressing a recent convention, made a timely plea for the wider application of business methods to hospital operation and for the enforcement of those economies without which the high cost of sickness will never be reduced.

No other country hand raised hospital construction to the high level it has attained in America. Our institutional buildings are characterized by beauty, cheerfulness, convenience, healthfulness and an extraordinary suitability in gross and in detail, for the purpose for which they were erected.

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“This Cross is Blue”
By J.C. Furnas, October 2, 1943

Blue Cross subscribers now number 11,000,000 in the United States and Canada. At least 5,000,000 more Americans have hospitalization cash benefits included in health-and-accident group policies. Probably a good seventh of the American people are far more secure against hospital emergencies than was possible when this sort of thing started fourteen years ago.

This June, Sen. Robert F. Wagner introduced in Congress a trial-balloon bill sketching an American Beveridge Plan, with compulsory Federal hospitalization insurance on an employee-boss-participation basis as a conspicuous feature. So early a definite threat of Government competition nastily jolted Blue Cross organizations. Having pioneered both general hospitalization group insurance and the boss-pay-part feature, they feel their present efforts to spread the idea into lower income brackets should be given a chance before Uncle Sam hogs the field.

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“Do You Really Want Socialized Medicine?”
By Steven M. Spencer, May 28, 1949

For the eighth time in ten years the American people are being urged to let the Government pay their doctors for them, with money collected from the American people. The system is called compulsory health insurance, and the theory is that everbody who doesn’t have enough medical care today will surely have it tomorrow because the Government will see to it that he does.

Both sides agree that no one who needs medical care should be denied it because he is unable to pay. The opponents of compulsory insurance maintain that it is in the American tradition that those who are able to care for themselves and their families should not lean on government for help. [Proponents] maintain it is too hard to determine who is able to care for himself and who isn’t, and that the easiest and fairest way to make medical care freely available to everyone on the basis of compulsory wage deduction.

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“Medicare: Headache or Cure-All?”
By Steven M. Spencer, May 20, 1967

As Medicare now approaches the end of its first year of operation, it is obvious that the program is too broad and complex to permit a final assessment. But it is also clear that it is not quite the glorious success its sponsors promised nor the miserable failure its opponents forecast.

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