US Healthcare History 3-7-24

US Healthcare Costs are high because of decades of cost shifting and government subsidies, but technological advances are impressive. 

In 1935 the Social Security Act provided for government subsidized healthcare to fund County Hospitals. Prior to this, Physicians treated patients at home and discounted patient treatment based on their ability to pay and ran charity practices to rural counties and were paid with produce.

My grandfather ran a rural charity practice on Saturdays for decades. Every Friday he bought the medicine for his charity patients. On Saturday he drove to Prairie du Rocher Illinois and did house-calls. He was paid with produce he used to feed his 12 kids.

His office was in St. Louis and he did house calls for his St. Louis patients. He met several Jesuit Priests on these house-calls. He hosted a 3-table bridge-game every Sunday afternoon and the Priests always attended. They all showed up to give him the last rites when he died in 1961.

He was born in 1886, was homeschooled on the family farm, took a factory job at age 11 to pay for a Science Tutor. He was admitted to Medical School at age 16, graduated at the top of his class with his MD degree at age 19, was appointed Professor of Internal Medicine and completed surgical residency in 1907 at age 21. He practiced medicine for 54 years until 1961. He had no student loans to repay. He witnessed and participated in the elimination of diseases and advances in surgery that raised US life expectancy from age 47 to age 75.

In 1865 US life expectancy was 39.4 years.

In 1900, US life expectancy was 47 years.

In the 1920s, the US began treating water with chlorine to reduce water-born diseases.

In 1950, US life expectancy was age 68. We had antibiotics, but lacked cures for cancer.

In 1953 the polio vaccine was introduced.

In 1961 US life expectancy was 75 years.

In 1965, Medicaid was introduced to allow indigent patients to be treated in private hospitals.

In 1965 Medicare was introduced to pay for healthcare for citizens at age 65. 

In 1965 our first child was born and the hospital bill was $600 and paid for by our own employer-based health insurance.

From 1965 to 2023 the cost of medical care quadrupled annually due to Federal Government subsidies and the exodus of Catholic church-based hospitals that were keeping hospital costs low. I blame Vatican II for the exodus of Nuns who ran the hospitals.

In the 1970s, as Catholic Nuns were selling their hospitals, the healthcare complex supported a push for more treatments that required expensive research and equipment. I was working at Washington University Medical School and HMOs were beginning to form. Technology was improving and NIH was giving grants.

In the 1980s, hospitals were required to treat patients who couldn’t pay their bills. This caused hospitals to cost-shift to paying patients. Hospitals should have set up payment plans. Before Obamacare, Health Insurance coverage was limited to medically necessary procedures to rescue and restore patients.

In 2009, Obamacare abandoned “Medical Necessity” as their insurance criteria and introduced funding abortion and sex changes costing $25,000 to $75,000 and subsidies its coverage. 20 million people are covered by Obamacare in 2024. Obamacare suggested limiting covered treatment to age 70 and above. Obamacare needs to be repealed. The US health insurance industry needs to return to “Medical Necessity” for Rescue and Repair.  Big Pharma needs to be replaced by good nutrition.

In 2019, columnist PJ Orourke wrote “If you think health care costs a lot now, just wait until you see what it costs when it’s free”. Healthcare costs in 2022 reached $4.5 trillion. Medicare costs in 2023 reached $454 billion. Medicaid costs in 2023 reached $805.7 billion.

In 2023, hospitals are going broke and are closing due to government required treatment of patients who can’t pay. The surge of illegal immigrants seeking healthcare is bankrupting hospitals and they are closing these facilities.

In 2023, I appreciated the technological advances that had been implemented in Dentistry and Ophthalmology. The equipment has evolved and is impressive.

Dental Crowns are now made using 3-D computer integrated milling machines, composite dentistry allows an easy fix for chipped front teeth, dental implant navigation systems allow for precise implant surgery, ultrasonic scalers improve efficiency and productivity for cleanings.

Eye Exam equipment was introduced to detect macular degeneration, glaucoma and cataracts. Painless shots in the eye arrest macular degeneration and surgery removes cataracts and inserts stints to correct glaucoma.

Cost Shifting to paying patients continues to be the main driver of hospital costs. Indigent care is bankrupting hospitals.

Comments

Heart Disease and Cancer are the two leading causes of death. It is unclear whether or not the current more effective cancer treatments will continue to reduce cancer deaths. We are yet to isolate what causes cancer cells to form. We know that our survival is enhanced by early detection.

We do know what heart disease is and continue to develop more procedures to treat it. The same is true for lung, liver, pancreas and kidney disease. Again, early detection is advised. Diabetes 2 is preventable with weight control.

Growing up in a medical family gave me a good start to understanding the human condition. I took pre-med courses in college and worked summers at St. Louis State School and Hospital. My entry to working at Washington University Medical School to establish a Personnel Program was easy. I spoke their language and understood their issues.  Later, I found myself as the Trustee for Corporate Medical and Retirement Plans.  I got a real-time view of recent medical history.

Norb Leahy, Dunwoody GA Tea Party Leader