Keep in mind that the Medicare program did not begin until 1965. Before that, the elderly pretty much depended on their own resources, or their family, or charity. I don’t recall anyone being sent off to the gas chambers.
Medicare itself did not–at least initially–change the fact of anyone’s dependency. It simply shifted the burden of caregiving from the family and charities to taxpayers in general. The younger generation still takes care of the elderly, only now they do it more through taxation than through family resources.
I grew up in a primitive part of the country a long time ago. If you were sick or injured, there were basically three options. 1) Recover the best you could. More often than not, that’s what people did, and recover is what otherwise reasonably healthy people nearly always did. Of course, you normally had a stock of patent medicines on hand, sold to you by the Watkins peddler. I’m not sure any of them did any good, but paregoric would sure settle your stomach and quell most pains. It actually had opium in it, but you didn’t need a prescription for it. 2) Call the doctor. At that time and place, the doctor came to you, administered the medications and directions he felt you needed and you called him again if you needed to. The doctor might recommend #3, following, but usually didn’t. Doctors were remarkably inexpensive compared to now. 3) Go to a hospital. Usually run either by charitable sisters of one order or another, or by some public entity. They cost about as much as staying at a hotel. The care was essentially palliative, and the sisters were extremely kind and caring. They actually did run the place. Of course, there were no MRIs, CTs, PET scans or any of the expensive stuff or exotic medications there are now. Unless it was a surgery, the doctor pretty much did the same thing he would do if you were at home, but he came more often, and the sisters were pretty observant. If you had trouble paying, you could pretty much work it out somehow. Nearly everybody was uninsured. There was no Medicare or Medicaid. The hospital in my town had a couple of surgeons and four GPs on the staff. Those were the same ones who would go to your house, so they were pretty busy. If you were dying, well, they tried to keep you comfortable and let you die. There wasn’t much they could do about it anyway. They couldn’t spend a million dollars to maybe give you an extra few weeks of life (possibly cure you) because there was nothing to spend it on. Most dying people went home to die, and were cared for by relatives for the fairly short time it took without all the life-extenders they have now. The doctor would visit you every few days until you did, and give you whatever he thought would make you more comfortable. He would leave meds with you. Doubtless some people inadvertently overdosed on narcotic drugs in an effort to kill pain and shortened their lives a bit in the process. But there was no real effort on the part of the doctor to “ration” you so you wouldn’t get addicted before you died.
Ambulances were, well, the local funeral director’s vehicle that sometimes also served as a hearse. No paramedics or anything. Just the director, a family member and you. No helicopters. If you didn’t make it to the hospital, you just didn’t, and nobody thought anybody was to blame for that. But the car was, most often, a Cadillac. I’ll give them that.
The first health insurance of which I was made aware was Blue Cross/Blue Shield, carried by my elderly aunt. It cost her $20/month. She actually had more than one policy, so she always made money if she needed care. I suspected her some of manipulating her health needs to make a profit, but I can’t be sure she did.
Now, of course, extraordinarily threatening conditions are much better treated. The more ordinary care, though, isn’t very good, and they throw you out after the insurance hits its allowable maximum. My wife is an RN and used to be in home health. Not infrequently, hospitals would call her to come and take care of a patient because they, themselves, didn’t have the staff for non-ICU patients who needed more than fairly indifferent care. Hospitals calling home health to come in. Amazing! If you go to a clinic now, you’re lucky to see a doctor and, if you do, the actual cost is staggering if you’re paying it yourself. Something like $200 for 2 or 3 minutes around here for most things. Mostly, though, you’ll see the NP and still pay $200. If you don’t pay, they’ll sue you in a heartbeat.
I don’t expect we’re likely to see hospital sisters again any time soon, for the most part. Even if we did, they would have to have all of the fancy equipment and super specialists and all the other stuff that costs so much, or they would be sued constantly for malpractice for failing to have it. Back then, they didn’t throw away everything you used. They autoclaved it and used it again. But you know, I never heard of anybody getting staph in the hospital then.
But I expect lots of people who survive now would not have survived then. Some of the million dollar folks’ lives are not extended by a day, though. That I know.
(continued)
Apparently his insurance will not cover rehab, only under very specific circumstances.
