Everyone knows that healthcare in the U.S. right now is really convoluted and almost no one appears to be happy with the system, except perhaps for the few with truly amazing plans (a group I have little to no contact with).
I was chatting with some younger doctors just finishing their fellowships in Internal Medicine subspecialties (the lower paying ones, like rheum, endo, ID) who said they expected to need to see at least 25 patients/day to make ends meet. An older doctor (I would say at least in his 70s) chimed in that when he was in private practice (let’s say 20-30 years ago, maybe longer) he would see 2 new and 10 old pts a day. He also said that 20% of his practice was gratis for indigent patients, and that poor people back then did not want for health care. I have often heard many older physicians remark that they needed to see relatively few patients decades ago, but they seem to have been reimbursed more.
So how did this system work? Did a large chunk of its feasibility rely on the fact that your primary expense back in the days before expensive imaging and procedures was simple doctors’ fees, so that everyone (except the indigent) paid the equivalent of $100 to see the doc, but not much more?
I would be really interested to know what healthcare was like back then. Maybe that knowledge could be used to shed insights onto how to deal with our current healthcare woes.