This is more a question about the real world aspect of paying for operations in the early 1900’s than a movie question, so I’m putting it here. Mods move if you must.
A popular dramatic device from the early 1900’s to the 1930’s or so, in movies, novels, radio plays etc., is that someone (usually mom or sis) needs money for “an operation” so they can walk/see/live etc. Getting this money for “the operation” is the main driving force in the plot.
How did this sort of thing pan out in real life? How did people really get sophisticated (for the time) medical care like orthopedic or ophthalmic operations if they were not well off? For operations was it really a large sum of money required upfront for “cash and go” medical care as these old movies suggest?
I’m not sure why you think this was merely a plot device in old movies. There are numerous appeals in my neighborhood to help raise cash for operations even today. Health insurance is hardly a universal phenomenon, (and even when one has it it often has strict limits on its use), and aside from handling the immediate trauma of accidents, hospitals are not required to provide treatment to people who cannot pay. Stitching and splinting back together the bodies mangled in wrecked cars is generally required for most hospitals (with the local community or a hospital reserve fund providing the money to pay for indigents). However, the multiple operations and therapy required to restore the now still-living but seriously damaged body back to a workable entity are generally not provided without cash.
I see many fund raisers for “basic” stuff such as leukemia treatment, reconstructive surgery, correcting bad heart valves, ands similar stuff at most of the convenience stores, hardware stores, and supermarkets in my (fairly affluent) neighborhood.
Poor people did without anything like the health care we now take for granted. Going to the doctor was reserved for dire illnesses. You set bones yourself, you tried out herbal medicines or old wife’s folk remedies, you went blind, you limped. Remember all that characters in older fiction and movies named Gimpy?
You had to pay the doctor, and even the rates charged then that seem laughable today - $2-5 - were as much as you’d pay for a suit or a fancy watch. You didn’t go to the hospital except when things were so serious you couldn’t be left in the house, hence the sayings about never coming out of the hospital once you went in. Most births were delivered at home. Emergency rooms didn’t exist.
Unions battled years for health care for their workers and that along with the New Deal and changed attitudes (health care was a right rather than unwanted welfare) after WWII sparked the renaissance in health care that makes some kind of care available to everyone.
Health plans didn’t even exist until 1929, when the first Blue Cross was set up as a way to smooth out income to hospitals during bad times. When times were rough, people put off medical care; since a hospital has a lot of fixed expenses, drops in usage hurt their bottom line. A Dallas businessman set up a system where people paid the hospital a monthly fee and in return had their medical care covered. It kept a steady income coming in to hospitals when beds weren’t filled.
Blue Shield was set up around the same time for doctors.
So prior to 1929 (and for many years after that, before BC/BS became established nationwide), people had to pay cash for the full cost of any care. The charges were lower than they are today, but so were incomes, so a major illness could wipe you out, and if you were short money, elective surgery was out of the questions.
Payment plans could be negotiated. I’m sure you could work out things so it wasn’t payment up front, and to pay on the installment plan, but the mechanisms like credit cards didn’t exist and the attitude toward lending money was much different.
So, basically, if you had some illness that required treatment, you probably would have a hard time paying for it, and if it was not a life-threatening situation, you would just let it slide.
IIRC, it was the wage freezes enacted by the government during WW2, combined with the severe labor shortages, that forced employers to think of new incentives to attract employees. One of these was employer-paid health insurance.
Some Googling indicates that Thomas Sowell said this in one of his columns.
It may have been a, but I rather doubt it was the factor. Unions had been putting together health plans for their members before WWII started. Another major factor was a WWII tax ruling:
Obviously this would have the effect of encouraging employer plans over competing plans. The fact that there were so many non-employer-type plans, however, is telling to me.
Of course, Sowell is a Friedmanite so he has a bias toward proving that the free market always leads to better results and I’m an anti-Friedmanite with a bias toward proving that the market is never free but artificially gerrymandered to favor business. Pick your poison.
