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The Way Healthcare Used to Be

Published April 2, 2014 5:01 PM by Renee Dahring
I find myself thinking quite a bit about how much healthcare has changed since I was young and trying to figure out how it is that we have come to find ourselves in our current situation.

I just want to state, for the record, that I am not that old. I was a kid in the 60s and I had my children during the 70s and early 80s. I am not talking ancient history here, only the last 50 years. 

When I was growing up my family didn't have health insurance. My father, who was a hairdresser, was considered self-employed so he did not receive any work benefits. But what he did for a living probably wouldn't have made much difference, because during that time most families didn't have health insurance as we know it today. With the exception of a major medical policy that covered only hospitalizations, people expected to pay for all clinic visits and medications out of their own pockets. And we did. And somehow it was affordable. Even the occasional trip to the emergency room wasn't unmanageable for most budgets. And for that matter, neither was having a baby. I had no insurance when I had my children but it didn't send me to bankruptcy court. Granted, my youngest was 5 years old before I owned him free and clear, but the monthly payments were reasonable! 

But that was another difference: We actually saw our bills. It's only in the last 30 years or so that bills starting going directly to the insurers rather than the patient. In those days it was up to the patient to submit the medical bill to their insurance company and wait for reimbursement.

There were no big healthcare "systems"; clinics were mostly privately owned. I also remember visit times being longer and less rushed even though charts were on paper and few offices even owned a fax machine. A person could get an appointment in a reasonable amount of time and if not perhaps a phone call was sufficient because the clinic "knew" you.  There was no such thing as an urgent care and believe it or not the emergency rooms were not overflowing. 

What is going on? I know the "good old days" weren't always so good but is this really progress? Yes, there have been some great advances in healthcare but are we really getting that much more for our money? It doesn't seem that patients are that much healthier (or happier) and not a day goes by that we don't hear grumbling from providers who are forced to dance to the tune of insurers and regulators. 

Maybe I am getting old ...








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    Occupation: Nurse Practitioners and NP Recruiters
    Setting: correctional healthcare/career consulting/teaching
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