Patients, who before the advent of Medicare & Medicaid, would have been covered by the Hippocratic Oath, suddenly morphed into a new source of revenue. The psychological effect was enormous.
Yes.
Hillary introduced big business to the idea that there was revenue to be exploited. Up to that time medicine was separate from business per se. It was an apprenticeship and charity care was part of being in that profession. The best of the doctors in the area participated in the teaching hospitals, donating their time for rounds and patient care of the indigent. The residents did the paperwork and routine care with attendings as back up.
There was a camaraderie that has been lost as the paperwork & regulations swamped the system and the idea of a week a month or two days a week rounding & operating on charity patients has been lost because of the press of busywork & pressure on fees from insurances. It was sad to see medicine transform from the calling that it was to many physicians, into a business model. It will be interesting to see where it will go from here. We can’t & wouldn’t want to turn back the clock but a shift back to the doctor patient relationship being primary, without the distortions of layers of regulation and with tort reform would be a good start.