The primary role of the physician is to provide medical service. His role in the financing of that service has, traditionally, been secondary. But, for many reasons, he has had to concern himself with the problem.
Prior to the depression of the 1930's, the predominant method of payment for physicians' services was on a fee-for-service basis, on a sliding scale related to the patient's ability to pay. Physicians treated the indigent for nothing, the low income group on a reduced fee basis, charged a normal fee for the middle income patient, and increased the fee for the upper income group.
Medicine Assists in Financing Plans
The prolonged depression created a new situation. The indigent and low income groups increased substantially and individual physicians found themselves unable to handle the load. Medical societies then began to assume a role in financing health care costs. They organized a variety of post-payment plans
Allman DB. MEDICINE'S ROLE IN FINANCING HEALTH CARE COSTS. JAMA. 1957;165(12):1571–1573. doi:10.1001/jama.1957.72980300012015
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