Elaine G. Breslaw: How Obamacare Compares To 19th Century Care

Elaine G. Breslaw is the author of “Lotions, Potions, Pills, and Magic.”

What was health care like in the “good old days”? And what was the government’s role? Today to relieve the taxpayer from the obligation to pay the hospital costs for the uninsured, the country is preparing for “Obamacare,” a mandate for everyone to have health insurance.

Before the 20th century, people did not bother with health insurance nor did they voluntarily go into a hospital, a source of infection and death. Only sailors had a mandate to pay into a federal program for medical care. The poorest, the homeless, those lacking social support like the sailors, were condemned to hospitals where doctors volunteered their services in return for the prestige of the appointment. Hand-washing was not expected and the results were deadly.

Neither professional nor government regulation existed to establish standards of care or of competency. There were no licensing requirements for those practicing medicine. Anyone could call himself a doctor and anyone, male or female, could practice medicine. That included the traditional Indian shamans, African-American conjurers or obeahs, midwives, or any herbal dispenser. By the nineteenth century there were even more unorthodox treatments and self-help alternatives from hydropathy to homeopathy to a profusion of sugarcoated patent medicines with unknown ingredients (the patent was on the shape of the container and not what was in it)....