Just a thought; was surgery and healthcare free back in the early 1900s? Nobody seems to mention payment, and even poor people are getting treated.

One hundred years ago, in 1908, health care was virtually unregulated and health insurance, nonexistent. Physicians practiced and treated patients in their homes. The few hospitals that existed provided minimal therapeutic care. Both physicians and hospitals were unregulated. When patients saw a physician, they paid their modest fees out-of-pocket; they were more concerned about the wages they would lose if illness kept them out of work than about the cost of their medical care.

Medical science and technology were primitive, and there was little that physicians could do to treat most illnesses. It had been only 40-50 years since the first understanding of bacteriology, antisepsis, and immunology; 21 years since the invention of a blood pressure measurement device; and 13 years since the discovery of X-ray technology. It would not be until 1910 that the first drug treatment to destroy disease—and not the patient—would emerge or that surgery would become common for conditions like tumors, infected tonsils, and appendicitis.

Commercial insurance companies did not write health insurance policies in 1908; they saw no way to avoid the risks of adverse selection (those who were sick would seek coverage, and those who were healthy would not) and moral hazard (coverage would encourage the insured to seek unnecessary services), and they lacked the means to calculate risks accurately and set appropriate premiums. Within the next 10 years, many European nations would adopt some form of compulsory national health insurance, but similar proposals in the U.S. were rejected because of lack of interest and resistance from physicians and commercial insurers [1].

Yet it was in the early 1900s that regulation and organization of health professions began to take hold. Membership in the American Medical Association (AMA) increased from 8,000 in 1900 to 70,000 in 1910 [2]. In 1904, the AMA formed the Council on Medical Education to establish physician licensure standards. The 1910 Flexner Report on medical education recommended stricter entrance requirements, better facilities, higher fees, and tougher standards for medical students [3]. By 1920, the cultural influence of the medical profession was growing as physicians' incomes and prestige increased.