Volume 71 Number 4 September 2004	back to contents

Address all correspondence to David A. Valone, Ph.D., Director of Cultural and Scholarly Programs in the College of Liberal Arts, Quinnipiac University, CL-AC3, 275 Mt. Carmel Ave., Hamden, CT 06518.

Presented at the Issues in Medical Ethics 2001 Conference on “Medicine, Money and Morals” at the Mount Sinai School of Medicine, New York, NY on November 2, 2001, and updated February 2004.

ABSTRACT
The form and amount of medical payments has been a contentious issue throughout the history of Western medicine. The prices charged by doctors, and the actual payments they receive, have reflected a complex interaction of the social, economic, and political forces impinging upon medical practice. Contemporary concerns about the medical payment system in the U.S. relate, in part, to the unprecedented scale and complexity of the modern system of medical payments. Historical analysis reminds us that medicine and money have always made odd bedfellows. Today’s problems may seem intractable, but such problems have been consistent throughout medical history.

KEY WORDS
History of medicine, payment, fees, elite, the poor, direct payments, regulation, Benjamin Rush, competition.