I was cleaning out my father’s desk after he died in 1988 when I came across a bill for Blue Cross/Blue Shield health insurance from 1945.

The bill, for a family plan, was $19.20 for the year (not month, year). That worked out to be 37 cents a week, or less than a penny for every hour worked. It was easy to pay for health insurance, even at 1945’s minimum wage of 40 cents per hour, or $16 per week.

In 2009, when I was laid off from my job, my COBRA health insurance premium for an individual was $610 per month, or $7,320 per year, which works out to $140.77 per week. I have no idea what a family plan payment would have been. What’s the difference between 1945 and 2009, when minimum wage was $7.25, or $290 per week?

For the most part, medicine got more expensive because of technology. We now have dialysis, transplant surgeries, CT scans and MRIs; even simple blood tests have far more components than they once did. In a hospital, we now have sophisticated bedside monitors, computers for everything from billing to medical records; even the bed itself is far more sophisticated than it once was.

Would any of us roll back the clock to 1945’s medicine? Would any of us roll back the clock to 1999’s medicine?

The human component of medicine also contributes to rising costs. We have far more specialists now than there once were, but we go to specialists because they can save more lives than the family practitioner, and that’s what we want. The increasing number of people who see specialists has driven up the cost of health insurance.

The pay for nurses nowadays bears no relationship to what a nurse made in 1960, but nursing itself has become far more sophisticated than it once was. Nurses are better educated, more specialized and far more an equal to a doctor than they once were. And they are paid commensurately for their skills.

In a hospital and medical practice setting, there is now a need for jobs and buildings to be compliant with the Americans with Disabilities Act, and for work spaces to be ergonomically designed. All of these things add to the cost of medicine.

The regulatory workload also has increased exponentially. Every time more regulations were added, more medical support jobs were created to make sure the medicine being practiced met the requirements.

Gone are the days when you went to a doctor who practiced alone and had one staff person, who was receptionist, transcriptionist, file clerk and doctor’s assistant, all in one job.

People used to die from cancer; now they’re cured. All of us have had at least one loved one who has been cured of cancer. Would we be willing to sacrifice that person’s life to have 1950’s medicine at 1950’s health insurance rates?

Now we have a dilemma. Because medicine is so expensive today, a lot of people can’t afford it.

Even a basic 15-minute primary care doctor’s visit for an established patient (where they don’t have to take a medical history, because they already know it) costs more than $100.

Private health insurance for an individual, not a family, costs almost $1,000 per month.

Who can afford these things? Hence the need for Medicare and Medicaid.

Are we going to tell the poor that they can’t have any health care anymore because we’re eliminating their Medicaid? How can they afford to pay $1,000 per month for private health insurance or pay $100 for each doctor visit?

Are we going to tell the elderly that they will have to pay the $300 per month for their prescriptions, when their Social Security payment is only $900 per month? Or that the day surgery to remove a skin cancer, which will cost more than $1,000, will no longer be paid for by Medicare or Medicaid?

People who have full-time jobs with health insurance benefits, even if they have to pay some of the health insurance costs themselves, are much better off than those on Medicare or Medicaid.

We shouldn’t begrudge the taxes we pay to provide what is now considered basic health care to those who can’t afford it. The people who complain that they can’t afford the taxes for this should remember that they already are paying the taxes and making ends meet.

That’s more than the poor and elderly will be able to say if they are required to pay for their own health care.

Phyllis Hyde of Augusta worked for 15 years in finance for a local hospital (MaineGeneral Medical Center), doing both accounting and budgeting for the hospital and the physicians’ practices owned by the hospital.


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