Caught in the Middle.

In 1930 a major concern for Americans was whether or not they could afford to be sick. The wealthy could pay for their own medical expenses, and the decade of the 1920s had seen a continuation of the development of charitable organizations that helped to support the very poor. But families of moderate means were caught in the middle. A number of trends in medicine contributed to the mounting costs of medical care, including the increased use of hospitalization for patients, medical specialization, the "sliding scale," and charity work of physicians.

Costs and Trends in Medicine.

By the fourth decade of the century medicine entered an age of hospitalization. Hospitals originated as charitable institutions for the poor, with a few private rooms added for the wealthy. As health care and technology improved, medical care focused more on hospital...