Bringing Much-Needed Transparency and Accountability to Indigent Care Programs | The Heritage Foundation
Before the 20th century, medical care for the poor was primarily provided by private charities, often with a religious affiliation, or by hospitals and clinics funded by local governments. As hospitals evolved into the locus of medical care for the general population, charitable and publicly funded hospitals increasingly served more affluent patients as well. In response, those hospitals adopted financial strategies that effectively cross-subsidized the treatment of indigent patients with fees charged to patients who paid for their own care either directly or through insurance.