During most of the 1960s my father (who had 6 children) was able to pay for all of our medical expenses out of his own pocket. This included child births, emergency room visits, doctor visits, and hospital stays. That all changed after the 1965 Medicaid Act. By 1971 he had to accept his employer's health insurance plan due to rapidly rising medical costs. Both Medicare and Medicaid distort market prices due to perverse incentives, and the unintended consequences of having the federal government distort supply and demand. Today, there is no true price for say, getting stitches. It all depends upon who is paying - which is normally a third party. Both health insurance and Medicare/Medicaid distort the price of medical services. Things were made worse by the 1986 health care reforms Congress instituted. They instituted those reforms to "fix" the the problems created by Medicare/Medicaid. Twenty years later it became painfully evident that those reforms were a disaster. ObamaCare just made a disaster a national catastrophe.