fewer than today, and the consequences of not getting it relatively less severe (since there was only so much a doctor could do). The cost of medical care was therefore a relatively minor factor in most people's budget. The great increase in average lifespan in the second half of the 19th century and the first half of the 20th had more to do with public-health measures, such as public sanitation, than with the direct intervention of physicians treating individuals.
The above is not to say that health care for individuals was insignificant as a public issue, but it was not a burning issue. Thus for example, in the United States the New Deal of the 1930s included the introduction of Social Security, but even the New Deal political coalition could not pass a national health-insurance program (Ayres, p. xii).
All of this changed during the Second World War, and transformed the health care systems of both countries, though in quite different ways. One cause of the change was the rapid progress in medicine itself. As medical care became more effectiv
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