In the 60s most companies only offered "major medical" which means insurance only kicked in for surgery, hospitalization etc. Same with individual policies. As benefit plans became more generous and unions put the screws to the auto industry and others, all of a sudden there was an expectation that all health care should be "free". That is one reason why costs have soared. It it is free, some abuse the system. Of course the explosion of the pharma/med device industry has added to costs as most of us want the latest and greatest. Until we as consumers are involved "financially" with our health care costs, they will continue to increase.