The funding of doctors and hospitals is a controversial political issue in many countries in the modern day. We think of social democracy, and the provision of healthcare by the state, as a relatively recent notion. However, it is an idea that goes back to the origins of modern medicine. In the fourth century BC, the Hippocratic Precepts, which set out the Hippocratic ideal of how doctors should operate, advised ‘Sometimes give your services for nothing, calling to mind a previous benefaction of present satisfaction. And if there be an opportunity of serving one who is a stranger in financial straits, give full assistance to all such.’
By the time of the Roman Empire, the rich paid for doctors but a public physician was also provided for the ordinary citizens by the local town councils. However, this was not always medical care of the highest quality. In 220 BC Rome’s first public physician was the Greek doctor Archagathus, whose preferred cures tended to involve the cauterizing iron and the surgical knife. His nickname was ‘the Butcher’, and the politician Cato the Elder was convinced he was part of a Greek conspiracy to murder all Romans.
The Chinese took the idea of socialized medicine further, by using a system of publicly employed doctors who were paid for by the central government. Initially set up in major cities in the second century BC, this system was extended to the whole country by the first century AD. Full training was also provided. By the fifth century, most major cities had a dedicated medical college that granted degrees in medicine.