Long before the modern pharmaceutical model existed, botanical medicine, homoeopathy, and naturopathic practice formed a rich and competitive landscape of healing in America, one that was methodically dismantled between 1910 and the 1970s, not because it failed patients, but because it couldn’t generate monopoly profits. The story of how two pivotal decisions shaped the most expensive, and in many ways least healthy, medical system on Earth is one that changes the way you see every prescription you’ve ever been handed.
From Willow Bark to Wall Street: The Century-Long Takeover of Human Health
There is a version of history in which modern medicine simply evolved, in which science gradually replaced superstition, laboratories replaced apothecary gardens, and pharmaceutical drugs replaced folk remedies because they were simply better. It is a reassuring story. It is also, in significant part, false.
The real story is a deliberate one, driven not by what healed people most effectively, but by what could generate the most sustained and scalable profit. It unfolded in two distinct phases across the 20th century, and we are living inside the consequences of both.
The Garden That Was Taken
At the turn of the 20th century, American medicine was genuinely plural. Patients had choices. Botanical schools, homeopathic colleges, naturopathic institutions, and eclectic medical programmes sat alongside conventional medicine, and competition between them was vigorous. If one approach failed you, another was available. The marketplace of healing was rich, decentralised, and rooted in centuries of observed results.
Willow bark had been used for pain relief long before anyone isolated its active compound and named it aspirin. Foxglove had managed heart conditions for generations before digitalis was patented. Cinchona bark had treated malaria effectively long before quinine was isolated and sold. These weren’t primitive guesses. They were the refined and documented product of generations of careful practice.
But here was the problem, from a certain perspective. You cannot patent a plant. Anyone can grow willow bark. Anyone can harvest foxglove. There is no monopoly to be built on knowledge that belongs to everyone.
By 1910, a single report commissioned by the Rockefeller-backed Carnegie Foundation changed everything. The Flexner Report, authored by a man with no medical training whatsoever, evaluated America’s 155 medical schools using criteria that were specifically designed to favour laboratory-based, pharmaceutical-oriented medicine. Schools were assessed on their buildings and equipment, not on the outcomes of their graduates or the wellbeing of their patients.
The result was devastating. Schools were condemned as unscientific. Funding was strategically withheld from institutions that refused to restructure around pharmaceutical approaches. Licensing boards, quietly reshaped by the same interests, began recognising only graduates from “accredited” schools, and accreditation meant meeting Flexner standards.
Institutions with 80 years of successful practice closed. Botanical knowledge refined across centuries began to vanish, not because it had been disproven, but because there was no longer a legal or financial framework to sustain it. By 1925, of the 165 medical schools operating in 1910, only 81 remained, and not one of them still taught botanical medicine.
The $2 Visit That Became a Bankruptcy
The second phase came quietly, in the form of a law that sounded entirely reasonable.
In 1960, a visit to a family doctor in America cost $2. A three-day hospital stay, including delivery, cost $46 in total. Employer-provided health insurance covered the overwhelming majority of working families, and the hospital you were taken to was run by a community, a church, or a university, not a shareholder.
Then came Richard Nixon’s Health Maintenance Organisation Act of 1973. Its surface logic was appealing: rather than paying doctors per visit (incentivising over-treatment), a flat fee would be paid to organisations whose mandate was to keep people healthy. Prevention over cure. Efficiency over excess.
What was buried inside that logic, recorded on tape in the Oval Office, was something else entirely. The adviser presenting the plan explained its beauty plainly: the less care the organisation provides, the more money it makes. Nixon nodded. He signed the bill.
The not-for-profit requirement that governed the original HMOs was removed in the 1980s. Wall Street arrived. Insurance companies merged, floated on the stock exchange, and reoriented their entire purpose from patient care to shareholder return. Networks, pre-authorisations, deductibles, formulary restrictions, and prior approvals began building walls between patients and doctors. By 1998, the proportion of Americans on traditional, unrestricted indemnity plans had collapsed from 95% to 14%.
The costs, which the HMO model was supposed to reduce, increased instead:
- In 1960, America spent $146 per person per year on healthcare
- By 2024, that figure had reached $15,474 per person per year
- Healthcare now consumes nearly 20% of the entire US economy
- 70% of Americans take at least one prescription drug
- 60% of adults live with a chronic condition
What It Means to Know This
These two histories, the botanical schools closed by the Flexner Report and the family doctor replaced by a managed care algorithm, are not separate stories. They are chapters in the same story, about what happens when health becomes a commodity and knowledge becomes property.
Botanical medicine was not eliminated because it failed people. It was eliminated because it could not be owned. The affordable, community-rooted healthcare of the mid-20th century was not dismantled by accident. It was restructured around a model in which less care meant more profit, and then that model was handed to shareholders.
The plants are still there. The body’s capacity to heal itself has not changed. The knowledge, scattered and fragmented though it is, has been quietly reassembling in the margins, in integrative practitioners, in herbal schools rebuilding without institutional support, in research programmes slowly rediscovering what traditional medicine always knew.
What has changed is our awareness of how it was taken, and that awareness is itself a form of healing.
Source: Prepare for Change
Join the Conversation
When you consider how much of our collective health knowledge was deliberately dismantled within living memory, what feels most urgent to you: recovering that knowledge personally, rebuilding the institutions that once carried it, or simply refusing to accept that the current system is the only one possible? What does your own experience of the medical system tell you about where healing is truly found? Share your experiences and insights below.
