The form and amount of medical payments has been a contentious issue throughout the history of Western medicine. The prices charged by doctors, and the actual payments they receive, have reflected a complex interaction of the social, economic, and political forces impinging upon medical practice. Contemporary concerns about the medical payment system in the U.S. relate, in part, to the unprecedented scale and complexity of the modern system of medical payments. Historical analysis reminds us that medicine and money have always made odd bedfellows. Today's problems may seem intractable, but such problems have been consistent throughout medical history.