There is a lot more to spend it on. I'm gen-X, ADHD wasn't even heard of by most people until I was in college, and then it was only diagnosed/treated in the worst cases. Today most kids I know are on some medication for ADHD. A few years ago a friend of mine was told "too bad you are not 25 - I know what treatment you need but we can't give it to someone over 25" - he went to the Mayo clinic for his condition at 23 but the treatment didn't even exist yet so it was a waste of time.

In 1860 someone who went to a doctor would have worse outcomes than someone who stayed home. As medicine gets better over time there is more and more value in seeing a doctor. In turn more an more people are talking to their doctor about things that they would have just ignored a few generations ago. Sometimes this results in unnecessary treatment, but it also results in catching and fixing a lot of real problems that would have made life worse before we could treat it.