Productivity, defined as output per person per hour, has hardly changed. All this means that if 21st century musicians are to have anything like a contemporary standard of living, the relative cost of their services will be much greater than it was in the 18th century. That's because productivity in other sectors has dramatically improved, and so have wages. Even though the musicians haven't increased their productivity, their wages have risen to keep pace with everyone else. Check the ticket stub next time you go to the symphony.
Some endeavors just take time and people, and there's no way around it.
For that reason, they aren't likely to yield significant productivity gains. Health care benefited from some simple changes brought about by the era of HMOs and practice management. But the hope of finding a continuous stream of cost-saving measures is dimming. That means the cost of low-productivity services like health care must invariably rise if those services are to be maintained. The price of medical care needs to increase in comparison with other goods and services that can become more productive.