Evening star. [volume] (Washington, D.C.) 1854-1972, 1931-02-15
BY DR.. RAY LYMAN WILBUR,
Secretary of the interior.


" VEN in time IF economic de-
- preston America has reason to
be proud of its great industries
- of its automobile factories, its
steel plants, its chemical labo-
ratories, of the myriad uses made of cleo
tricity Indeed economists tell us that
one of the reasons for our present diff
culties is that science and organization
have made it possible for us to produce
goods faster than we are able to buy
and consume them.
But there is one industry of which
this is so far from being true that the
actual supply of its goods" falls below
even the minimum demand for them.
This Is the health industry" one of
the greatest in the country, measured
by personnel or by invested capital
Since coed health is essential to human
we'll being, perhaps it is the most i'm
portant of them all.
Distribution Inadequate.
The force engaged IN "manufactur-
ing" health numbers nearly 100000
men and women of whom about las, 900
are physicians. There is thus, theoretl-
cally. one health worker, good, bad or
Indifferent, for every hundred of us, and
about one physician for every thousand.
Yet only few Illustrations or personal
experiences are enough to show that
medical care Is as yet anything but
adequate in distribution.
A certain North Carolina county
has, or had not long ago, a population
of 10000. There were only four active
and capable physicians to look after
its health. In the large cities there
sometimes seem to be almost too many
doctors. New York certainly does not
lack for them, nor for hospitals to
which their patients may be sent. Yet
a recent survey of the Mulberry dis
trict of Manhattan showed that nearly
20 per cent of those too i'll to be at
work or at school had had no medical
care from a physician. Childbirth is
a critical time for both mother and
infant. On conditions at that moment
may depend the health and even the
lives of both. Yet out of about 2,400,-
900 births each year about 360, 900 are
attended only by midwiveS, many. OF
whom are ignorant and incompetent.
Patients and Doctors Complain.
Even where medical facilities seem
to be adequate patients complain of
what they consider excessive bills from
physicians, surgeons and hospitals;
physicians protest that much of their
work is done for nothing and that
many patients pay less than they could
and should, and hospitals, even when
many of their expenses are paid out
Of endowments and contributions, often
find it hard to make both ends meet.
Thus, If we think of health as COM
modify, the supply is insufficient. the
buyer usually thinks he pays too much
and the seller Gf we may use the
term for the sake of making the figure
completely is not, on the average, over
paid.
Allowing for the normal human
frailty which makes most Of us want
to receive a little more than we de-
serve and pay little less than we
| owe, a situation of this SORT points at
a defect Of organization. There must
be something wrong with the health
| industry which 1t is per-
haps possible to cure.
War Lacks Common Front.
A health map of the United States
showing all medical services or any
given kind of medical service, looks like
bad case of measles or good case OF
freckles. City, county, State and Fed
eral health officials, as well as the pri-
vate practitioners and institutions, all
| fight the common enemy, disease, but
they do not fight on common front
The struggle against i'll health for the
most part is carried on more ike guer-
rilla warfare than like an organized
campaign.
It was this situation-not rejecting
on any individual or group of individu-
ais, but throwing light on the erratic
nature of scientific progress-that led to
the creation of the Committee on the
Costs of Medical Care. The purpose of
this committee is the solution of the
problem of "the delivery of adequate,
scientific medical service to all people,
reasonably met by them in their respec-
tive stations in life" which Secretary