Evening star., 1932-06-12
CARE Of SICK HELD
A LOCAL PROBLEM
Cabinet Member Declares
j. S. Has Gone Far Enough
In Hospital Building.

BY RAY LYMAN WILBUR,
University. chairman the Committee on the
Costs OF Medical Care. former president
American Medical Association
All men are equal In the presence of
disease. There are none exempt from
the possibility of falling victim to it
where It lies In wait in high places and
low all around the world. Rich. poor
ignorant, erudite, face the possibility of
feeling the need of proper medical care
that they may live and maintain their
physical vigor
The repository of human knowledge
that exists that disease may be success
fully fought is great. Additions have
been made to it century by century,
decade by decade, are still being con-
tributed every year. So great has 1t
become that it is quite sufficient to
meet most emergencies. The medical
knowledge of the world would be ade-
quate to meet the great mass of Its
needs II access to 1t were as nearly uni
versal as Is exposure to disease.
But there Is no equality in the ap-
plication Of medical care to those who
require it. Millions languish constantly
because means have not been provided
to get competent doctors to their bed
sides. The result is innumerable trag-
edies that might have been averted.
Avoiding these tragedies by reaching
the whole public with proper medical
care is a stupendous responsibility that
must be met.
Health Preservation First.
Men with vision, both within and
mi ~
ginning to realize more fully than ever
before that the preservation Of health
Is of greater social moment than the
care of sickness. They believe that the
direct costs of preserving health are
actually no greater than the costs OF
treating disease, and that the vast sums
which all countries spend on medical
services of various kfnds-approXimate-
ly $4,000. 100000 per anpum in the
United States-could we'll be reappor-
toned. If, Furthermore, the indirect
costs due to premature death and to
economic inefficiency be included, there
can be little doubt that health work
pays its own way" Finally, of course,
the human costs Of disease in terms Of
suffering, fear. anguish and despair are
factors which no one can measure ex-
cept in the depths of his own soul
history of the human race in its long
fight with disease, pain and death.
Ignorance, hocus-pocus and neglect
have been the rule. Even today more
of our fellow human beings are denied
the privileges Of medical science than
receive them.
While great progress has been made
In the elimination or control of con-
tagiouS diseases. many people are un-
touched by the possibilities CT preven-
tive medicine. Some of them receive
anly second-rate care when Ill and
others are entirely without scientific
care. In a recent survey. 35 per cent
of the cases OF illness excluding colds
and minor digestive disturbances were
not seen by physician. Unframed,
ignorant. and superstitious midwiveS
bring nearly IS per cent of our future
citizens into this world each year. Few
of us enjoy the benefits of a complete
annual physical examination.
Large Gain In Dentists.
We have seen the tremendous growth
in the number of dentists in our coun-
try and in the quality OF the services
which they render; yet from 80 to 90
per cent of school children on examina-
tion by dentists are found to have Carl
Gus teeth Only one-third of the Amer
ican people receive any dental atten-
ion whatsoever during year.
Some of our doctors are working to-
day with the education given them 30
years ago. They are antiques that need
repolishing Our facilities for post
graduate work are still inadequate In
view Of the opportunities We poss ess for
developing the highest type of post
GRADUATE instruction. our present offer
ings seem feeble indeed Even If they
were adequate. however. we should have
to find a method whereby the doctor
could leave his practice for one to six
months and. on his return. find 1t still
waiting for him.
Among 1850 families who kept rec
ords Of their total medical charges
during year, a recent survey revealed
wide range Of charges per family
There were l738 of these families
whose total annual incomes for the year
were under $4,000 per family. Forty
per cent of these low income fam
lilies incurred medical costs for the en-
tire family Of less than S25 for the
year. 20 per cent had charges from s25
to $50, 81 per cent from $50 to S1OO.
IA per cent 500 to $3.50. per cent
$3.50 to $500, per cent $500 to 81 900 and
two-tenths of per cent 81 900 to 50. 500.
Eighty-one per cent Of this group had
bills Of less than 500 for the year.
and would pay their medical charges
without serious hardship but the re-
manning l9 per cent must impair their
living standards. draw on savings or
borrow money if they are to meet their
expenses. The 81 per cent paid only
SO per cent of the total bill of the en-
tire group, while the l9 per cent were
<a ~.
making the average per family eight
times as high in the latter group
Few "Gougers" in Medicine.
No we'll informed student of medical
economics believes for a moment that
the patients difficulty in paying med
ical costs is primarily or basically due
to excessive fees on the part of physi-
clans and other practitioners. There
are few 'gougers" in medicine, just
as there are in all walks of life, but
any impartial analysis of the incomes
OF physicians leads to the conclusion
that in view of the time devoted to
training and education. and the re-
Sponsibilities assumed. there is no gen.
eral overpayment of practitioners In
fact. one Of the most significant aspects
of the practice of medicine in the Unit.
ed States is the financial precarious-
ness and insecurity of the major prac-
titioners concerned.
Good medicine today has to b. mere
costly than the sCod medicine of even
25 years ago. but If our talent for pro-
ducing medical services economically
and efficiently is intelligently organized
the cost should not prove too great for
our present society For inadequate
medical services. produced with all the
oSfa ir,h in, lf1-ic,
tlce, we now pay about $50 per capita