Evening star., 1936-04-26

Pile fact that the considerable part
Of the population that is without ade-
quate medical care Is also without
adequate housing and fuel and cloth
ing and food, and most other things.
You can't discuss the economics
of medicine separately from the eco
nonlics of the rest of life" writes a
South Dakota doctor: "In these parts
during the past three years the price
of corn has varied from Is cents to
81 bushel: oats from cents to 10
cents a bushel; hogs from $3.50 to
SlO50 per 100 pounds" Adequate
medical care is only one of a number
of things to which these folks cannot
give stable financial support.
Many of the doctors point out that
attempts to solve the problem from
only the economic angle, or from only
one angle of any kind, will fail As
one doctor put 1t in his letter: How
ever the problem before us is to be
defined, it certainly cannot be defined
as the need Of making mediocre med
ical care available to a greater num-
ber of people"
Leaders Recognize Problem.
Our present correspondence shows
that the leading medical scientists
of the country, men of lucid mind
and large temper, recognize that there
is problem and that medical men
wish to aid in solving it.
But they would define it first. They
would break up the problem into its
component parts in order to see If
any one answer will really meet them
all.
Here are some of the questions they
raise:
What is adequate" medical care?
Before We attempt to solve the prob
lens of the availability of medical
care and its costs, must we first get
rid of the quacks that prey on the
public, of self nominated specialists" {?
Are we in a position to define "ade-
quate" medical care in terms of the
whole country, or to say whether
there are now "too many doctors" or
too few?
Are our citizens trained to recognize
adequate medical care? Is growth
in public understanding a preliminary
necessity,
Can medical care be successfully
organized" on a broad national base
so long as a large part of the public
invokes medical aid only after the
drug store clerk has failed to cure?
Care for INDECENT.
How should Government and medi-
cal men cooperate to care for the
INDECENT sick in some less haphazard
manner than now prevails in most
places? How shall We define the in
digent"? Is the cost of their care, OF
whatever nature. a logical charge
upon local or State tax funds?
Are there practical ways of bring
ing disqualification within reach OF the
low-income group that can meet the
cost of ordinary illness, but not Of
catastrophe" illness? Is the hos
pital insurance plan the solution?
Can prepayment for medical care
be made to work?
40 lllC AloGA oilvS PA AA4SiPiN '7oNAiN - ,
related to health protection-i.e.. is
illness to be classified with cyclones
and lightning and other "acts of
God" to be insured against. on the
lottery principle; or, like flood control,
should it be subjected to more con-
structive and preventive planning or
the part of the State and the indi-
vidual?
Are Costs Reducible?
Are some of the present costs Of
medical care Immediately reducible?
Could the resources of tax-supported
laboratories and unsupported hospi-
tails be made more generally available
to practitioners, thus cutting greatly
the cost of X-ray, laboratory tests,
etc?
Should we return to less elaborate
tradition in building and operating
hospitals and by getting rid Of the
frills cut the cost Of the hospitals
daily rate?
How can we reasonably get good
young medical men to settle in sparsely
populated districts? How can Govern
ment and medicine cooperate to this
end?
These and a multitude Of other
questions are raised and sometimes
answered in the replies to this in
quiry.
Some of the men point out that il
only a few of these leading questions
were answered-if, for instance, by
cooperation between medical men
and local governmental authorities the
care of the INDECENT sick and the pay
ment for 1t were adequately organ
lied in every State and every COM
munity-the rest of the problem might
fall into very different perspective and
more manageable dimensions.
Does the whole answer lie in q
grand new deal? Or in partial an
swers to parts of the problem? Is
evolution or revolution indicated? On
this point many of the most thought
full of our correspondents are not dog
matte. They want it recognized as
jointly problem of scientific medi-
cine, of community organization, OF
government. Above all, they would
reject any solution that involves COM
promise as to the primary considera-
ton of maintaining the highest achiev.
able quality in medical care.
The United States, they point out
now holds-in medical research, edu-
cation and practice-the leadership
that IS years ago belonged to Europe
To retain it, to advance it, will, in the
long run, be the only direct and "ade-
quate" way to aid Our millions in need
of medical care, whether the wealthy
or the INDECENT. And no plan, they
believe, for making medical care more
generally available can genuinely serve
the "underprivileged" if it fails te
meet this test.
III Roe-o~c:h1o