Evening star., 1937-10-17

something very close to State
medicine confronts the District
u OF Columbia.
The proposed health insurance
clinic Of the Home Owners Loan
Corp. represents such a far-reach-
ing move in this direction that
the great American Medical Associa-
ton, whose membership includes at
least 80 per cent of all qualified ply
sician in the United States, has
stepped into the local situation.
The medical profession of Wash
ington itself is highly alarmed at q
potential threat to its very existence.
4 Here, as the American Medical As
sociation analyzes the local situation,
editorially, is about what the proposed
set-up will amount to:
A presumably adequately stated
medical and surgical clinic will be
established and physicians and other
employees paid reasonable salaries for
their full-time services.
Employees of the Home Owners
Loan Association will be charged a
small monthly fee. In return they,
and members of their families, will
be entitled to any medical services
they may need, with certain minor
exceptions, at this clinic free of
charge.
Check-Oh Proposed.
The clinic will be subsidized at first
by a national foundation. According
to its incorporation papers, member
ship will not be limited to workers in
the Home Owners Loan Corp, but
anybody in the Government service
in Washington may join. Thus it may
include conceivably two-thirds of the
population Of the city. 1t is even pro-
posed-the American Medical Asso-
citation believes that this will be lille
gal-that fees be collected by the
check-of system from Government
pay rolls.
This set-up will be ostensibly pri-
vate agency. No Federal funds, SO
far as known, will be directly involved
But all the directors will be Federal
officials. All the customers" will be
NSSioi SLAAplCJCo itNdl
foresee such close tie-up with the
Government that the clinic will be
factually, while not theoretically.
practically indistinguishabl from a
Federal bureau
And as a private enterprise, the
association involves something which
strikes at the heart of the private
practice Of medicine, something which
medical ethics cannot tolerate. That
is the exploitation of the practitioner
hiring a mans services and then re-
selling them. There is, perhaps, no
loglcai objection to Home Owners
Loan Corp. being as philanthropic
towards its employees as it pleases.
1t might, If it could obtain legal
sanction and Federal appropriations,
provide any sort Of medical care alb
solutely free for everybody in Wash
ington, providing no compulsion was
exerted. 1t would be tough on the
doctors, but there wouldn't be much
they could say about it. Various pri-
vate businesses do something of the
sort. What is proposed here is very
different. The clinic, it seems, pro-
poses to set itself up in the business
of selling medical services-of buying
them in wholesale lots and dispensing
them over the counter in retail lots.
The intent behind this organization,
of course, is entirely idealistic.
Could Be Used"
But supposing it eventually got into
the hands Of gang of crooks. or
even hard-headed business men with
eyes only on profits?
Specifically it would seem that
there is a good deal to be said in
favor of some such set-up. Some
Of the arguments advanced by physi-
clans are not likely to stir much en-
thusiasm. With some very sound ar
guments at their disposal, the medi-
cal profession has shown an unfor-
tunate tendency to waste energy on
some very tenuous rationalizations,
often contradictory.
1t seems, for instance, rather silly
to cry Socialism" and expect this
to be sufficient argument. So is
the municipal water system or school
system Socialism"
Perhaps no more perplexing eco
nomic problem faces the American
people today than that of medical
care. Consider the local situation.
1t may as well be admitted that there
are few Government employees who
do not live up to their incomes.
Their salaries are expended on rou-
tine bills and a few luxuries with very
little, if anything, left over for emer-
gencies.
Sickness is almost always an emer-
gency. It cannot be foreseen. Conse-
quently, with the Washington way of
living, there is seldom any money to
pay for it. 1t necessitates going into
debt-perhaps with overwork and
worry which brings on more sickness.
Men and women often will let them
selves become very sick indeed before
calling doctor. They can't afford it..
Moralists may argue that this is a
bad way to live. One should lay aside
money for emergencies, and reduce
ones scale of living accordingly. But
we are dealing with actualities, not
ideals Washingtonians are caught in