Evening star., 1938-01-24
PHYSICIANS STUDY
PLAN TO PROVIDE
HEALTH INSURANCE.
Medical Society Proposal
Obviates Some Group Pro-
gram Objections.
FUND WOULD BE BUILT
BY PAYMENT OF DUES
Members of Association Could
Choose Own Doctors in "Catas-
trophic Illnesses.
A plan of health insurance for per-

trophic Illnesses.
A plan of health insurance for per-
sons of moderate incomes, which, at
least on the surface, obviates some of
the outstanding objections of the med
ical profession to such schemes in
general, now is being studied by COM
mittees of the Medical Society of the
District of Columbia and the sup
posedly very progressive New York
State Medical Society, it was revealed
at public forum held by the local
organization yesterday afternoon.
This plan has been in operation for
more than a year in the little city of
Brattleboro, VT, and reputedly has
met with considerable success.
1t provides for a voluntary associa-
tion which builds up fund through
payment of dues by its members. Out
of this fund will be met bills for medi-
cal service ranging from S25 to $500.
The association employs no physicians.
Members choose their own physicians
and simply turn over to the society
the bills they receive between these
amounts.
catastrophe Illnesses"
This movement is based on the
theory that the individual with an
average income is not seriously hurt
by the run of 50 to IS doctor bills
encountered in the course of the aver
age year. He can even calculate them
roughly from past experience and al
low for them in his budget. 1t is the
so-called catastrophe illnesses
such as serious accident, major
surgical operation or an attack of
pneumonia. where the legitimate doc
tors fee may run anywhere from $50
to $500. that hit the $2,oO0-S4 900 in
come family harder blow than it
can endure.
Organized medicine. it was stressed
by Dr. Arthur C. Christie, is not un-
alterably opposed to the principle of
health insurance, but has put thumbs
sented in the past-of which the
Group Health Association of the
Home Owners Loan Corp is a fair
example in the light of his
tory, there can be little question that
they will prove expensive failures.
"A thousand or more such schemes
have been tried. Dr. Christie said,
both in the United States and Eu-
rope. Almost invariably their history
has followed a tragic pattern. For
time, reasonably good service is given
and new members are attracted.
Eventually saturation point is
reached Then the funds become in
sufficient. The service drops off badly.
The government steps in, as in Eng
land and Germany. and takes over
the organization. More members must
be had to balance its books. It is
only step to compulsory insurance,
with compulsory payment of dues by
employers and employees. The doctors
ana nurses are government employees.
Politics enters the set-up.
Scope of Schemes.
Such schemes are necessarily for
Che middle class with reasonably ade-
quate, fixed salaries. They make no
difference whatsoever in the medical
care of the unemployed or the great
mass of persons with salaries made
Quate to pay dues.
In Germany, Dr. Christie pointed
out, the sickness rate is three times
that in the United States although
every German has government-paid
physicians to keep him we'll. Health
insurance has been in operation there
for 80 years.
England's sickness rate is twice that
OF the United States. Health in
surance has been in force there for
20 years. It looks as if the longer
'such schemes are in operation the
oftener people are sick. This is due
to two reasons, DR.. Christie explained.
First, folks want to get their moneys
worth and will rush to the doctor
with petty illnesses which they would
not think of consulting a physician
hbout If they had to pay him. Sec
ondly, they do actually get sick of
disease which is no joke, but is
frankly recognized by the medical
profession-"compensation neurosis."
This does not mean that great num-
bers of people fake illnesses in order
to draw benefits. They are just as
truly sick of compensation neurosis
Is they would be of typhoid fever.
With the increase of work, DR..
Christie stressed, it invariably hap
pens that the doctors get poorer and
poorer. They lose their professional
pride in the lethargy of wage earners.
This aspect was emphasized by DR..
Wallace M. Yater, the next speaker
The physician is no longer working
for the patient, but for the insurance
= company or the government. His
bread and butter depends on his pleas
ing his employer, which he can often
do best by keeping down expenses.
Under the compulsory insurance
system, said DR.. F. x. McGovern, the
patient still presumably has the pro-
lection of medical ethics, yet expert
ence abroad shows that these tend
TO deteriorate very rapidly. In the
past three months in Germany, he
said, it has been necessary to enact
= stringent laws regulating nearly every
aspect Of q physicians life, and yet
these laws hardly go beyond what the
average American physician imposes
on himself.
Handed Written Questions.
At the end of the forum DR.. Chris
tie. who presided, was handed writ
ten questions, many Of which were
from members of the H. o. L. c. group,
praising the services being rendered
A.~ ;,1;o