The people's voice. [volume] (Helena, Mont.) 1939-1969, 1944-03-03

sions for medical and hospital care
for the bulk of our population. The
bill amends and extends the existing
Social Security Act to include work
ers and self-employed people and theil
families, totalling approximately 100
ITO millions. The benefits to be de
rived under the bill would be financed
tons from beneficiaries and industry
In this and subsequent articles we
shall discuss only the medical provi
sions of the bill
WHAT DOES "coMPULSoRYv
MEAN?
The beneficiary will be compelled
to contribute a portion of his income
to the Social Security Fund in the
same manner as he does today He
will not be compelled to accept med
ical benefits under the bill. There is
no doubt that some proportion of
these insured persons will prefer to
continue to engage the services of
their physicians under the present
method of private practice. There is
nothing to prevent their doing so.
The physician is under even less
compulsion than the patient. The
physician may or may not, as he
chooses, enter the system of health
insurance. He will be at liberty to
practice insurance medicine alone, pri-
vate medicine alone, or a combination
of the two. He will not be free, how
ever, to accept patient as an insur-
ance patient and then charge him adj
ditional fees for extra" services, be-
cause all services are included in the
bill
FREEDOM OF CHOICE
Doctors have always felt that the
doctor-patient relationship is highly
personal one and that the patient
should have. the right to choose his
physician. The Physicians Forum has
always accepted this premise. But it
has felt that it was unfortunate that
the right of free choice has often been
limited by the patients ability to pay
and that most clinic patients have &C
tually had no free choice whatsoever.
The bill would remove these restric-
lions. A very large proportion of the
present clinic population, which at
present has no right of choice, would
be covered by this bill and hence
would have the right of free choice
of private physician
Mnfbino in ha oaf 10
harm the present personal relation be-
tween physician and patient On the
contrary, the relationship would be
improved, for the physicians fee, so
often source of friction between
doctor and patient would be paid by
the insurance fund and not by the |
patient.
Doctors also will have the right of |
choice under the bill. No doctor need |
accept a patient whom he does not !
wish to treat. He is free to reject |
the patient. There is only one limita-
ton to this right of choice by the |
doctor, in a clause which was evident |
ly included as precaution against a |
possible eventuality That limitation |
is, that if a small group of patients
in the community were to be rejected |
by ALL the general practitioners, then
certainly some step would have to be
taken to secure to these patients the |
medical benefits to which they would |
be entitled. In such a case, the Sur
geon General would distribute such
beneficiaries among the physicians in
the community, because the medical
care of the people in the community
is the joint responsibility of all the
practicing therein.
There is one other qualifying clause
in the bill which limits the freedom
of choice both of physicians and of
patients. We all know that there is
a limit to the number of patients
which can be adequately cared for by
any one physician. Beyond such
limit, the quality of medical care in
deteriorates. There is a pro-
vision in the bill, therefore, which
takes this limit into consideration,
and provides that not more than a
stipulated number of insured patients
nay be in the care of any one doctor.
However, as the number of patients
entitled to care by private physicians
lnder the bill is so greatly increased
,ver the number available now, there
s no reason to fear that physicians
will not have enough patients to treat. t
t is even possible that the reverse
night be the case.
HOW WOULD DOCTORS BE PAID?
The bill provides three possible
icing under the insurance system will
lave the right of choice as to the {
method by which they prefer to be {
aid The method used will be the L
ne chosen by majority of the phys .
clans practicing in the community
Whichever method is chosen, the mon
y will be paid directly to the phys
clan and not to the patient. This is Il
safeguard which protects the phys 7
clan. S
l. Fee for Service Method: This is t
he method currently in use among 7
rivate practitioners. The patient t
avs by the visit; the more visits the
lore pay, only in this case the insur n
nee fund would be billed and not the !,
atient. This method of payment is
ne which is suitable for specialists A
ervices, but we believe it to be bad t
lethod so far as general practition- i
rs fees are concerned, because it a
ffers financial inducement for the