Evening star., 1945-11-19

recommend solving the basic
problem by distributing the costs
through expansion of our existing
compulsory social insurance system
This is not Socialized medicine.
Every one who carries ire insur-
ance knows how the law averages
Is made to work so as to spread the
risk and to benefit the insured who
actually suffers the loss. II. instead
Of the costs Of sickness being paid
only by those who get sick, all the
people-sick and well-were re-
quired to pay premiums into an in
surance fund. the pool of funds thus
created would enable all who dc
fall sick to be adequately served
without overbrdening any one
That is the principle upon which all
forms Of insurance are based.
During the past Is years. hospital
insurance plans have taught many
Americans this magic OF averages
Voluntary health insurance plans
have been expanding during recent
years, but their rate of growth does
not justify the belief that they will
meet more than a fraction of our
peoples needs. Only about 3 pei
cent or per cent of our population
now have insurance providing COM
prehensive medical care.
Would Prevent Disease.
A system of required prepayment
would not only spread the costs OF
medical care, it would also prevent
much serious disease. Since medi-
cal bills would be paid by the insur-
ance fund.- doctors would more often
be consulted when the first signs OF
disease occur instead OF when the
disease has become serious Modern
hospital, specialist and laboratory
services. AS needed. would also be-
come available to all, and would i'm
prove the quality and adequacy OF
care. Prepayment of medical care
would go long way toward furnish
ing insurance against disease itself
as we'll as against the medical bills.
Such a system OF prepayment
should cover medical, hospital. nurs.
ing and laboratory services. II
should also cover dental care, rs
fully and for as many OF the popu'
lation as the available professional
personnel and the financial re.
sources Of the system permit.
The ability OF our people to pay
for adequate medical care will be
increased if, while they are well
they pay regularly into 4 common
health fund, instead OF paying
sporadically and unevenly when
they are sick. This health fund
should be built up nationally, In
order TO establish the broadest and
most stable basis for spreading the
costs Of illness, and to assure ade-
quate financial support for doctors
and hospitals everywhere. If we
were to rely on State-by State ac-
ton only, many years would elapse
before we had any general coverage
Meanwhile health service would con-
tinue to be grossly uneven, and dis
ease would continue to cross State
boundary lines.
Medical services are personal
Therefore the Nationwide system
must be highly decentralized In ad-
'ministration. The local administra-
tive unit must be the keystone OF
the system so as to provide for local
services and adaptation to local
needs and conditions. Locally as well
as nationally, policy and admins
tration should be guided BY advisory
committees in which the public ano
the medical professions are repre-.
sented.
Rates Should Be Adjusted.
Subject to national standards
methods and rates of paying doctor;
and hospitals should be adjusted
locally. All such rates for doctor,
should be adequate, and should be
appropriately adjusted upward TO,
those who are qualified specialists
People should remain free to
choose their own physicians and
hospitals. The removal of financial
barriers between patient and doctor
would enlarge the present freedom,
OF choice. The legal requirement,
on the population to contribute in.
wolves no compulsion over the doc.
tors freedom to decide what serv.
Ices his patient needs. People will
remain free to obtain any nav TO,
medical service outside OF the health
insurance system If they desire. ever
though they are members OF tn.
system; just as they are free to SEND
their children to private instead O,
to public schools, although they
must pay taxes for public schools.
Likewise physicians should remain
Tree to accept or reject patients
They must be allowed to decide for
themselves whether they wish to
participate in the health insurance
system full time, part time or not
at all. A physician may have some
patients who are in the system
and some who are not. PHYSICIANS
must be permitted to be represented
through organizations OF their own
choosing, and to decide whether
TO carry on in individual practice
or to join with other doctors in
group practice In hospitals or In
clinics.
Our voluntary hospitals and our
city. county and State general hos
pltals, in the same way, must be free
to participate in the system to what.
ever extent they wish. In any case
they must continue to retain thei,
administrative independence.
Voluntary organiza tions which
provide health services that meet
reasonable standards of quality
should be entitled to furnish service,
under the insurance system and tc
be reimbursed for them. Voluntary
cooperative organiza tions con.
cerned with paying doctors. hos
pitfalls or others for health services
but not providing services directly
should be entitled to participate i,
they can contribute to the efiiciency
and economy OF the system.
Insurance-Minded People.
None Of this is really new. The
American people are the most insur-
ance-ninded people in the world
They viii not be frightened of from
health insurance because some peo-
pie have misnamed it "socialized
medicine" :