The people's voice. [volume] (Helena, Mont.) 1939-1969, 1946-04-12
C0MPLE C0VERAGE UNATTAINABLE
UNDER VOL UNTARY HEALTH PLANS
SERVICES LIMITED, CONTRIBUTIONS NOT BASED ON
ABILITY TO PAY; CONSUMER NOT REPRE-
SENTED IN MANAGEMENT

The following is second in a Sc
ries of articles about the Wagner
Murray-Dingell National Health Bill
IS. 1906, HR 4730) and the need for
such legislation, in view of the in
adequacies of numerous voluntary
health plans.
The National Health act provides
among other things for comprehensive
prepaid personal health services fol
gainfully employed workers and theii
dependents. Physicians care in the
office, home and hospital, and hospital
care would be provided by physicians
and hospitals of the patients choice
X-ray and laboratory services, and re-
lated services, certain medicines and
appliances, and POSSIBLY limited)
dental and6home-nursing care would
also be provided.
Some of the services provided under
this bill are now available to some
people through voluntary prepayment
plans. The questions are raised, "Why
can't voluntary plans do the whole
job? Why have compulsory insurance
system?"
Why Voluntary Plants Can't Do the
Job. The reasons are found in the ex-
periences of the voluntary plans them
selves, why such plans can't do the
job.
Complete coverage UnattainabIe. No
type of voluntary plan, here or abroad,
has succeeded in including all of the
population in a region or has even ap-
proximated this goal. AS a rule, those
who are most in need of protection
are not covered. Experience the world
over has shown that only through So
cial insurance can complete coVerage,
and certainly coverage of those most
in need of protection, be assured.
Membership Restricted. Most or all
existing voluntary plans have restric-
tions. some will not enroll persons
above or below a specified age, or per-
sons not enrolled in groups, or per-
sons above a specified income. Some
are limited to particular occupational
or other groups.
Services Limited. Service provided
in voluntary plans is usually limited,
and such plans are tending to narrow
the scope of services offered instead
of broadening it. With only a few ex-
ceptions, the only plans with substan-
tial membership are those providing
only hospital care or care while the
patient is in the hospital In most of
the plans with any considerable mem
bership care is not available until
the patient is already seriously i'll
and needs hospital surgical or obstet-
rical care. Most plans will not give
care for pre-existing conditions or
chronic illness and many exclude care
for various specified conditions.
Patient Charged Extra. Many plans
that give more extensive care limit
the total money value of care that
will be provided in year; or they
require the patient to pay regular fees
for, the first one or two calls in each |
illness, thereby discouraging the pa
tient from seeking care early in an ill |
ness.
Costs Are High. Because voluntary
plans tend to attract those who expect
to need medical or hospital care, the
premium costs are necessarily higher
than with comprehensive coverage.
Enrolment costs, and the constant
turnover in membership, contribute
to increase the overhead costs of vol
untary plans.
Contributions Not Related to Ability
to Pay. Usually in voluntary plans con-
tributions are not related to income;
under the National Health act pay
ments would be related to ability to
pay.
Consumer Not Represented in Man.
agement. Voluntary plans owned by
groups of physicians or sponsored by
medical societies exclude the consum-
er from planning and management.