Evening star., 1949-05-01
Pro-

Voluntary plans are complete
lily inadequate to meet the need oi
most of the population, pro.
ponents Of nation health insur.
ance say.
Even the conservative Ameri.
can Medical Association now
agrees that prepayment insurance
is an answer to the payment Of
medical expenses. But voluntary
systems fail to meet the need.
! Under a compulsory plan, Blue
Cross voluntary hospital pre-
payment and Blue Shield (volun-
tary medical care prepayment
programs could continue to Offer
supplementary" benefits in areas
where the compulsory plan may
not be able Immediately to offer
full services because of limited
facilities.
After full coverage and protec-
ton are attained. the voluntary
/ plans could continue to represent
groups of doctors and hospitals
in dealing with local government
tai agencies and community COM
mittees to handle submission OF
claims and payment for them
This would relieve doctors and
hospitals of administrative loads
and "red tape" tie-ups which seem
to be one Of their greatest fears
Objections. Cited.
There are many reasons why
voluntary plans cannot cope with
the problem of medical and hos
pital costs, in the view of compul-
sorry insurance advocates.
These plans. they say, are aimed
only at middle-income groups.
And they must use large amounts
of money to "sell" and enroll par
ticipants, then to administer the
benefits.
But even all the people who can
afford to join these programs do
not want to take advantage Of
them. Some people would rather
gamble with their previous good
health records. Others, who join
and do not need services, feel the
investment is not worth while.
Those who do need services, and
know it, are most likely to join
the plans and remain in them.
Thus, voluntary insurance is
most likely to attract persons who
need the care most-bad risks,
who keep up the cost of care
while those who are better risks
are more reluctant to come in.
BY the very nature Of voluntary
plans, they must set up regula-
tions that restrict some people
from joining, argue advocates Of
National insurance. Other regula-
tions restrict the amount Of serv-
ice. 4sg
Groups Required.
Most plans require that appli-
cants be employed in a group
whose employer wants to partici-
pate. The doors are closed to in
dividuals. Only recently. Group
disqualification, Inc. in Washing
ton. decided to allow persons over
65 who were not working to re-
main eligible for benefits.
But many more people are bar
red because they cannot afford the
fiat rates that plans charge for
their limited service. They can
offer limited service at a reason
able cost, but not ample protec-
ton. If these rates are lowered,
the plans cannot raise their bene-
fits. If the rates increase, more
benefits will be open to fewer
people who can pay the rates.
Under National health insur-
ance, however, everyone would pay
what he could afford and there
would be no such restrictions on
enrolment. This plan would not
cost the wage-earner more to get
protection for his wife and de-
pendent children.
Serve Restricted Group.
Voluntary plans can serve a re-
stricted group, but the mass of
people are not satisfied with plans
laden with restrictions, which
meet only a part of their needs.
The National compulsory plan
would foster group-practice pro-
grams by local doctors. which, es-
pecially in areas short of doctors,
would improve and expedite medi-
cal care.
Another failure of voluntary
plans is that they have no stand
ardization. In one area, a plan
offers fairly complete protection
against hospital and doctors bills.
In another. it is much weaker.
Voluntary disqualification protec-
ton plans are far ahead of the
pre- payment medical care pro-
grams. How far doctors will al
low the latter to grow is still an
unanswered question.
1t would appear the ANA
showed no great confidence in the
ans-certainly not to the extent
1t professes-when four months
ago it refused a proposal by DR..
Paul r. Hawley, Blue Cross and
Blue Shield director. to reach
some National Standardization in
benefits of the plans.
HyaffsviIIe Mothers 10 Hear
Visiting British Teacher