Evening star. [volume] (Washington, D.C.) 1854-1972, 1949-04-30


for TIE Government. say cgspe~
Elents Of the plan
II is .oollxh to say ne 6s,4sd st@y
5at Of tire program kxewes as l&o~
lated c&SeS. there woQ.a 10. ex
enough demand .os has Se;H KRIS
The doctor scsald have far }tss
assurance Of being PAD adequate
u than nc has ROW.
No doctor re1oacrs about D. - un.
paid bills But he knows tlsycush
tbs; MS eaggs.saes dr..
pend on his ability Ia give ~egH4cs
He sears his living 70 thai income
anc Is free 70 pursue hsS osuteS-
SloI2Al practice, Saaee he - tseSi
able 10 do IL as an individual
IN a study ot this plan laSt year
The Rrook!ngs Institution pointed
pat that financial incentives are
aot necessarily selfish
"A successful person may EEK
The financial rewards o. success
because they enable hum a 90
what he wishes ior others N &c
oordanee with his own lights it
declared.
Would Choose Fee Payments.
II this plan were enacted. meeii-
cal authorities say most doctors
would choose the fee bass method
d payment This naturally. would
require tremendously more records
and administrative machinery
Than the other two methods. be-
cause each service would be han
died separately,
This administrative load would
be passed along 10 the Federal
In checking and pay
Ing claims The load would be so
great. opponents feel. that In OF
der 10 be practical. the plan would
have 10 move TO the eapitatlon
method. as Britain has, This, they
teel. is Just one step away from
moving directly 10 q Government
salary.
There are other disadvantage
10 the fee-basis method. II would
foster lack OF control. II would
Increase the doctors incentive 10
give unneeded services, II would
tend TO prevent him from telling
patients there is nothing wrong
with them that medical care can
help.
In England. according TO a re-
cent dispatch TO The Star this Is
what Is happening to doctors;
Many doctors find that the
desk and administrative work
which the service has piled on top
Of their purely professional duties
Is too much for one brain and one
pair of hands. Nowadays. IL has
become slavery. In trying TO cure
other people. the doctor Is in dan
ger of killing himself, What is
more serious. he no longer has the
time for careful and considered
the groundwork OF all
Encourages Fee Splitting.
The report points out that every
doctors Office has It's filing cab
met for Government forms. rec
ords and cards. necessary for the
myriad Of medical services. drugs.
and other items.
It would not be possible for pa
tents 10 go directly 10 specialists
II they are under the plan, This
would give general practitioners
control over special
lists. which would help neither Of
them. It also would be an OPEN
door invitation TO such practices
as "fe-splittinR." In which the TN
general practitioner
could receive a part OF the fee col
Ieeted by the surgeon or other
specialist he called in. whether
there was a need or not,
No one has spelled out exactly
what services would be included in
sickness insurance" There might
be ceilings on rates. More i'm
portant. there might be ceilings on
services doctors would know 10 be
necessary. After the act was
passed. they fear. these things
would be beyond their control,
The administration bill provides
here would be no distinctions in
patient doctor relationships as 70
race or religion. The problems
This would pose IN many areas
short OF colored doctors
IS obvious.
National insurance advocates
are over optimistic TO state they
ian wipe out medical indiRency
1t a fell swoop. Thousands Ct
people. not covered by the plan
and who would remain needy.
would have TO be cared for by
charity. Federal or local govern
nent aid.
ProIong Hospital Stays.
This would mean. for hospitals
forced into the plan. no decrease
n their problem of getting paid
Tor treating needy patients. And
all too often the public has found
that services In municipal and
State hospitals suffer from made
yuate government appropriations
Those persons covered. rather
han facing prospects Of unlimited
care, would more likely be re-
stricted because Of the trench
dous expense tn operating hos
pitfalls. The doctor who tended 10
excessive drugs and hos
pital facilities--and there would
De such a tendeney--wouic soon
ind funds running out. The re-
suit would have to be tightening
u regulations.
Patients whose home conditions
we're not ideal would prefer 70
stay In hospitals for longer PC
I'LL. - MSx.sR ksn~