Evening star., 1949-04-28
Health insurance
u. S. Need of Compulsory Plan
Strongly Disputed, Defended
(Second of a SeresJ
BY George severidse
Does the Nation need national compulsory healt
insurance?
NO
No, say its opponents.

| NO
No! say its opponents.
The emphasis OF the Truman
program, they say. Is In the wrong
place.
Government could solve Q large
part Of the medical-economic pro-
gram, II it would carry out . gen
orally agreed upon responsibility
for the care Of low-income groups.
A large portion Of this care should
be provided by local governments,
with aid from Federal funds. as
provided In other bills now before
Congress.
! Voluntary health insurance
plans have not yet provided com
plete protection for the middle and
low income groups. But they are
giving good protection against the
greatest expense-large hospital
bills-to more than 10000, 900
Americans. In their expansion lies
the answer for the vast majority
Of the middle income public. Peo-
pie are being educated to the point
where they cannot afford to pass
up such insurance.
Would Develop Resources.
But primary emphasis should be
placed on developing better medi-
cal care, enough doctors to pro-
vide 1t and enough hospitals for
them to work in.
A prominent Washington ply
sician who is b member OF the
American Medical Associations s
House of Delegates, listed expan-
sion of basic public health pro-
grams as the single most impor-
tant health need.
BY these basic programs. which
are taken for granted in many
urban centers, he meant sewage
control. adequate water and milk
inspection. child and maternal
care and down e-hnd-
ing programs to combat COM
municable diseases. About 40
000, 900 people. he pointed out,
live in areas that lack the basic
protection of public health pro-
grams. And only about 10 per
cent of the present programs ap-
proach reasonable standards Of
adequacy.
Diagnostic Centers Urged.
In q plan he recently proposed
DR.. Paul B. Magnuson. Veterans
Administration medical director,
hit on another health funda-
mental in calling for 1 network
of diagnostic centers. the basis
of preventive medicine. These
centers, he said. could be oper-
ated in every community with
local control.
Until it recently brought out
a 12-point program the American
Medical Association confined itself
chiefly to a war Of words. which
antagonized many Of its own
members. against national health
insurance. But most. doctors and
medical associations oppose the
plan.
Doctors point rightfully to the
Job medicine has done on q free"
basis. One of the best examples
of medical progress Is the grow
| ing Importance Of heart ailments,
cancer and diseases OF the aged
as causes of death. Many dis
eases have been nearly elimin-
ated as death causes. People, in
fact, now are living to die from
ailments of the aged.
But If people are educated to
know what good health is. they
will have less need for medical
care. A compulsory plan that
would invite trips to the doctor
at no cost would not be All in
centiye to good health habits.
There Is no way of knowing
how many people stay away from
doctors because they can't afford
| to see them. For most people,
doctors fees are not calamitous
burdens. A Brookines Institution
study last year placed the aver
age cost Of medical care at be-
tween 4 and S per cent OF family
incomes.
In response to Mr.. Ewing q
statement that 325, 5,0e0 people die
every year whom could be saved,
DR.. Paul r. Hawley. former Vet
erans' Administration medical di-
rector and one OF the most force
| full figures in American medicine,
answered, 1T is not true this is
due to 4 want Of medical care. "
Opposes Radical System.
DR.. Hawley said he recognized
elements of weakness In medical
care which should be corrected
without delay. But he said he
strongly opposed their correction
by radical. socialistic methods
which would demoralize the pres
ent organization of medical care
to the point of producing COM
plete chaos"
while the political control Of
the ANA remains in the hands
of ultraconservatives.'' he con-
tinued. my association with the
rank and file Of the medical pro-
fession throughout the country
has convinced me that the ma
jority Of physicians-certainly the
majority of the better ones
think about as I do"
DR.. Hawley, who directed Army
medicine in Europe during the
war. said the s'old myth" Of the
| s. .OOO, 900 draft reflections has
been completely exploded long
since"
This was not due to any lack
| of medical care but to conditions
which modern medicine cannot
| yet prevent, and to an inordi-
nAtely severe set Of physical
standards insisted upon by our
lown armed forces" he said.
DR.. Hawley said he thought ne
could accept without any. great