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

Yoar doctor would be wrwk.rg
for the Government. say eppc-
nenis O. the plan
II Is foolish TO say ne could STAY
cut q The program Except N ssc-
lated cases, there would noa N
enough demand for his services
The doctor would have FAR lrA,
assurance Of being paid adequate.
~ than he has now.
No doctor rtiosees about his un-
paid bills, But he knows tlsresss h
Iexperiencs that his eArnsngs de-
pend on ais ability 10 give service
He gears his living 20 that income
and Is free to pursue ms nsctrs-
sionAl practice. s.nes he Is ecxs
able 10 do II as an individual
In q study Of this plan last year
the Brookings Institution pointed
out that financial incentives are
not necessarily selfish.
a successful person may seek
the financial rewards OF Alccexs
because they enable him 20 CO
what he wishes for others IN &C
cordanee with his cwn lights. II
declared.
Would Choose Fee Payments.
II this plan were enacted. medl-
cal authorities say most doctors
would choose the fee basis method
OF 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
Government in checking and pay
Ing claims. The load would be 10
great. opponents feel. that in Or
der TO be practical. the plan would
have 10 move 10 the capitai.on
method. as Britain has. This, they
feel. is just one step away from
moving directly TO q Government
salary.
There are other DISADVANTAGES
to the fee-basis method. II would
foster a lack OF control. I, 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. II has
become slavery. In trying 10 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
diagnosis. the groundwork OF all
medicine"
Encourages Fee Splitting.
The report points out that every
doctors ONCE has It's filing cab
met for Government forms. rec
ords and cards. necessary for the
myriad Of medical services. drugs.
medicines and other items.
1t would not be possible for pa
TENTS to 70 directly to specialists
II they are under the plan. This
would give general practitioners q
tremendous control over special
lists, which would help neither OF
them. II also would be an open
door invitation to such practices
as "fe-splitting." In which the I'M
scrupulous general practitioner
could receive q part OF the fee col
lected 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 to be
necessary. After the act was
passed. they fear. these things
would be beyond their control.
The administration bill provides
there would be no distinctions In
patient doctor relationships as 10
race or religion. The problems
this would pose In many areas
already short Of colored doctors
Ii obvious.
National insurance advocates
are oyer-optimistic TO state they
can wipe out medical indigency
at a fell swoop. Thousands OF
people, not covered by the plan
and who would remain needy.
would have 10 be cared for by
charity. Federal or local govern
ment aid.
ProIong Hospital stays.
This would mean. for hospitals
forced into the plan. no decrease
In their problem Of setting paid
for treating needy patients. And
all too often the public has found
that services In municipal and
State hospitals suffer from made
quate government appropriations.
Those persons covered. rather
than facing prospects OF unlimited
care. would more likely be re-
stricted because Of the tremeD-
dous expense In operating hos
pitfalls. The doctor who tended 10
prescribe excessive drugs and hos
pital faciiities-and there would
be such q tendency--wouid Soon
find funds running out. The re-
suit would have to be q tightening
OF regulations.
g.