Evening star., 1949-04-23
Mr.. Trumon's HeoIth PIon

Mr.. Trumon's HeoIth PIon
One can read from beginning to end
the Presidents message TO Congress on
medical care and he will not find in 1t
the word compulsory.
Perhaps this Is unimportant, for the
essentials Of the plan are clearly set out.
Yet the omission of any reference to COM
pulsion was not an accident. 1t was done
by design and it Is a design that Is not
reassuring
Compulsory health insurance. with the
emphasis on compulsion, is the keystone
of the program. Without this compulsion
the whole structure would collapse. Yet
Mr.. Truman never uses the word, and 1t
would be interesting to know why. Pre-
sumably he Is concerned over widespread
fears that compulsion in his plan would
not stop with the insurance feature, but
would go on to include compulsion with
respect to doctors, patients, hospitals and
medical schools. Mr.. Truman takes ratns
to deny that there is basis for these fears
But this would be more convincing IL he
did not try to gloss over even the COM
pulsory aspect of the insurance program
The principal criticism which lies
against the plan itself, as distinguished
from the manner of its presentation, Is
that Mr.. Truman wants the Federal Gov
ernment to bite of more than it can chew
He gives no cost estimate in his message
nor does he set out any specific plan for
meeting the cost. Heretofore, however
he has indicated that he favors a payroll
tax on both employers and employees to
meet cost which unofficial estimates have
placed at 81 billion In the first year,
ranging up to we'll over IS billion in ten
years.
There are two things to be said about
this. One is that the cost is too great.
despite MIR. Truman's generalized conten-
tion to the contrary. After all, this is only
one item on his domestic legislative pro-
gram. Add them all together and the
total assumes alarming proportions. The
other has to do with the payroll tax plan,
If that is what the President now has in
mind. AS Mr.. Truman himself points out,
the most urgent need for better health
facilities and more doctors, dentists, etc,
is In the rural areas. But how is it pro-
posed to set up an effective payroll tax
system in the rural areas? Or If this is
not contemplated. how would the benefici-
aries of the Presidents plan in the rural
areas be required to pay their fair share
of the cost?
Other criticisms, and they, too, may be
well taken, run to the philosophy embodied
in the assumption by the Federal Govern
ment Of primary responsibility for the
health of the people. At the present stage
of the game this comes down to matter
of opinion, although it should be pointed
out that there is an impressive body of
opinion by no means confined to the
American Medical Association, which holds
that adoption of plan such as the Presi-
dent has in mind would lead inevitably to
state control Of medicine. But even If
Mr.. Truman is right in his denial that
such would be- the result, the impression
remains that he wants the central govern
ment to take on too much. The necessity
for Federal aid In medicine Is as self
evident as 1t is In housing and similar
fields. But any program Of Federal aid
should rest on the premise that all of the
people, as individuals, should do what they
can to help themselves. Taxpayers in one
locality should not be called upon to
assist people in another locality unless the
latter are willing to do the best they can
for themselves This result is more apt to
be obtained through the medical program
sponsored by Senators Taft Smith and
Donnell than through the plan advocated
by Mr.. Truman.