Evening star., 1955-11-23
Bitter Pill

John McKelway's factual re-
porting on medical subjects is
one of The Stars fine public
services. In a recent article he
explained the social and politi-
cal challenge facing our local
Blue Shield surgical ana
obstetrical service prepay
ment plan. Somehow doctors
must md q practical method
to extend this self help pre-
payment insurance to include
medical service in hospitals
and minor surgery in the doc
tors ONCE.
Mr.. McKelway indicated .
false start in the early l940s
was due to . lack Of public
interest. He had no way OF
knowing that our real problem
then, as well as ct present, was
one Of medical economics. The
false start, referred TO. was
Mutual Health Service. Robert
v. Fleming, chairman OF our
Citizens Advisory COMMITTEES.
told us why IL wasn't practical:
Single persons earning more
than 42, 900 q year or family
groups whose combined EARN
ings exceeded $500 were not
eligible to subscribe. As Mr..
Fleming explained, participa-
ton would be limited TO those
least able to afford it and when
their situation improved so
they could afford it, they be-
came ineligible to continue.
He urged a policy Of all-in-
elusive participation similar TO
group disqualification but to
require those wanting more
than minimal benefits to pay
the difference.
Our medical society rejected
Mr.. Flerning's recommendation
on the grounds it not only
meant standardized fees but
would eventually deprive the
doctor Of his most profitable
source OF dependable income.
How long would our paying
patients tolerate such dis
criminatory fee schedules?,
Would they not begin to say:
Doctor. how come that you
charge John Smith $50 for de-
lFering his wife's baby and $50
to remove his appendix and
you charge me four times as
much for the same service? ]
don't make four times as much
as Smith. just because ! can
pay my way at a higher level,
why do you have to soak me.
Doctor? II you give Smith q
break, why can't you be as
merciful with me?"
We listened to the voice of
the turtle and junked Mutual
Health Service. But now we
have incorporated Mr.. Flem-
ing's recommendations In our
present setup and something
still lis lacking. History caught
up with us by making 80 per
cent Of our patients eligible for
our reluctant concessions. "A
higher standard Of living for
all has raised our national
average family income. And
the above-ayerage family in
come Is leveled of with pun
ishing taxation. Most of us
now are In the same boat. with
little justice for discrimination
in being eligible for health Sc
curity self-help. But our pres
ent problem Is to eliminate
discrimination against the
general practitioner. He is the
day laborer Of the medical pro-
fession. Yet no way has been
found to indemnify him for
the medical care he provides
his hospitalized patients.
Neither does Blue Shield COM
pensate him for office proce-
dures which save subscribers
costly and unnecessary hospi-
talization. On the other hand
the specialist rarely is frus-
trated in the matter Of both
getting his fee and justifying
disqualification.
Blue Shield has learned that
doctors heal patients. not
pocketbooks. Now they have
one thing more to learn: The
general practitioner also heals,
! Thomas e. MattinsIy. MR