A “HEALTH FUND”

Dominion, Volume 25, Issue 275, 16 August 1932, Page 3

A “HEALTH FUND”

Medical Economist’s Plans APPLICABLE TO N.Z. Benefit of Group System VISITING DOCTOR’S VIEWS Dominion Special Service. Christchurch, August .14. An organised system of medical care under which every man, woman, . and child in the State would contribute toward a common “health fund,” and receive in return expert medical service embracing not merely the .cure but the prevention of illness, is that envisaged by Dr. Allon Peebles, a distinguished medical economist of the United States, who is 'now approaching the end of a five years’ research into this problem. Dr. Peebles, who has arrived in Christchurch on a holiday visit, declared in an interview that not 10 per cent, of the people of the United States were receiving the full benefit of scientific knowledge in medicine, partly because individual doctors could not apply it and partly because the people themselves could not pay for it. , The system which he urges, and which he claims may be as readily adopted in New Zealand as in the United States and Canada, would at once increase the efficiency of medical practice to a marked degree and reduce its cost to the Individual. “Group medical service must come —the situation demands it;” declared Dr. Peebles. Thorough Investigation. Dr. Peebles, who is a Ph.D. of Columbia University, is a member of the committee on the Costs of Medical Care, composed of 50 doctors, dentists, nurses, public health officials, and representative laymen, which has been engaged on a five years’ research programme on the following three subjects:— , , . (1) The extent of illness and defectiveness in the United States and the existing facilities for taking, care of sickness. (2) The costs of medical care to individual families and to the nation, and the incomes received by physicians, dentists, nurses, etc. (3) Existing experiments in the provision of, and payment for, medical care. Dr. Peebles explained that the committee was essentially a fact-finding organisation, and w r as not obliged to find solutions for the problems involved. At the same time it was committed to making a series of recommendations to the public, and when these were brought forward in November next State conferences would be called to discuss them. Through the 15,000 people who bad been receiving its publications, the committee had already built up an informed body of public opinion. Two Main 'Necessities. “There are two main necessities in the situation as it is to-day in th® United States,” said Dr. Peebles. The first is that medical service should be provided on an organised rather than an individualised basis. Personally, I believe that independent private practice cannot be so efficient in a medical sense as group practice, and cannot bo so economical as group practice. When the practitioner could carry all his instruments and all his technique in a saddle-bag there was no need for co-operative practice; but to-day, when more and more instruments are developed, and the science of medicine becomes more and more specialised, it Is very wasteful and very expensive for each man to have a full equipment when 15 or 20 physicians could use one plant in common. “Even the reduction of expense which would be brought about in this way is second in importance to the improvement in the quality of medical care—an improvement that would result not only from the stimulus given to each man by co-operation with his fellows and the ease of consultation for the public, but through the fact that each practitioner, would have a well-equipped laboratory and would be able to use the most modern aids to accurate diagnosis and sound therapy.” _ ' The second necessity was that payment for medical care should be made on a regular annual basis. The present distribution of the costs of medical care was very unequal. Every year a majority of people paid nothing, while a small minority was severely hit. Systems of Group Practice. Different systems of group practice with annual payments had already been put into effect in the United States. Many large business firms deducted small amounts from their employees’ pay, contributed subsidies themselves, and thus organised very efficient medical units as part of their businesses. Many of the universities had taken similar action. Finally, there were private group clinics —associations of physicians, mostly on a profit basis, which entered into contracts with individuals to give medical care for an annual fee. “There is no earthy reason why some modification of these schemes could not be worked out- in New Zealand,” added Dr. Peebles. “There must be businesses that have as many as 1000 employees; if there are not, two or more businesses could combine. As for the general public, for them, too, some scheme could be devised, although one could not have a complete group clinic for less than 40,000 to 50,000 people. Personally I am much in favour of group practice.” Mere group practice, he emphasised, did not guarantee reduced fees, although it did make reduced fees possible. Ho himself could not see any other effective method of control of the economics of the system than control by the State: not that the incomes of the doctors should be fixed by law, but that some kind of effective administration should be set up to control fees.