SOCIALISED MEDICINE

Otago Daily Times, Issue 23830, 9 June 1939, Page 4

SOCIALISED MEDICINE

AMERICAN DOCTORS' FEAR CREATION OF MALINGERING COMPLEX OPPOSITION VOICED Writing in the Christian Science Monitor on compulsory health insurance, Dr Peter Irving, secretary of the Medical Society of the State of New York,’States.*— “ Compulsory healtli insurance is really what most of us are thinking about when' we try to answer the question of further socialisation of medicine in America. By this is meant a system under ’which the services of physicians are paid for under a Government-con-trolled bureau supported by pay-roll contributions, contributions by employers, and by contributions from the Government. ... "The practitioners of the country have voiced their opposition in definite terms at the faceting of the American Medical Association last September. Reasons for Opposition - Everybody is entitled to know -why the practitioner has reached the conclusion that it would not be wise to install that form of socialisation in medicine in this country. lam glad of the opportunity to explain the reason underlying his decision. . . . " What he seeks first and foremost is conditions that will permit him to get the satisfaction that comes from rendering his .service well. His selfinterest/ and his patient s self-interesi coincide. ... " ■ ~ "In compulsory health insurance, the practitioner sees at once certain conditions which are inherent in the. system and cannot be removed, and which he thinks tend to detract from Its usefulness. They make for less adequate medical work than his can give, and, therefore, are against the Interests of both himself and his patients. " They do this first by hampering the establishment of the true patient-phy-sician relationship. This relationship the practitioner regards as basic and essential for successful medical service. He must have the full confidence of his patients; built partly on his reputation, but also on the way he measures Up as time , goes on a:;—responsible to his patient first, last and all the time. “ Malingering ” Disease “The system, compulsory health insurance, tends itself to create in the workers a personality maladjustment. I might almost call it a disease known as—malingering. The worker who has to-depend on the panel doctor to Ret his wage allowance while disabled may only too readily yield to the temptation to. prolong his stay away from Work longer than he needs, and may even simulate disability to get his certificate. This kind of situation in itself interferes with the proper relations between the physician and his patients. “Other things that the practitioner takes exception to are the creation of a cumbersome red-tape mechanism with intrusion into the picture of an administrative office force supervising,the doctor’s ‘methods of diagnosis and treatment, and dictating . the remedies he;',uses, ; ■' " _’ ' "Again the. physician s office tends to be overcrowded so that he has. less, time than: is required;to carry out in proper fashion his work in diagnosis and treatment, and? in'-.the post-gradU-ate study he must keep up throughout his medical life. - To. have to do a poorer medical job than he knows how to do faeans dissatisfaction to him and ultimately to his, patients. . “When he. thinks of the installation of that system in this country, he looks with alarm at the probability that , administration? of this kind of insurance would be performed .by a political bureaucracy. That sewmS a real danger because the .-Government, in making financial contributions, •wbuldr’.surely feel it a duty to supervise the administration. \ ; Sickness Expensive “ This 'is - really straight socialised medicine, even though employer and employee themselves make contributions. These contributions are made under the compulsion of law whether the employer or employee wish to participate or not, and become, therefore, veritably taxes—and taxes that would in the end probably fall on the business only. .. .. . , , , . “The practitioner is interested naturally in any measures that can be taken which would help more,people to get good medical care. There are other ways, some of which are already at work, and others can be set up which would not have the defects of State medicine or compulsory health insurance. ... “Voluntary hospital insurance has proven itself successful and helps to spread the cost of hospitalisation quite comfortably by the prepayment method to cover risk, thus relieving; to a considerable degree the burden for each individual. ... “ Voluntary non-profit insurance for budgeting the doctor’s bill is the latest and most promising suggestion, and its development has been officially approved by the American Medical Association. This is by no means as simple a matter as hospital insurance, but it holds out real hope of budgeting for catastrophic illness, the expenses 01. which are often so hard to bear. . . . “ This is the answer of the practitioner of medicine to the question Rethinks that America would completely socialise its medicine if it put in force either State medicine or compulsory health insurance.”