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The facts
Theibneriean JournalofIlhrgery Copyright, 1949 by The Yor!+ Publishing Co., Inc. A
PRACTICAL
JOURNAL Fiftyeighth
BUILT
ON
MERIT
rear of Ptcblication
AUGUST, 1949
VOL. LXXVIII
NUMBER
TWO
THE FACTS
T
HE other day we received in the mai a sixteen-page foIder issued by The American Medical Association entitIed “The VoIuntary Way is the American Way.” Th is pamphIet contained fifty questions and answers on CompuIsory versus HeaIth-the HeaIth Insurance American Way. No doubt you, too, received this pamphIet. If not, the foIIowing few seIected questions and answers wiII give an idea of what physicians shouId know about this subject. ShouId you wish this story of compuIsory heaIth insurance versus voIuntary heaIth insurance in fuI1, you may send for a copy to The American MedicaI Association, I North La SaIIe BuiIding, Chicago, IIIinois.
Q.
\Vhat is “CompuIsory
Health
Insurance”?
Insurance?
about
Compul-
There is A. The payroll tax is compuIsory. no escape from it. But there is no compulsion on Government to maintain standards or fuIfiI1 promises. That’s the joker I
Q. WiII people who don’t wish to use the
at this time?
Government
A. Government advocates argue that Iow standards of public health and medica care in America today make Government control imperative.
heaIth
HeaIth
A. The Federal Security Administration. The President. AI1 who seriously believe in a SociaIistic State. Every left-wing organization in America. Two speciaIIy organized propaganda groups-the “Committee for the Nation’s HeaIth” and the “Physicians Forum”-whose prime concern is campaigning for Compulsory HeaIth Insurance. (Most rank-and-fiIe union men are more payroll vioIentIy opposed to deductions.) The Communist Party. is “compulsory” sory HeaIth Insurance?
dollar program proposed by the of&e of the FederaI Security Administrator, which would suppIant VoIuntary HeaIth Insurance with CompuIsory HeaIth Insurance-Ievying a payroI1 tax to support the new Government-reguIated system of medicine.
Q. Is it true that America
Q. Who is for Compulsory
Q. What
A. It is a multi-biIIion
Q. Why is it proposed
A. No. Among a11 the great Nations. the highest standards the worId has ever known in medical care and scientific progress, both in reducing disease and lengthening life--are bere in America.
service have to pay the tax?
A. Yes. Everybody with a paycheck or an income will pay the tax, whether he uses the service or not.
Q. WiII veterans
has “10~ grade”
medica taxed?
care?
‘43
care
who already have paid for by their war service, be
EditoriaI
I44
In Germany it took one Government empIoye for every IOO persons insured. At that ratio, America would require a million and a half non-medical employescIerks, administrators, bookkeepers and tax-coIIectors-on the Federal payroI1, siphoning off medica funds before they ever bought the patient care of any kind.
A. Yes. Veterans wiII pay the tax, even though they don’t need the service and don’t want it. Q. WiII members of faith healing religions be taxed?
A. Yes. MiIIions of members of a11 faiths whose principIes wouId prevent use of the service, nevertheIess wiI1 be taxed for it.
Q. Will peopIe who aIready are protected under satisfactory PIans be taxed?
Voluntary
HeaIth
Q.
Is CompuIsory “insurance”?
HeaIth
Insurance
reaIIy
A. The medica bill of the average famiIy wouId be doubIed, if not trebIed. The staggering cost to the Nation has been estimated at from 6 to 13 biIIion doIIars.
A. It is not. And it is graveIy unfair to the peopIe to pretend that it is. Reasons it is not “insurance” : Though an arbitrary “premium” is coIIected, in the form of a payroI1 deduction, benefits are neither specified nor guaranteed. In the exact Ianguage of the sponsors, certain services are promised “when funds are avaiIabIe,” “insofar as possibIe,” and “when facilities permit”! Sound insurance is based on sound actuarial standards-and on contracts cIearIy setting forth both benefits and costs. MiIIions of Americans have such guarantees in writing-under VoIuntary Health Insurance. But the only guarantee in the Compulsory Health “Insurance” proposal is guarantee of a new payroll tax-the amount unpredictable!
Q. Why don’t the sponsors advise the peopIe
Q. Did the NationaI HeaIth AssembIy rec-
A. Yes. Whether protected under medical care PIans, commercial, industria1, fraterna1, or Iabor PIans, they will be compeIIed to pay the tax for the Government Plan.
Q. How much wiI1 the tax be? A. Sponsors have used various figures. Estimates range from 3% to 10% on every paycheck up to $4800, haIf paid by the empIoye and haIf by the employer. The seIf-empIoyed wouId pay the whoIe amount.
Q. What does that make the total biII?
honestIy and cIearIy on this ah-important matter of cost?
A. They know they are apt to be wrong however we11 they figure. No Nation which has tried Government-controIIed medicine ever has been abIe to anticipate the cost correctIy. In New Zealand, the cost muItipIied eight times in five years. In EngIand Government medicine has gone 200 miIIion dohars in the red in the past nine months, grossIy exceeding estimates first given the peopIe. And the type of assembly-line service being rendered there would not be tolerated by Americans!
Q. Why shouId the cost, even for secondrate service, run so high?
A. Because Government-controlled medicine is political medicine!
ommend CompuIsory HeaIth Insurance?
A. No. After a meeting of the NationaI HeaIth AssembIy, the ofhce of the FederaI Security Administrator submitted to the President a “Report on the Nation’s HeaIth” and a “Ten Year Program.” These are the persona1 reports and recommendations of a FederaI offrce hoIder. The AssembIy refused to recommend CompuIsary HeaIth Insurance.
Q. WouId sociaiized medicine Iead to sociaIization of other phases of American Iife?
A. Lenin thought so. He declared: “SociaIized medicine is the keystone to the arch of the SociaIist State.” Today, much of the worId has launched out on that road. If the medica profession shouId be sociaIized because peopIe need doctors, why not the milk industry? American
Journal
of Surgery
Editorial Certainly, more peopie need milk every day than need doctors. On the same erroneous premise, why not the corner grocery? Adequate diet is the very basis of good health! Why not nationaIize Iawyers, miners, businessmen, farmers? Ge~any did, Russia did. England is in the process.
Q. What
does this prove?
A, It proves t/x&America
is the lust great free Nation on earthy It is strong and productive and viriIe enough today, under its own system, to shoulder the burdens of the rest of the worId! It proves tfsdt tiSegreatest error in all history would be jar America to start borrowing the ~~~uccess~u~ ~~s~~~ of ~ore~~~,countries which today are on their feet on& because the American s.ysteem is strong enough trr support them!
Q. How
do movements Like Compulsory Health Insurance get started?
A. Because
peapIe of short m~nlory for American history, and shorter vision for the American future, proclaim that increasing p&&al controf of .American lives and work is a “trend.” IE is a trend only so long as ~?lergetic people who like the .A~e~~can way of lije above all otters, look tbe other way u&en political controls like “ ~o~~~~~~so~ ~ea~~~ b-nsurance’” as% ~~o~osed~
145 Deterioration of medica education, training and research. Degeneration of medical standards, and of medica care. Steady decline of the people’s health.
Q.
Why does medical care suKer under pofiticai medicine?
A. Because doctors are responsible to politicians &t-and their patients, second. They are overwhelmed with paperwork and red tape. They are swamped with patients who do not need care, as we11 as those who do. In England today, for example, many physicians are seeing 8s many as 8o patients in the four hours of off& practice, according to the authority of Efizabeth WiIson, American writer and actuary who has studied the British system first-hand. That permits about three minutes per patient for diagnosis a.nd treatment! Such a system would scarcely suit Americans! Why are some prominent British visitors here reIuctant to comment on how socialized medicine is working in England’? A. Criticism of their So&a&t Government would jeopardize American loans to that Government. Every thinking American is aware of this, Q* To the average family, are medical hills the biggest problem?
A. Germany had the first and strongest allin&&e program. -cf bhe world needs prortf of wt)& reg~~~n~a~ tion and political ~~~~~io~ of doctors and scientists can do, even in this modern world --the ~uere~~~~rg Trials have s~~~~ied it. The medical men of Germany, once honored for their humanitarian progress, have not yet been admitted hack into the World MedicaI Society.
A. No. The most critica proMem in theaxrage household today is not the medical biI1, but the tax biII! ~~~ed~ca~ care costs the average Americas fan+ about 47* of income, a~co~d~~g to tbe Brookings ~~st~t~t~o?~= But tax bifts t& &3m 20 to 30 per cent: o~~a~~~~ ~~~o?~~~ If the unreasonable costs of Government were reduced, the Ameri~a~l peopIe couId afford better heaIth standards-better food and better housing. But CompuIsnry Health Insurance would add to the btxden, rather than relieving it?
Q. Why do doctors generaIIy oppose Compulsory HeaIth Insurance?
Q. Is it true Coming”?
A. Because it is compukory regimentation, and because the historica record of every great country to try poIititcalIy-controI~e~ medicine, is a record of
A. It is here. The only question is: How wiff you have it? On a ~o~u~~ar~basis with doctors in chargeor on a ~o~~~~~$or~ basis with politicians in control?
Q. Where did CompuIsory Health Insurance start?
that
“Health
Insurance
is
Editorial
146
Q. Has VoIuntary
HeaIth
Insurance
been
tried extensiveIy?
A. Yes. Doctors
discovered Iong ago that most famiIies need some means of cushioning the economic shock of sudden iIIness or accident. State MedicaI Societies started studying, approving and initiating sound non-profit MedicaI Care PIans over a decade ago. Hospital pIans-and insurance company pIans-also are operating successfuIIy in every section of the country. Today, VoIuntary PIans are providing budget-basis hospita1, medica and surgica1 care for miIIions.
Q. What has the experience proved? A. That there is nothing Government can do in the field of Health Insurance which the private citizen can’t do better for himself-and at jar less cost!
Q. How many peopIe are protected under VoIuntary HeaIth Insurance?
A. More than 53 miIIions are protected under hospita1, surgica1 or MedicaI Care PIans. That is more than a third of the entire population, budgeting its own health protection! Compulsory Health Insurance Means: Second-rate medica care. DecIine of medical education, training, research. Invasion of persona1 privacy in medica matters. PoIiticaI contro1 of medica systems. A growing political hierarchy of Government administrators. ConstantIy mounting payroI1 taxes. Extension of controIs over other professions.
One standardized brand ojmedicine for America -the Government-controlled brand. Voluntary Health Insurance Means: Guaranteed protection from financia1 shock in time of iIIness. High quality medical care, free from political red tape or interference. Low budget-basis cost and certain knowIedge of the costs. AbsoIute guarantee of the benefits. Free choice of service. Free choice of doctor. Freedom from new payroI1 taxes. Privacy in persona1 medica affairs. The right to spend the medica doIIar as desired. Maintenance in America of the worId’s highest medical standards. Just before we started this “abstract and paste-up” job, we read an A. P. Washington dispatch. It said that the United States Chamber of Commerce disputed the administration’s argument that compuIsary heaIth insurance is needed because most Americans cannot afford doctor biIIs. “ In 1947,” the Chamber said, “the American peopIe spent $~o,ooo,ooo,ooo for liquor, $4,000,000,000 for tobacco and over
$2,000,000,000 for cosmetic items-to mention onIy a few non-essentials. In the same year they spent $1,700,000,000 for physicians’ services.” Our nation’s heaIth is better than ever before and compares favorabIy with that of any other nation. Let us keep it that way. T. s. w.
American
Journal
of Surgery
PRACTICAL
JOURNAL Fiftyeighth
BUILT
ON
MERIT
rear of Ptcblication
AUGUST, 1949
VOL. LXXVIII
NUMBER
TWO
THE FACTS
T
HE other day we received in the mai a sixteen-page foIder issued by The American Medical Association entitIed “The VoIuntary Way is the American Way.” Th is pamphIet contained fifty questions and answers on CompuIsory versus HeaIth-the HeaIth Insurance American Way. No doubt you, too, received this pamphIet. If not, the foIIowing few seIected questions and answers wiII give an idea of what physicians shouId know about this subject. ShouId you wish this story of compuIsory heaIth insurance versus voIuntary heaIth insurance in fuI1, you may send for a copy to The American MedicaI Association, I North La SaIIe BuiIding, Chicago, IIIinois.
Q.
\Vhat is “CompuIsory
Health
Insurance”?
Insurance?
about
Compul-
There is A. The payroll tax is compuIsory. no escape from it. But there is no compulsion on Government to maintain standards or fuIfiI1 promises. That’s the joker I
Q. WiII people who don’t wish to use the
at this time?
Government
A. Government advocates argue that Iow standards of public health and medica care in America today make Government control imperative.
heaIth
HeaIth
A. The Federal Security Administration. The President. AI1 who seriously believe in a SociaIistic State. Every left-wing organization in America. Two speciaIIy organized propaganda groups-the “Committee for the Nation’s HeaIth” and the “Physicians Forum”-whose prime concern is campaigning for Compulsory HeaIth Insurance. (Most rank-and-fiIe union men are more payroll vioIentIy opposed to deductions.) The Communist Party. is “compulsory” sory HeaIth Insurance?
dollar program proposed by the of&e of the FederaI Security Administrator, which would suppIant VoIuntary HeaIth Insurance with CompuIsory HeaIth Insurance-Ievying a payroI1 tax to support the new Government-reguIated system of medicine.
Q. Is it true that America
Q. Who is for Compulsory
Q. What
A. It is a multi-biIIion
Q. Why is it proposed
A. No. Among a11 the great Nations. the highest standards the worId has ever known in medical care and scientific progress, both in reducing disease and lengthening life--are bere in America.
service have to pay the tax?
A. Yes. Everybody with a paycheck or an income will pay the tax, whether he uses the service or not.
Q. WiII veterans
has “10~ grade”
medica taxed?
care?
‘43
care
who already have paid for by their war service, be
EditoriaI
I44
In Germany it took one Government empIoye for every IOO persons insured. At that ratio, America would require a million and a half non-medical employescIerks, administrators, bookkeepers and tax-coIIectors-on the Federal payroI1, siphoning off medica funds before they ever bought the patient care of any kind.
A. Yes. Veterans wiII pay the tax, even though they don’t need the service and don’t want it. Q. WiII members of faith healing religions be taxed?
A. Yes. MiIIions of members of a11 faiths whose principIes wouId prevent use of the service, nevertheIess wiI1 be taxed for it.
Q. Will peopIe who aIready are protected under satisfactory PIans be taxed?
Voluntary
HeaIth
Q.
Is CompuIsory “insurance”?
HeaIth
Insurance
reaIIy
A. The medica bill of the average famiIy wouId be doubIed, if not trebIed. The staggering cost to the Nation has been estimated at from 6 to 13 biIIion doIIars.
A. It is not. And it is graveIy unfair to the peopIe to pretend that it is. Reasons it is not “insurance” : Though an arbitrary “premium” is coIIected, in the form of a payroI1 deduction, benefits are neither specified nor guaranteed. In the exact Ianguage of the sponsors, certain services are promised “when funds are avaiIabIe,” “insofar as possibIe,” and “when facilities permit”! Sound insurance is based on sound actuarial standards-and on contracts cIearIy setting forth both benefits and costs. MiIIions of Americans have such guarantees in writing-under VoIuntary Health Insurance. But the only guarantee in the Compulsory Health “Insurance” proposal is guarantee of a new payroll tax-the amount unpredictable!
Q. Why don’t the sponsors advise the peopIe
Q. Did the NationaI HeaIth AssembIy rec-
A. Yes. Whether protected under medical care PIans, commercial, industria1, fraterna1, or Iabor PIans, they will be compeIIed to pay the tax for the Government Plan.
Q. How much wiI1 the tax be? A. Sponsors have used various figures. Estimates range from 3% to 10% on every paycheck up to $4800, haIf paid by the empIoye and haIf by the employer. The seIf-empIoyed wouId pay the whoIe amount.
Q. What does that make the total biII?
honestIy and cIearIy on this ah-important matter of cost?
A. They know they are apt to be wrong however we11 they figure. No Nation which has tried Government-controIIed medicine ever has been abIe to anticipate the cost correctIy. In New Zealand, the cost muItipIied eight times in five years. In EngIand Government medicine has gone 200 miIIion dohars in the red in the past nine months, grossIy exceeding estimates first given the peopIe. And the type of assembly-line service being rendered there would not be tolerated by Americans!
Q. Why shouId the cost, even for secondrate service, run so high?
A. Because Government-controlled medicine is political medicine!
ommend CompuIsory HeaIth Insurance?
A. No. After a meeting of the NationaI HeaIth AssembIy, the ofhce of the FederaI Security Administrator submitted to the President a “Report on the Nation’s HeaIth” and a “Ten Year Program.” These are the persona1 reports and recommendations of a FederaI offrce hoIder. The AssembIy refused to recommend CompuIsary HeaIth Insurance.
Q. WouId sociaiized medicine Iead to sociaIization of other phases of American Iife?
A. Lenin thought so. He declared: “SociaIized medicine is the keystone to the arch of the SociaIist State.” Today, much of the worId has launched out on that road. If the medica profession shouId be sociaIized because peopIe need doctors, why not the milk industry? American
Journal
of Surgery
Editorial Certainly, more peopie need milk every day than need doctors. On the same erroneous premise, why not the corner grocery? Adequate diet is the very basis of good health! Why not nationaIize Iawyers, miners, businessmen, farmers? Ge~any did, Russia did. England is in the process.
Q. What
does this prove?
A, It proves t/x&America
is the lust great free Nation on earthy It is strong and productive and viriIe enough today, under its own system, to shoulder the burdens of the rest of the worId! It proves tfsdt tiSegreatest error in all history would be jar America to start borrowing the ~~~uccess~u~ ~~s~~~ of ~ore~~~,countries which today are on their feet on& because the American s.ysteem is strong enough trr support them!
Q. How
do movements Like Compulsory Health Insurance get started?
A. Because
peapIe of short m~nlory for American history, and shorter vision for the American future, proclaim that increasing p&&al controf of .American lives and work is a “trend.” IE is a trend only so long as ~?lergetic people who like the .A~e~~can way of lije above all otters, look tbe other way u&en political controls like “ ~o~~~~~~so~ ~ea~~~ b-nsurance’” as% ~~o~osed~
145 Deterioration of medica education, training and research. Degeneration of medical standards, and of medica care. Steady decline of the people’s health.
Q.
Why does medical care suKer under pofiticai medicine?
A. Because doctors are responsible to politicians &t-and their patients, second. They are overwhelmed with paperwork and red tape. They are swamped with patients who do not need care, as we11 as those who do. In England today, for example, many physicians are seeing 8s many as 8o patients in the four hours of off& practice, according to the authority of Efizabeth WiIson, American writer and actuary who has studied the British system first-hand. That permits about three minutes per patient for diagnosis a.nd treatment! Such a system would scarcely suit Americans! Why are some prominent British visitors here reIuctant to comment on how socialized medicine is working in England’? A. Criticism of their So&a&t Government would jeopardize American loans to that Government. Every thinking American is aware of this, Q* To the average family, are medical hills the biggest problem?
A. Germany had the first and strongest allin&&e program. -cf bhe world needs prortf of wt)& reg~~~n~a~ tion and political ~~~~~io~ of doctors and scientists can do, even in this modern world --the ~uere~~~~rg Trials have s~~~~ied it. The medical men of Germany, once honored for their humanitarian progress, have not yet been admitted hack into the World MedicaI Society.
A. No. The most critica proMem in theaxrage household today is not the medical biI1, but the tax biII! ~~~ed~ca~ care costs the average Americas fan+ about 47* of income, a~co~d~~g to tbe Brookings ~~st~t~t~o?~= But tax bifts t& &3m 20 to 30 per cent: o~~a~~~~ ~~~o?~~~ If the unreasonable costs of Government were reduced, the Ameri~a~l peopIe couId afford better heaIth standards-better food and better housing. But CompuIsnry Health Insurance would add to the btxden, rather than relieving it?
Q. Why do doctors generaIIy oppose Compulsory HeaIth Insurance?
Q. Is it true Coming”?
A. Because it is compukory regimentation, and because the historica record of every great country to try poIititcalIy-controI~e~ medicine, is a record of
A. It is here. The only question is: How wiff you have it? On a ~o~u~~ar~basis with doctors in chargeor on a ~o~~~~~$or~ basis with politicians in control?
Q. Where did CompuIsory Health Insurance start?
that
“Health
Insurance
is
Editorial
146
Q. Has VoIuntary
HeaIth
Insurance
been
tried extensiveIy?
A. Yes. Doctors
discovered Iong ago that most famiIies need some means of cushioning the economic shock of sudden iIIness or accident. State MedicaI Societies started studying, approving and initiating sound non-profit MedicaI Care PIans over a decade ago. Hospital pIans-and insurance company pIans-also are operating successfuIIy in every section of the country. Today, VoIuntary PIans are providing budget-basis hospita1, medica and surgica1 care for miIIions.
Q. What has the experience proved? A. That there is nothing Government can do in the field of Health Insurance which the private citizen can’t do better for himself-and at jar less cost!
Q. How many peopIe are protected under VoIuntary HeaIth Insurance?
A. More than 53 miIIions are protected under hospita1, surgica1 or MedicaI Care PIans. That is more than a third of the entire population, budgeting its own health protection! Compulsory Health Insurance Means: Second-rate medica care. DecIine of medical education, training, research. Invasion of persona1 privacy in medica matters. PoIiticaI contro1 of medica systems. A growing political hierarchy of Government administrators. ConstantIy mounting payroI1 taxes. Extension of controIs over other professions.
One standardized brand ojmedicine for America -the Government-controlled brand. Voluntary Health Insurance Means: Guaranteed protection from financia1 shock in time of iIIness. High quality medical care, free from political red tape or interference. Low budget-basis cost and certain knowIedge of the costs. AbsoIute guarantee of the benefits. Free choice of service. Free choice of doctor. Freedom from new payroI1 taxes. Privacy in persona1 medica affairs. The right to spend the medica doIIar as desired. Maintenance in America of the worId’s highest medical standards. Just before we started this “abstract and paste-up” job, we read an A. P. Washington dispatch. It said that the United States Chamber of Commerce disputed the administration’s argument that compuIsary heaIth insurance is needed because most Americans cannot afford doctor biIIs. “ In 1947,” the Chamber said, “the American peopIe spent $~o,ooo,ooo,ooo for liquor, $4,000,000,000 for tobacco and over
$2,000,000,000 for cosmetic items-to mention onIy a few non-essentials. In the same year they spent $1,700,000,000 for physicians’ services.” Our nation’s heaIth is better than ever before and compares favorabIy with that of any other nation. Let us keep it that way. T. s. w.
American
Journal
of Surgery