A Revolutionary Answer to Medical Costs

Peters, Charles

A Revolutionary Answer to Medical Costs by Charles Peters Pactically everyone now realizes that we need some form of national health insurance. The problem is how to control its cost. Our...

...Our experience with those precursors of national health insurance, Medicare and Medicaid, suggests that extending their benefits to the entire population could produce national bankruptcy overnight...
...People of similar standing simply do not receive similar care from our civilian health system...
...We wonít let him be stuck in Boisie for too long...
...The doctor wonít have to salute...
...Under the present system of health care, prices are set by the providers of health services-the doctors and hospitalswho also decide what services will be furnished and where they will be available...
...We now control every group with a lifeprotecting function except doctors...
...This would deprive them of the last shred of justification for the self-pity that seems to possess all but the most decent doctors in later life, the selfpity that says because I was strapped to pay those tuition bills and because I was exploited as an intern and resident, I am now justified in robbing my patients blind...
...If people donít like public control, they can choose not to become doctors, just as they can choose not to become midshipmen or cadets...
...In fact, we may want a small group of physicians to remain in private practice to provide a competitive measuring rod for the public service...
...The doctor who thinks $75,000 a year is his divine right-indeed, a bare minimum from which he should advance to ever higher fiscal heights-is the spiritual father of the gross extravagance of our present health delivery system...
...It is time to end that exception...
...A system with so much sheer waste -ridiculously expensive heart-lung machines and brain scanners in five or ten hospitals in a city where only one of each is needed...
...The military that was brilliant at Midway was a parody of bureaucratic malfunction at Pearl Harbor...
...Doctors who have already completed their training and elect to participate in the national service should be reimbursed for that part of the cost of their training that they actually paid...
...This is not the way we have dealt with others in the business of protecting our lives: soldiers, sailors, policemen, firemen...
...We spend twice that for a system that ignores millions of people...
...Of course, it will have its disadvantages...
...We tell them where to serve...
...He wonít have to wear a uniform...
...Is there any logical reason why medical salaries, specialties, and places of work should not be equally subject to public control...
...I received consistently superb care...
...Just because an army officer wants to be a cavalryman is not an adequate reason for letting him be one...
...Isnít the assurance of good medical care as important to Charles Peters is editor-in-chief of The Washington Monthly...
...The British spend only four-and-ahalf per cent of their gross national product for a system of free health care for everyone...
...During World War 11, I spent ten months in army hospitals with a broken back...
...This suggests an immediate reform that might be made...
...Public control is the only way we can master these problems...
...And pending the day when we turn that system into one that the public controls, anything we can do to reduce his greed will at least delay our date with bankruptcy...
...A national health service should of course pay for all the costs of the training of its members, just,as we pay for the training of our soldiers and sailors...
...For them, I offer the Foreign Service as a model...
...The sailors canít all be based in San Francisco...
...A system that squanders huge sums of money on sophisticated medical technology that only prolongs illness by delaying death for a few months...
...If they are already doctors, they can choose not to participate in cither the benefits or the restraints of a national health service...
...The policemen canít all patrol Park Avenue...
...Shouldnít their income be geared not to what they want, but to what the public can afford...
...you as the assurance of adequate protection by the police or the military...
...Shouldnít doctors be trained in the areas of medicine where they are needed and stationed accordingly...
...For some people, particularly those on the left, military analogies are not likely to be persuasive...
...Those who control whether we live or die must be under our control...
...But ow civilian health system is Pearl Harbor every day, with a fragmentation of responsibility so complete that one of the major problems in malpractice litigation is figuring out whether internist A, specialist B, or hospital C was responsible for the particular disaster at issue...
...We do not permit even the greatest general to charge us whatever he wants...
...I was a buck private in the infantry...
...The public should take over the entire cost of physician training-we already pay a high percentage-and we should give every intern and resident a generous salary plus a free Jaguar...
...But he will still be a servant of the public with a choice, just like the foreign service officer, of accepting assignment in the public interest or resigning...

Vol. 8 • October 1976 • No. 8


 
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