Middle Way for Medicine
RORTY, JAMES
Middle Way for Medicine Doctors, People and Government. Reviewed by James Rorty By James Howard Means. Author of ?°His Master??s?± Little, Brown. 197...
...The intervening years have been filled with the sound and fury of controversy, in which the quiet and reasonable voice of James Howard Means has frequently been heard...
...In Elk City, Oklahoma and Seattle, Washington, local medical societies have made peace with medical cooperatives which they formerly obstructed, and the movement represented by the Cooperative Health Federation is gaining momentum...
...Means does not believe that preserving the traditional individualistic, fee-for-service type of medical practice is necessary or desirable in order to protect either the freedom of the physician or the health of his patients...
...those who can't should be subsidized into the system by state and municipal funds and by some application of the general principle of Federal grants-in-aid...
...not, however, in one of its expensive private pavilions, but in the open ward...
...In this book, Dr...
...Means's book is most timely, because many of the problems he discusses are now in the lap of the Eisenhower Administration: for example, how to save the medical schools and teaching hospitals which seemingly must have Federal aid if they are to survive and meet their increasing responsibilities: how to rationalize the expanding medical empire of the Veterans Administration, and so on...
...Although he is by temperament a liberal conservative...
...As for the matter of payment, Dr...
...Twenty years ago, you may remember, the Committee on the Costs of Medical Care, headed by Herbert Hoover's friend Ray Lyman Wilbur, came to approximately the same conclusion...
...Tomorrow's Food" and other books If you are sick, one of the best places in the world to be is the Massachusetts General Hospital in Boston...
...197 pp...
...For Dr...
...Recent court decisions have demolished some of the barricades that hitherto have blocked this middle road...
...Means does not even discuss the establishment of a Federal system of compulsory health insurance...
...Those who can pay, should...
...He walks the middle road of cooperation: Patients should be encouraged to organize their own voluntary prepayment plans and employ groups of doctors to serve them who have complete control of all the medical aspects of the service...
...Means crowns his recent retirement from the staff of Massachusetts General and of the Harvard Medical School (he is still active in the medical department of MIT) by giving us one of the most informed and illuminating discussions of the problem to date...
...Means, the ward service of such a great teaching hospital, with its disciplined group practice and its readily available consultative and laboratory services, provides the administrative model on which a modernized system of universally available medical care should be based...
...Means and the able group for which he speaks...
...There you will get, for nothing, the services of the hospital's able salaried staff, of which for twenty-eight years the author of this book was director...
...In answering these and main other questions, the Administration will be well advised to lake counsel with Dr...
...3.50...
...On the contrary, he adduces from his own experience persuasive reasons for believing that salaried doctors are fully as devoted and efficient as salaried corporation officials: that the rich resources of modern medical care can best be made available by medical groups whose members don't have to write bills or collect them, hence are not tempted to split fees with their associates, to operate when in doubt, or to coddle rich hypochondriacs...
Vol. 37 • April 1954 • No. 16
