Health Problems

"The American Medical Association still believes President Eisenhower's health insurance program will not achieve the desired results," the AMA announced last week. But for all the unusual mildness of statement, it would be wrong to assume that the AMA has decided to give expanded health insurance a trial run. The same $2,000,000 lobby which fought Blue Cross health insurance, Social Security, and workmen's compensation in the 1930's stands prepared to combat suggested programs which would bring essential protection of medical health insurance to more people.

The AMA has been traditionally outspoken, and its pronouncements have often been designed to uphold the standards of American medicine. Emphasizing the need to set rigid standards for physician's training, the AMA has also established codes of ethics and high requirements throughout medical practice, using its power to expel and discredit members who violate the rules of their state medical associations. In maintaining medical facilities at the highest levels, the AMA has done valuable work--which could have been done only by learned men, experienced in their profession.

But learned men have a special influence on both public and Congressional opinion, and unfortunately, as Raymond Rich stated upon resigning as public relations counsel for the AMA, the organization has allowed its influence "to become identified with the economic interests of the doctors." The respect the Association has won by its distinguished membership has allowed representatives to tell Congress and the country that it "believes in working for the best health of the nation," while opposing new programs that would make it possible for more people to obtain proper medical care.

Every program that has been designed to provide health insurance for patients who cannot afford to pay for it, or who are now excluded as "poor risks" has won the Association's opposition as "socialistic" or "unworkable." In 1932 Dr. Morris Fishbein, then editor of the Journal of the American Medical Association, stated that voluntary health insurance was "socialism and communism, inciting to revolution." Characteristically, today the AMA supports the voluntary health insurance pools it called "medical soviets" twenty years ago, and resists significant improvements on them. It has entered an active campaign to prevent Federal assistance in medical school construction, so that increased facilities for physicians' education have been stricken from the President's health bill. The Association has never proposed a new, constructive program of its own, yet it has consistently denied that special study commissions have the knowledge or indgment to set up a health program that can benefit the nation.

Even opponents of AMA policy have unfortunately tolerated the doctors economic lobbying as part of the American tradition, although the influence of the lobbying rests on professional claims to special knowledge about health problems. It is precisely this familiarity with needless suffering and illness that should make the members of the AMA try to keep America's health service ahead of public demand rather than behind it. The American Medical Association should indeed criticize the Eisenhower health proposals--not because they re the "entering wedge of socialized medicine" (as the AMA called them last year) but because they are inadequate even as an initial attempt to mobilize the country's medical resources for the nation's entire population.

(Monday's editorial will discuss the Eisenhower health program.)