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Objections. Opponents of socialized medicine, especially the powerful A. M. A., have long argued that State control of medicine would be a radical and costly experiment. Millions of dollars would be spent on extra medical care at a time when the nation is in grave economic difficulties. All the fine old traditions of private practice would be swept away. A patient would no longer be free to choose his own physician, and the close relationship between patient and physician would be spoiled. Standards of medical care would be greatly lowered, for doctors would become involved in so much red tape that they would have no time for careful diagnoses or experimental" laboratory work. Physicians would have no incentive to improve their skill, for they would remain on fixed salaries. Worst of all, politicians would dictate to medical men, and public health officials would change with each election.
Rebuttal. In his quiet lecture hall in Baltimore, 40 miles from the Capitol, Dr. Sigerist was repeating, in a new course on "medicine and its relations to society," his rebuttal to A. M. A.'s famous arguments. His chief points:
1) State control of medicine is not a radical departure. "More than sixty per cent of all hospital beds are owned and operated by the Government. . . . Only one-tenth of the work performed by the Public Health Service is devoted to ... control of water supplies, sewage systems. and so on, and nine-tenths of the work consists of new tasks which private medicine was unable to fulfill." In the past 30 years the duties of the Public Health Service have grown to include care for cases of tuberculosis, blindness, leprosy and narcotic addiction, and research on practically every disease, common and uncommon, that is found in the U. S.
2) To finance a system of State medicine in the U. S. would not be difficult or extravagant. An estimated ten billion dollars of manpower is lost each year through sickness and premature death and the nation's medical bill is three-and-a-half billion dollars annually. This money is "spent in a haphazard and wasteful way. If the same amount were spent rationally, little more would be required to provide adequate medical service for the whole population.'' The most efficient system, under the present circumstances. Dr. Sigerist believes, would be one in which the indigent would receive complete medical care, free, in well-equipped Government health centres; the low income group would finance its medical costs through compulsory health insurance:*the higher income group would take care of their health in any way they pleased. All competent doctors who wished would be placed on salaries in medical centres.
3) To say that salaried doctors lose their incentive to do good work is an insult. Koch, Pasteur, Gorgas, Reed, Welch were all salaried men. So are the workers in the Mayo Clinic and the Rockefeller Institute and 15% of U. S. doctors who work in other institutional hospitals. "Whenever a [salaried] position is vacant, hundreds [of doctors] apply for it." (The average income of a U. S. general practitioner is under $3,500 a year.)