We have left undone those things which we ought to have done . . .And there is no health in us.
—Book of Common Prayer
WHAT the people of the U.S. ought to have done may be debatable in many areas and in many details. What has been most conspicuously left undone involves health. As long ago as 1883, Iron Chancellor Otto von Bismarck (who could hardly be called socialistic or radical) gave Imperial Germany the world's first Sickness Insurance Act, covering workers and their families. Similar benefits now protect the people of virtually every industrialized nation in the world. But not Americans. Only now are influential members of both parties in Congress giving serious consideration to proposals for blanketing the nation's 205 million citizens with some form of national health insurance.
Jump into Chaos. Last week Robert H. Finch, Secretary of Health, Education and Welfare, declared: "We must build a health-care delivery system of surpassing quality, accessible to every American, everywhere in this nation." But then, at a Manhattan meeting of the United Cerebral Palsy Associations, Finch abruptly backed away from early adoption of a truly comprehensive program. "To move now into some scheme of national health insurance," he said, "would repeat the experience of Medicare and Medicaid, and multiply its consequences ten times over. Without prior planning, preparation and creation of basic resources, we would invite literal chaos." That was literal truth if the operative word in Finch's statement was now. There is no prospect that Congress will enact a comprehensive insurance program and expect to have it working in 1970.
For that matter, at their present rate, Finch's HEW staff is not likely to produce any program by 1980 either. In 1932, the Committee on the Costs of Medical Care, headed by the late Dr. Ray Lyman Wilbur, recommended that doctors be encouraged to practice in groups and that the costs of medical care "be placed on a group-payment basis, through the use of insurance, through the use of taxation, or both of these methods." Though Wilbur was Republican President Hoover's Secretary of the Interior and a former president of the American Medical Association, his recommendations were denounced in the Journal of the A.M.A. as "socialism and Communism."
U.S. citizens now spend $60 billion a year on medical, dental and nursing care, drugs and appliances. Of this, the federal share is $21 billion. Yet by the best estimates, 80 million Americans lack adequate health care. For the majority, the barrier cutting them off from decent care is financial. Either they do not qualify for health insurance under any of the plans offered, or, if they qualify, they have no money to pay the premiums.
Mental and Dental. The Health Insurance Institute reports that 170 million Americans now have insurance to defray hospital expenses and receive more than $7 billion annually in benefits. But in many cases the insurance does not cover all costs, so that $6 billion still has to come out of the insured patients' pockets—and 35 million people have no protection whatever.