Rising
Medical Costs Alarm Social Scientists
October 24, 1977
Thirty years ago, plans for expanded
medical care were prompted by concern for the loss of productivity that
sickness cost the nation. Ironically, many
of the statistics were garnered when from the period of the great depression
when there were not enough jobs to go around, and the death of a man cost
nothing in economic terms because there were plenty to take his place.
Only in times of full employment is
sickness costly to the nation. It was,
however, this supposed economic loss that social scientists used to rationalize
their programs.
Now the tables are turned. The expansion in medical care benefits
combined with technical progress, is extending life beyond the wildest dreams
of all but Malthus, and lo – instead of increasing normal productivity, the
saving of lives is draining the treasury because, by far, the greatest number
of lives saved belong to people who have passed the mandatory age for
retirement.
They produce nothing. In fact, they are not allowed to work, and it
costs money, social security and pensions, to succor them while they live.
So the social scientists, alarmed
perhaps at what they have wrought, are now concentrating their efforts on cost
containment in medical care. They want
to trim the medical establishment, reduce replication, and centralize
sophisticated medical technology.
Thrift in health care is the new
password. They want to match precisely
the number of available hospital beds to the number of sick, so that there will
be no empty beds. No matter that the
nearest available bed for a sick patient in Toms River happens to be in
Chicago.
They want to regimentalize
services. Thus, a patient requiring
radiation therapy will have to travel 50 miles to secure it, or a person
requiring a
Social scientists who originally sought
their raison d’etre in terms of human relationships have separated themselves
from their roots, and think now only in monetary terms.
They have forsaken the individual for
the mass. They pretend that the only way
to solve the medical problems of individuals is by orienting their goals to the
community. They ask the doctor to “keep
the community in mind” when treating a patient.
The English translation of this
ambiguous folderol is, “Hold back on hospitalization if you possibly can,
because there is probably some deserving soul out yonder who needs
hospitalization more than your patient does.”
The scary thing about this, as about
all propagandist sloganeering, is that it is catching on, and people are
starting to worry more about the soaring costs of medical care than what will
happen to them when they become sick – such as, will there be a hospital bed
available?
My generation of doctors were brought
up to the ideal of individual patient care, but young doctors learn meaningless
epigrams about community health. They
are being trained to a different perception.
They sit on institutional committees and second-guess their
colleagues. They participate in medical
audit that stereotypes the subtleties of medical practices, without qualm, not
even aware that they are subverting the traditions of the profession of
medicine; and these men of my generation have also sold their medical
birthright for a mess of pottage to sit in judgment on the holy work of their
colleagues.
Twenty-four states, at the instigation
of the Federal government, have instituted the odious Certificate of Need,
which requires two years of negotiation before a new hospital bed can be created,
and the government would extend this to 50 states if it could.
Thus, we are being shortchanged on
health care with our own tax money.
Funds that could be spent to expand health facilities are being diverted
to a self-perpetuating bureaucracy that is purposely curtailing health
facilities. At the same time, there is a
drive on to make every ambulance a small mobile hospital, complete with all
manner of resuscitative equipment – for what – to transport the salvaged victim
to a hospital that has no vacant beds?