Doctors' Revolt

Like a transcontinental echo of Bernard Baruch's challenge, San Francisco rumbled last week with a battle over compulsory health insurance. Under fire was a medical system covering San Francisco's 12,000 municipal employees. The only governmental compulsory health insurance system in the U.S., it provides medical care in return for a small monthly fee deducted from members' pay.

This plan, voted by San Franciscans ten years ago over doctors' objections, has had a rough career. Because members' payments were set too low, doctors have often been paid less than the scheduled fees. Last fortnight, aroused by rebuffs of their demands for a 15% raise in fees, and by Medical Director Alexander S. Keenan's suggestion that they had needlessly pyramided costs by calling for too many laboratory tests and X rays, the doctors finally rebelled.

Led by the county medical society, more than 900 of the system's 1,000 doctors resigned, refusing to treat city employees except as private patients. Said Dr. Anthony B. Diepenbrock, the society's president: "The doctors of San Francisco will not ... be parties to any bureaucratic experiment in cheap, assembly-line medicine. . . . The experiment has failed."

Cried Director Keenan: "The American Medical Association felt that this little system of city employees had to be destroyed." To break the doctors' "strike," he invited 250 San Francisco doctors who are not members of the county society to join the system. Said Keenan defiantly: "We have an income of more than $60,000 a month from the city employees. With that much money coming in, you can't kill us."

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