The Moon & Sixpence

With disarming casualness, President Truman sent up to Capitol Hill one day last week what was potentially one of the hottest political and economic issues Congress has ever had to handle. The President asked Congress to enact a compulsory health-insurance program for most U.S. citizens. Said the President in a special message: "To see that our people actually enjoy the good health that medical science knows how to provide is one of the great challenges to our democracy."

The challenge was there all right; the question was how wisely the President had proposed to meet it. The essentials of the Truman health program:

All of the 85 million Americans now under Social Security (and another 35 million more if Social Security is expanded) would be entitled to complete medical, surgical, dental and hospital care. Even eyeglasses, false teeth, glass eyes, artificial arms & legs would be provided, as under Britain's new socialized medicine.

Most of the money would come from a 3% federal payroll tax, 1 1/2% paid by employee, 1 1/2% by employer. The tax would apply on the first $4,800 of individual income. From the U.S. Treasury, the Government would kick in 1/2% of the fund the first year, 1% thereafter.

The Government would finance training of doctors and nurses, expand its grants for hospital construction. Patients could choose their own doctors, and doctors could join or not join the program as they saw fit. Doctors could also reject patients. The doctors would be paid by the Government on either a salary or fee basis.

Cart First. Harry Truman had asked for the moon, and left Congress in the position of having to haggle over the sixpence. He had kept his campaign promise by submitting the bill. But, as he well knew, his compulsory insurance proposal --the only real issue in the bill--had little chance of passing in this session of Congress. Most critics thought the President's program was also unrealistic, because it put the cart before the horse. The nation's corps of 190,000 doctors, and the hospitals available to them, would have to be vastly expanded before they could cope with the millions entitled to care under the Truman program.

There were already two other major health bills (by Ohio Republican Robert A. Taft and Alabama Democrat Lister Hill) before Congress. Both would pay the premiums of the poor so that they could join such voluntary private health-insurance programs as the Blue Cross which already cover 50 million Americans. Taft's bill also provides federal subsidies for training doctors and building hospitals. Truman's answer to these bills: "Medical care is needed as a right, not as a medical dole." One sign of the trouble the President's bill faces: seven of the 13 members of the Senate Labor and Public Welfare Committee (including two Democrats) are already committed either to the Taft or Hill bills.

"Medical Mills." Even before the President's bill was sent to the Hill, three Catholic welfare groups objected to the program as "practically a Government monopoly." The powerful American Medical Association, which was trying to raise $3,500,000 from its members to fight the President's program, raised an excited and angry voice. Said the A.M.A.: "Government-herding of patients and doctors in assembly-line medical mills would lower the standards of healthy America to those of sick, regimented Europe."

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