Dr. Ward's Last Words

American Medical Association President Dr. Donovan F. Ward, a Dubuque, Iowa, surgeon, knew full well that his testimony would not "stay in the slightest degree the hand of the Senate in the approval of this bill." But the prospect of imminent congressional approval of the Administration's $6 billion-a-year medicare bill did not deter Ward from uttering some last words about his organization's opposition to the measure. Last week, before the Senate Finance Committee, he did just that, without rancor but with deep feeling.

"This may be your last chance to weigh the consequences of taking the first step toward establishment of socialized medicine in the United States," he said. Noting that a deterioration in medical service could be expected once the plan went into force, he continued:

"All physicians soon learn they must expect instances of patients, particularly among the elderly, who seek treatment for vague ailments with ill-defined symptoms merely to have someone to talk to. When costs get out of line, and let me assure you they will, there are three possible courses of action. The first is to reduce the benefits; the second is to increase taxes; the third is to impose Government controls on the services in an attempt to control costs. We know welfare benefits are not likely to be cut back once the public has learned to enjoy them. Certainly, constantly increasing taxes are undesirable. This leaves the third approach: controlling the providing of services. This bill contains the mechanism for doing exactly that."

Two Out of Three. Ward asked the committee to delete two of the bill's three main provisions: the social security-financed hospitalization plan for all people 65 and older, and a voluntary insurance program that would cost $3 a month and provide 80% of the cost of doctors' fees (after the first $50) and medical extras, such as X rays, lab tests and wheelchair rental. In their place, Ward suggested the A.M.A.'s "Eldercare" plan, an expansion of the present Kerr-Mills medical-assistance-for-the-aged program.

Specifically, he recommended 1) a sliding scale of income eligibility for those covered by the bill; 2) state and local administration of the program; 3) that the program offer something more than medicare's "single type of standardized protection which is certain to be unsuitable for many"; 4) that the major health-insurance carriers be designated the underwriters of any such program because of tbeir previous experience in the field; and 5) that the insurance carriers be legally permitted to recognize the "customary" charges made by physicians rather than Government-set "reasonable" fees.

"The Ultimate Sufferer." Concluding, Ward said: "The American system of medicine for generations has been a system of quality medicine practiced through a voluntary relationship between patients and physicians, with doctors free to make decisions based on the patients' specific needs and nothing else. Forget for a moment the staggering, though unpredictable, cost of the pending program. Ignore the administrative problems that it would create, and the burden it means for wage earners at the low end of the income scale. Look only at the intrusion of Government in the field of medicine, which cannot be avoided if this measure is adopted. With the quantity of care thus restricted for the sake of controlling costs, the quality must deteriorate. The patient is the ultimate sufferer."

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