Evening Star Newspaper, March 29, 1931, Page 82

T THE SUNDAY STAR, WASHINGTON, D. C, MARCH 29, 1931. — Cutting the High COST OF BEING ILI 4 PLAN ADVOCATED BY Dr. Ray Lyman Wilbur, Secretary of the Interitor. Private-Group Clinics, Which Operate Satis- Sactorily in Many Cities, Are Studied in a Survey Being Made for the Purpose of Saving People Mil- lions of Dollars 1Yearly. HE most important consideration to every individual is his health. Sick- ness not only entaiis physical suffer- ing, but loss of time from work and a consequent loss of wages or salary either to the individual or the company by which he is employed. In addition, there is the depressing presence of doctor bills, hos- pital bills, nurses bills and bills for medicine. One single siege of sickness sometimes sets & family back so far financially that a year or two may elapse before it is on its feet again. The United States has been among the most progressive countries in the world in promoting health work. A great tribute is due to the physicians of the Nation for their unselfish, generous and patriotic service in the cause of preventive medicine—a service which has saved thousands of lives with little or no actual cost to the individual. But in spite of these facts, the bill for il health in this country is distressingly large. It o ey s g 8 actuall ann y. e o€ ibility of permanent impairment, the figures oved up much higher—possibly to 10,000,000,000. of health work, only 143,000 of whom physicians. Practitioners of various sorts, dentists, laboratory workers, hospital at- ts and health officials make up the re- mainder. According to the latest figures avail- able, only ome other industry employs more yeopie. ITHIN the next year there will be available - to the public an almost febulous story ‘concerning the cost to the individual and to families of their own illnesses, the actual time which they lose because of sickness or ill health and the huge sums of money which are ex- pended every year by families in their efforts to keep well, This great gift of medical knowledge is com- ing from the Committee on the Costs of Medi- sal Care, an organization sponsored and financed by the greatest foundations of the country. Already nearly four years’ work on the five-year program of the committee has been completed. Tre ultimate ideal in such a survey is to furn'sh such an analysis of the cost of medical care zs will enable each member of civilized society to obtain the greatest possible advantage from all the pooled knowledge of the medical profession at a price that will be within his means. But it has been kept in mind at the same time that the physician must be enabled to make a comfortable enough living to justify the years of study and the actual expenditure in money which have gone into his training. The rapid changes incident to a new economic order of living in the United States have placed the public, especially those of moderate means, in the position of paying more than they can readily afford for the service they get, and at the same time placed the doctors, or most of them at least, in the position of not receiving anything like sufficient pay for the services they give. Doctors, perhaps the greatest group of individualists in the world, now seem to be in the position of having to work out some sort of co-operative program whereby their eom- bined knowledge will be made available to everybody. The committee, even when it has completed s work, cannot bring about the organization of the medical profession along social or eco- nomic lines. It can, however, make recom- ,mendations that will point the way toward a solution of some of the problems—a solution which may be effected by medical practitioners and jnstitutions 10, 15 or even 20 years hence. It is making the first comprehensive survey of the work of a profession which affects the welfare of every man, woman and child in the country. It will furnish the most compilete picture which has yet been painted. Oxunrymupectofmemeuchbdn( done at the present time is a study of the completed, is that the cost per family for illness is higher than had been previously estimated. In the past it has been thought that probably from $80 to $10C per family per year was about the average. The inquiry so far shows that it varies from $71 for families with incomes less than $2,000 to $311 for families with incomes above $5,000. The group is large enough to be considered a representative cress-section of the country as a whole. The last census estimates the number of families in the country at 27,000,000. An average expenditure within the above estimates would make the annual bill for medical care considerably above the $2,500,000,000 at which-it has been conservatively placed. Nor does that tremendous sum include the loss in money to industry represented by a loss of time by workers, or to workers themselves if they are “docked” in wages for illness. When this particular study has been completed it ey, 72 :B0,. Some idea of the loss to industry, or to the individuals in salary or wages where they are “docked” for illness, may be gained from the following: The census figures show that there are approximately 36,000,000 wage earners in the country. Several surveys shcw that on the average a wage earner loses from 7 to 12 days annually from illness, making a total of about whether to the employer or to the employe, or both. THERE seems to be a sufficient number of doctors and hospitals to take care of the sick in this country without any material ine crease. There are enough beds in the hospitals to give each man, woman and child his day in the hospital. This is the average for the coun- try as a whole. But in some sparsely settled localities the hospitals are inaccessible to the sick, bringing the average occupancy of hos- pital beds to about 65 per cent. The questiom of the distribution of facilities for hospitaliza= tion and treatment by competent medical of- ficers eaters largely into the availability ef medical service. . It is not the purpose of the Commitiee on the Costs of Medical Care to inquire into the high cost, but merely into the cost of medical care. The rich often pay well for medical serv- ice, "because their demands are exacting and there is & compensatory force acting to balance the great amount of work which must be done by physicians for those who cannot or will not pay for the medical services they must have or which they demand for their families. This is responsible for the sliding scale for the cost of the same medical service, which may vary from $25 to $10,000, according to the wealth of the individual. It is this uneven cost of medical care to the individual in the varying income classes, to- gether with the free service which tradition has always demanded of the physician and which the physician has given so gladly, that especially complicates the physician’s problems. ‘There is no other profession or business from which the individual could demand service without expectation of paying a standardized price for that service. The more than 100 members of the Los Angeles County Medical Associsftion who are on the attending staff of the county hospital for indigent, sick and in- jured give annually professional services which have a money value of more than $500,000. The lawyer, the grocer, the butcher, the clothier or the street railway operator could not exist if required to render so much charity service. Nor would they permit such an uneven organization of prices in their various busi- nesses. This is interesting in view of the fact that the physician’s is the only professional re- lationship into which the factors of life and death enter. An arresting fact brought out by one of the studies of the committee was that the average salary for a trained physician in a rural com- munity, which in general is typical of the whole Middle Western part of the United States, s Continued on Eleventh Page