Plan & Poise

In the last few years, while one third of the population has lacked adequate medical attention, thousands of doctors have twiddled impecunious thumbs in empty offices. The American Medical Association has talked much, done little. Last year revolt rocked the genteel profession when 430 doctors, with big names and big practices, demanded that the A. M. A. pay more attention to the social problems of medicine, urged that the Government step in to help doctors as well as patients.

Answering this challenge, President Roosevelt last February published a detailed report of the nation's health prepared under the supervision of Josephine Roche who, as Assistant Secretary of the Treasury (1934-37), formerly headed Government health activities. He also called a National Health Conference, which met last week in Washington to sound out popular opinion on an extensive Government program of medical service. Present were 175 delegates of the American Farm Bureau Federation, American Federation of Labor, National Consumers' League, National League of Women Voters, United Mine Workers, etc. Also present were Dr. Hugh Cabot, leader of the 430 rebel doctors, and the A. M. A.'s triumvirate: President Irvin Abell, General Manager Olin West and Editor Morris Fishbein.

Said gracious Miss Roche, elaborating on her February report: "Fifty million Americans are in families receiving less than $1,000 a year. . . . The average cost of private medical care is $76 a person annually. . . . The total [yearly] cost of illness and premature death is $10,000,000,000. We cannot attack successfully with small change a ten-billion-dollar problem." She proposed that the Government embark on a ten-year program to spend $850,000,000 annually. Suggested appropriations: $705,000,000 for expansion of public health facilities, development of maternity and child health centres, financing of medical specialists, eradication of tuberculosis, venereal diseases and malaria, control of fatalities in pneumonia and cancer, promotion of mental hygiene and industrial hygiene; $145,000,000 for erecting hospitals with 360,000 extra beds, maintaining free beds, promoting medical research. The delegates heartily approved.

Answering Miss Roche, diplomatic Dr. Abell at first offered A. M. A. cooperation. Then suddenly the meeting lost its professional poise. Eminent Surgeon Cabot, of the Mayo Clinic, declared: "There are very large areas in this country where the practice of medicine . . . is medieval." Manager West arose and barked: "I don't know whether the medical profession is any more proud of him [Cabot] than he is of the medical profession." As for the plan, he continued "centralization of control of medical service by any State agency" would bring "great danger to the health of the nation." Said Editor Fishbein, vexed that Miss Roche had not consulted the potent A. M. A. in preparing her program: "I could tear to pieces . . . this program. . . . Medical care is not the most important problem before the people of the United States today. . . . The fundamental needs of mankind are food, fuel, clothing, shelter and a job, and medical care and dental care must always be subservient to these main human needs."

The conference cheered Dr. Cabot, gasped at Dr. West, applauded Dr. Fishbein's oratory, loudly contested A. M. A. ideas. Asked for no formal endorsement, the delegates hailed Miss Roche's assurance that the next Congress would consider her program. To Manhattan went Dr. Hugh Cabot and friends, where they proceeded to hold their first annual meeting, under the name of the Committee of Physicians. They upheld the Roche program. To their Chicago fortress went A. M. A.'s triumvirate, repeating: "There can be but one master in the house of physician."

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