Health and Fiorello

New York City's Mayor Fiorello H. LaGuardia last fortnight filed incorporation papers for a city health-insurance plan. He hopes it will get started by January with 190,000 city-employe subscribers. But all New Yorkers earning less than $5,000 a year will be eligible.

Mayor LaGuardia's plan is the first in the U.S. to offer such inclusive service. For 4% of his income (paid half by his employer, half by himself), a citizen will get complete medical, surgical and hospital care for himself, his wife and all children under 18. The Mayor suggested that plans already in operation and conflicting with his (e.g., Associated Hospital Service with 1,500,000 subscribers, Community Medicine, Inc. with 43,000 members) merge with it.

If enough doctors sign up, medical care will be provided by an open panel of doctors (any doctor on the panel may be selected by the patient) on fixed fees. Otherwise, the plan will resort to a closed panel of doctors on salaries ranging from $6,000 to $20,000 a year and grouped throughout the city in centers designed to serve about 100,000 people each.

Among the incorporators are Henry J. Kaiser, Beardsley Ruml, Sidney Hillman, Wendell Willkie, the deans of four local medical schools, many a prominent doctor. But the five county medical societies are not represented.

Both the Mayor and society members denied that this indicates a rift between His Honor and local organized medicine. The societies accept the insurance idea in principle. They object to: 1) the idea of a closed panel; 2) letting in subscribers earning more than $2,500 (which would put many doctors almost entirely on a fixed-fee basis). The Mayor said he was "certain that the completed plans will meet universal approval."

All that medical society disapproval could do would be to cut down the number of doctors willing to take part. The Group Health Association case in Washington (TIME, April 14, 1941) established that any official opposition to group practice violates the Sherman Anti-Trust Act.

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