Letters to the Editor

Hawke's Bay Herald-Tribune, Issue 173, 9 August 1937, Page 3

Letters to the Editor

K.

SIMSON.

Doctors and State Health • Insurance Sir, — Dr. Cashmore's criticisms of the Government Health Scheme should not be accepted without question. Eirst of all, let me say that Hr. Cashmore's integrity and altruism are known to everyone and doubted by none. But, though charity is ono of the highest personal virtues, in this imperfeet world we have to build on a flrm foundation of law and regulation. Until the scheme •in its linal form is made public, and, has been interpreted by the Minister responsible for it, judgment may well be suspended; but some consideration of Dr. Cashmore's remarks seem called for here and now. In the first place, are medical men "in the pest position to know the best scheme"? Their advice, of course, is necessary, but the problem is not a medical one but one of^applied sociology — namely the efficient distribution of the best available medical and hospital services among the gi'eatest possible number of people. Applied sociology is the business of politicians when they are doing their job and not when they are bolstering up vested interests. Doctors, in this connection, make good servants but bad masters. Dr. Caskmore is reported as saying that "there is no reason why a man who is able to pay for his own services should be taxed to pay for those who cannot pay. " I submit that that is rank heresy and contrary to the principles of religion, of inorals, and of good government. Is it not necessary and just, and accepted practice in civilised communities that those who can alford to pay should be taxed to supply such things as drains that servo, to their common advantage, both those who have paid for them and those who have not? Then surely the existence in. our midst of a large body of people who are unable, through no fault of their own, to seek medical advice is similar to the e-xfstence of an open drainless cesspool. The wealthy man may die horribly from a foul disease that he has caught from eorae poor devil who could not aflord to go to a doctor. And do not all epidemics begin and spread among the poor to inf ect tho^e who are better fed, and better housed, and better served by doctors; and their children too? Those to whom money is the measure of all things can practice what J. M. Keynes calls ' 1 a perversion of mathematics" and do a little sum to see if they are getting their money 's wortn. If they should also be employers they will have to add the prolit that will come to them from more healthy and therefore more efficient employees and from the saving of time-off for illness. There are otliers who will feel amply repaid in their pride of country, pride of race and the exaltation of knowing that for once in a capitalistic country some of the goods of that vast accumulation of scieutific knowledge — the lifework and life-sacrifice of our fellowbeings — has become the heritage of all. ' From what has been made known of the scheme it is perfectly safe to say that it is certainly not socialisation of the medical profession. Who said th'e State was goin'g to take over the whole profession? No one. The scheme is merely practical social reform. I suggest that the medical profession should co-op'erate with the Government^ because a very strong case can be made out for 6omplete socialisation when their services would be as impartial and as free as our socialised police force or po'stal service. f'Under the scheme," says Dr. Cashmore, "the spirit of competition would be gone." If so, we should be very thankful. When we consult a doctor we want to be treated disinterestedly as a human being in trouble, in pain, and not as a nleaty bone in a doctor 's dog fight. Happily there is to-day a .new spirit abroad (not general yet but spreading); the spirit of a man. with a job to do, a problem to splve and who wanta to be set free economically in order to get on with his job of work. No high-f alutin ' idealism. Just that. By common consent the best health service in the world is that of Soviet Russia. Incidentally, Moscow, with a population of 3,600,000, is served by 8000 doctors and a staff of 40^000 and the whole service, ineluding a holiday for convalescence, is free to everyone, ineluding foreigners; vide, "Moscow in the Making," by Sir E. D. Simon. We are a small, compact country, rich in undeveloped resources and with no rigid age-old institutions; we also call ourselves Christians. How are we going to meet that challeiige? Not, it is certain, by obstruction. By the way, since when has the Hastings Rotary Club set up as a political propaganda bureau? Aren't they rather naughty? — Yours, ete.,

"aveiuci. orrn^August y, 1937. 1 1 [Although Dr. Cashmore did say that "there is no reason why a man who i? able to pay for his own medical services should be taxed to pay for another who is unable to pay," ko indicated clearly in his address that there is a section of the community who nuist be a cliarge upon the State for these services. The principal feature cf the British Medical Association 's health scheme is the division of the community iuto three groups, the first of these .being unemployed, pensioners, t.nd all those who aro unable to couIributo to a health insurance scheme. Dr. (.'ashmore was referriug to the propused special tax ou all carniugs by whieh an uukuown numbcr of millious oC pyuuds a year would be collected just as tho unemploymeut ckarge is at prosent collected. — Editor.J