Medicine: For the Nation's Health

• Share

(2 of 2)

Personnel. After money, the biggest problem is personnel, the commission found. "From the big cities and from the forks of the creek," it reported, "the people asked for more physicians, nurses, dentists . . . There are not enough general physicians, and most of those that we have are so busy that they cannot give the patient the time and sympathetic care the old family doctor could give." Acute shortages were found in all specialties "with the possible exception of surgery."

Experts differed on how severe the doctor shortage would be by 1960. The commission could only conclude that then, with an estimated 171 million people, the U.S. will need from 22,000 to 45,000 more doctors. It proposed:

¶ Federal grants to schools of medicine, dentistry, nursing and public health, for modernizing and enlarging their plants.

¶Similar grants to help the schools meet their budget deficits, with no interference in the running of the schools.

¶ Federal scholarships to help needy students through the costly medical course.

Research. The commission was shocked to find that the $180 million spent in 1951 for medical research was "less than the amount spent on monuments and tombstones." In mental illness the picture is worse yet: the state and federal governments are spending $1 billion a year on the mentally ill, but only $6,000,000 on research into ways of cutting down this staggering tax burden. The commission's answer: spend more for research now, to save still more later.

Hospitals. The hospital outlook is bleak. Many rural areas have none. Mental and TB hospitals are hopelessly overcrowded. Almost as bad, says the commission, is the condition of obsolete hospitals: "It is difficult to practice good medicine in many of these run-down structures, and their weary air is a depressant to both patients and staff." Some should be modernized, others scrapped.

Using the standards already accepted by Congress—one general-hospital bed for every 220 population and one mental-hospital bed for every 200—the commission figures that the U.S. needs 230,000 new general hospital beds and 330,000 for mental cases.

"The hospital of tomorrow should be a well-rounded health center from which preventive, diagnostic treatment, rehabilitative and home-care services radiate to the entire community." To make this vision an actuality the commission proposed that federal grants to help build hospitals (already being made under the Hill-Burton Act, which expires in 1955) should be enlarged and continued.

The Setup. "The genius for organization, so characteristic of American life in general, is conspicuous in health services by its absence," the commission lamented. It charged that the most highly skilled doctors, dentists and nurses waste too much time doing jobs that less highly trained technicians could do as well or better, and that a lot of expensive equipment is not properly used for the benefit of doctor and patient. To get things running better, the commission urged:

¶ Federal loans to help local groups get a prepayment health plan started, itsdoctors to practice as a group.

¶ Establishment of a Department of Health and Security, to be headed by a secretary with Cabinet rank.