ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS 230 NORTH HICHIGAN AVENUE CHICAGO, ILLINOIS 60601 PRESIDENT'S HEALTH MESSAGE ‘The Presidents health message calls for expansion feral government interference in the practice of He helps lay the groundwork for “nationali- zation of health” and simultaneously denies sary. He pours fuel on the fire calling it “a crisis” while the real “crisis” is reckless government usurpation of power ond deficit spending. In 1965 federal interventionists, by the unconsttu- tional assumption of power, established the principle of federal government interference in private medical care. As they said then re Medicare “all we want to do is get our foot in the door and we will expand the program after that.” The first paragraph of Mr. Nixon's message, ask- ing for expansion of government, explains that: Ameri- a's medical bill went up 170% in the last ten years, ‘and the federal government was largely responsible. However, he doesn’t propose to re-establish the sound constitutional principle that the federal government has no authority to extract money from the people to spend on health schemes - but asks, “What ore we getting for all this money? As if “we” meaning most- ly the government has @ just right to the money. President Nixon’s proposed expansion of central ‘government interference in medical care appears mild compared to the radical plan of Senator Kennedy. Yet, it is very dangerous ond contains some of the same radical basic proposals of the Kennedy scheme. Both plans will increase costs and lower the quality, of care. Both are against individual responsibility upon which this country’s success is based. Both violate the clear meaning of the Consitution os intended by its founders. Neither is authorized by ony amendment to the Consiution. Both illegitimately usurp power. Both violate ethical principles - are uneconomic - and perpet- vate @ hoax against unsuspecting potients ond tax- ayers. Both ore collectivist oriented. The differences are of degree only. Mr. Nixor’s plan would subsidize closed-panel NEWS LETTER : Index No. 3 March, 1971, Volume 25, No. 3 IN THIS ISSUE President Nisow's Health Mevioge ae Sot of the Nation's Heath Fnily Health Insurance Plan 3. Crunching Burdens of Bureaveracy Sympathy Private Doctors nau. - ‘Apel 1517, 1971» Chea per-capita prepayment groups ax would both Senator Kennedy's and Senator Javits’ (R. New York - ardent erventionist). Per-capita payment is the basis of so- cialized medicine in Great Britain. Mr. Nixon says his dministration is “enthusiastic” about this scheme ond says, "That is why we proposed legislation lost March to enable Medicare recipients to join such programs.” This concept was in the 1970 Social Security Bill (HR-17550) which passed the House and the Senate last yeor but died os the last session expired before the House and Senate could reconcile their differences. It has been reintroduced. It, oo, was strongly supported by the lefts: who understood how it would gradvally undermine our system: ‘AAPS strongly opposed it in testimony before the Senate Finance Committee in September. Most other medical groups who say they are for saving private medicine, gave only token opposition to it. AMA, in fact, submitted its own plan of subsidy and control (Medi- credit and Peer Review) which could be used as a club to police doctors via medical societies as agents of the federal government. The closed panel plan was recom- mended to Mr. Nixon by entrenched advisers in H.EW. They sugar-coated this “old” and deadly socialized medicine scheme calling it new and giving it the pleas- ‘ant sounding name “Health Maintenance Organiza- tions.”Government centralizers of every hue have favor- ed the plan for 40 years (Write: U. S. Department of H.E.W. for Research Report No. 29 which shows that the plan was proposed in 1932). If enacted, it will help pre- are public acceptance later for the more harsh and obviously damaging other provisions of the Kennedy plan of subsidy ond control. In fact, Senator Kennedy told HEW. Secretary Richardson that the HMO pro- posal is “one of the most imaginative and creative os- pects of the President's program.” The New Republic (February 27), considered to be the outstanding Fabian-Socialist magazine in this coun- tty, while dutifully parroting the falsehoods of Wilbur Cohen about infant mortality and the rest of the inter ventionist propaganda for compulsory nationalized medicine and while promoting Senator Kennedy's circus (called @ Senate Health Hearing) says. “Mr. Nixon has come a long way on the issue and many of his pro- posals are to be commended.” Also, Mr. Woodcock, President of UAW, successor to the late Walter Reuth- fer, in February testifying before @ U. S. Senate Committee said: “I take special pleasure in compliment: ing the Administration in placing great emphasis on the need to support the development of HMO's — Health Maintenance Organizations. This term embraces Neighborhood Health Centers and Family Health Cen- fers, ond — what we and mony others have for years known as group practice prepayment plans (GPPP') ‘end Professional Foundations (PF')." To cap the climax, AMA, according to quotations in the Chicago Tribune, endorsed the President's plan soying: “Our initial reaction to President Nixon’s health proposals is generally favorable.” It then endorses the revolutionary principles of the Medical Committee for Human Rights (Dr. Quentin D. Young, post national chairman, ete.) saying, “We endorse the principal that the basic right of every citizen to have available to him adequote health care.” Mr. Kennedy knows it leads to loss of freedom and more control; apparently our friends do not. Even the New York Times warns against the Nixon- Kennedy plans saying: “Both the Nixon and Kennedy proposals rely in different degrees upon the assump- tion that increased use of pre-paid group proctice systems - what the President calls Health Maintenance Organizations - can simultaneously lower costs and improve care. Unfortunately, this assumption requires more proof than is yet avoilable and there are some students of medical economies who challenge this claim Vigorously. Moreover, some existing systems of pr paid group practice - such as Keiser Permanente groups = have found that they tend to be inundated by clients whose troubles are more emotional than organic, thus hindering patients with serious organic illness from ‘gaining timely access fo proper care, More study and ‘experimentation are needed.” “WHICHED” Friends and foes, patients and doctors, are being ‘“whiched” - “which” of two government programs do you choose? “Which” route should the nation take as far 1s medical care is concerned with respect fo more taxes, more inflation, more red tape, more bureaucracy, more political interference in personal transactions, more special deals for insiders, and more government em- ployee interference with the medical judgment of quali- fied doctors? The question isn't asked, “Should we stop plung- ing into the chaos of government subsidy ond control?” = We are asked “which” government plan should we accept? Thot being promoted by AMA, AHA, Nixon, Kennedy, Javits, Pell, Omar Burleson (the insurance in- dustry) or dozens of others? This “which” is a trap. The question isn't "which’ of the proposed government plons do you choose?" It is “do you choose to be a private doctor, exercising your free ond independent judgment, dealing directly with your patient and look- ing to him only for poyment” or "Do you choose to be © political puppet smothered by minute government rules ond regulations and looking to government for payment?" Both the settlers ond many of the recent immi- grants to this country left Europe to avoid government domination. The answer is clear - Americans who believe in our system of doctors and pati system ask: "Oh, but what are you going to do about the poor who need care and aren't getting it?” That question is also a trap. It assumes that if the right kind of a government program is forced upon us the “needs” of everyone will be token care of as they wish or at least better than now. If this is tue, the “needs” of everyone in Germany, Britain, Russia, etc., would be taken care of os each citizen wished or better than is done here. As a motier of fact, the evidence doesn’t support this. Yes, they are "taken care of” better there than here as judged by the extent of government con- trol of individuals and most of their activities. Under ‘our system, we have more and better trained doctors per thousand citizens, more and better hospitals, more and better drugs than ony other area in the world.STATUS OF THE NATION'S HEALTH Secretary Richardson testified in February thot “Amid ll the possions raised about health in the United States, itis all too frequently forgotten that o variety of measures indicate that the health of our peo- ple has been steadily improving. Since 1950, li Pectancy has increased 3.4 percent, the infant death rate hos dropped 2.3 percent, the maternal death rate has gone down 66 percent, and the neonatal death rote has fallen by 19.5 percent. Between 1960 ond 1968, the doys lost from work per person have de- creased by 3.5 percent, and the days lost from school per person have decreased by 7.5 percent. “Another set of indices tells us thot the national effort to purchase better health has been expanding at @ rapid rate. Health care expenditures, for example, have been increasing at a faster rote than the growth in the Gross Notional Produet: in 1955, total health expenditures were $18 billion, or 47 percent of GNP, whereas in 1970 they amounted to $67 billion, or 7.0 percent of GNP. "Yet other indices inform us that resources hove been growing faster than hes population, especially in recent years. There were 12.4 hospital beds per 1,000 people in our civilian population in 1963; by 1968, there were 13.5. Between 1950 and 1966, while the popula- tion of the United States was increasing by 29 percent, the number of people in health occupations increased by more than 90 percent - three times as fast. In 1960, ‘health workers comprised 2.9 percent of the civilian labor force: by 1966, the percentage was 37 ond rising. Our supply of physicians increased by 34 per- cent in the some period. “Finally, in our review of the facts, we note a marked rise in health insurance coverage for all mem- bers of our population. In 1950, 48.7 percent of em- ployed workers were covered for hospitalization; in 1967, almost 72 percent were so covered. In 1950, only 35.5 percent of employees were covered for surgi- cal benefits, 16.4 percent for regular medical benefit, ‘and none for major medical expenses. In 1967, the comparable percentages were 70.5, 61.2 and 288. For the population as @ whole, 20 years ago, only 50 percent had health insurance; today, it is 80 percent.” Our system has made 85% of us the envy of the world. Through government intervention, the 85% of us can be dragged down to the level of the 15% who haven't made it. By being “whiched” you can contribute fo tearing down the good of the 859%. But why do thot? Why not, through voluntary non-governmental means help the 15% to improve themselves? Through cour system, the 15% have o chance to improve their lot. Under foreign schemes, 100% ore trapped by government with escape being their only chance for improvement. The unfortunate few among the 15% her ‘who are legally judged incapable of caring for them- selves should first be token care of compassionately ‘and personelly by their family, neighbors, church, or local government. When individuals cannot care for “needs” those closest to them can judge the their own “ne extent of their needs and how to help them best. This is not Heaven, yet it isnt the Hell of political medieine for everyone. Those who do not believe in freedom have cobandoned the idea of “need” and say ” medical care is @ right” They also say reading is @ right. This, of courte, is begging the question. We either build on our system of individual responsibilty and keep government in check or we repeat the mistakes of history and per- mit political medicine to destroy good medicine. Under Mr. Nixon’s expansion of federal interfer- cence, private employers would be forced to poy for insurance for employees which the central government would control through the establishment of standards ‘and other subtle means of manivplating the insurers cond the insured. It could force cancellation of private insurance through refusal of double coverage. We ore feminded that the old folks regardless of their desire or ability to pay lost their insurance by mass cancella- with government approval. We wonder what the health insurance industry will have left to it. The whole scheme proceeds a pace in helping to destroy private decision-making (private capitalism) and in- floting government monopoly capitalism. This is the revolutionary transition blueprint Lenin followed and his disciples are new using. One Senator summed the whole thing up in a couple of words when he was asked what was going fon in the health core field, he scid, “An auction!” = meaning that a political auction is taking place between competing candidates for the presidency os to how to buy the election with Federal Treasury funds, cond never mind the fact that it will result in the patients paying more, getting less, and losing their heritage. The President's Fomily Health Insurance Plan: The Health message also called for doing away with Medi- caid programs run by the stotes, except for programs for the aged, blind, and disabled. The Federal Govern- ment would pay premium costs for insurance for o fomily of four having @ taxable income of $3,000 or less. Families having taxable income of $3,000 to $5,000 would poy a portion of premium costs depend: ing upon the size of the family.‘Also, the President recommended additional sub- Sidies for @ number of schemes such os on additonal $23 million to closed-ponel prepayment per-capita group practice plans - Federal loan guarantees of $300 million to help such plans raise capital so they can take edvantage of « handsome subsidy (unfairly diseriminat- ing against privete practice); @ series of new area health education centers for which he requests $40 nillion to implement the Emergency Health Personnel ct whereby salaried public health service personnel will practice political medicine in areas designated by the government; on additional $40 million in new money for educating additional health professionals; increase the Allied Health Personnel Training Program by 50% over 1971 levels to $29 million and that $15 milion of this emount be devoted to training physician’ assistants. He instructed H.W. to presture 22 states to abandon laws ogainst delegating certain medical tasks to cssistants. He called it eliminating state bar- riers. Former Secretary Wilbur Cohen expressed the same principles. The President also proposes that peo- ple over 65 stop paying for Part 8 whichis now schedul- ed to rise to $5.60 per month. He would pay it all out of increased Social Security taxes. This is the program that Mr. Johnson used fo establish the principle of gov- ernment intervention through Medicare - which he said would only cost old people $1.00 per month and wouldn't cost the Federal Treasury anthing CRUNCHING BURDENS OF BUREAUCRACY Yet Mr. Nixon told the American College of Cardiology “we must keep the doctor free from the terrible crushing burden of bureaucracy.” “I don't want my doctor to spend so much time filing out forms ‘that he doesn’t spend enough time doing what is need- fed to be done as a doctor for the patient.” Judging from Mr. Nixon's protest about his in- tentions and his conflicting advocacy of government intervention os proposed by H.EW. and government interventionists for the past 90 years, he is trapped and confused. Only vigorous and intelligent action by you ‘and your patients and many other doctors and their potients will stop the “auction” and “the confusion.” ‘SYMPATHY It is with deep regret that we inform the memb ship of the death of Louis S. Wegryn, M.D. Sea Girt, New Jersey on Sunday, February 14, 1971. He wos President of the Association from 1959-1960 ond served the Associaton in many capacities - President, Director, Delegate ond Chairmen and member of several Com- mittees. We extend our deepest sympathy to Mrs. Wegryn and other members of the Wegryn family. PRIVATE DOCTORS INSTITUTE The Private Doctors Institute will be meeting in Chicago on April 15-17, 1971 at the Hotels Ambassa- dor, Chicago. Enclosed with this News Letter is a brochure giving complete details on this IMPORTANT Meeting, listing speakers, registration fee and other pertinent data. Please fill out the room reservation form ond return it with your check for registration fee to AAPS Chicago Headquarters - AT ONCE, Time is short - please mail your card today. WOMAN'S AUXILIARY The APS Woman's Auxiliary will hold its second meeting at the April sessions, Hotel Ambassador, East, Kennedy Suite. Mrs. Maurice W. Peterson is Choirman of the Auxiliary for this year. There will be @ "get ac- quainted” session on Thursday; Friday will be Ladies Day with a luncheon in the fashionable PUMP ROOM, «tour of the Chicago Board of Trade Building, and Business Session where Committees will be appointed fon Scturday morning. Plan now to attend this meeting with your husband to make this newly formed group RESOLUTIONS: Resolutions to be considered at the April Meeting by the Resolutions Committee must be submitted in usual resolution form, in writing, and preferably typed cond received at Chicago Headquarters no later than March 26, 1971 Sincerely, \newtce W; Maurice W. Peterson, MD. President Enclosure: Private Doctors Institute brochure with reservation form