JANUARY 19, 1962
NEW YORK—At last the American Medical Association has felt the pressure of public opinion and has proposed a plan of health insurance for persons over 65 through the Blue Shield organization, which it sponsors.
The announcement has been made to prevent the passage of an Administration-approved bill which would provide certain hospital and nursing benefits under the Social Security system. The objective of the Blue Shield plan, according to the AMA, is to prevent a dread thing called "socialized medicine."
Certain other countries, notably Great Britain, seems to be fairly well satisfied with their experiment in so-called socialized medicine, and I would like to see a clear analysis of the difference between the British plan, as it has operated for a number of years, and the one now proposed by the AMA.
The AMA plan must be advertised in April in order to be put into operation in July, so there is a little time to examine this plan and the government plan to determine which would be more beneficial.
The reason for the delay, of course, is that the new insurance must be approved by the 69 affiliated agencies now in existence through private Blue Shield health insurance.
Cost of the AMA plan is estimated at $3 a month per person. At present, throughout the country, Blue Shield plans for older persons run from $1.65 to $8 a month, depending upon the benefits.
The new program will pay full costs of medical and surgical service for a single person whose annual income is $2,500 or less and for couples whose income is $4,000 or less. Persons with larger incomes will be charged more if the physician desires.
Surgery would have to be performed in a hospital or doctor's office, and only medical care in a hospital or nursing home would be covered, not care needed in the patient's residence. The number of doctor's visits that would be covered has not yet been determined, but it would be between 30 and 70.
Those who have been hospitalized under some Blue Cross plan before may be interested in knowing that the new plan would include payments for, among other things, anesthesia, radiation treatments, X-rays and laboratory tests.
The announcement said limitations and exclusions will be minimal. This will be interesting to those who, when holding Blue Cross insurance, found that they had to pay almost a third of their hospital bill outside of their insurance coverage. This is a considerable sum for anyone on a limited income.
Whether this Blue Shield-AMA plan is really better and whether it will give more satisfactory care than under the government Social Security system is still not clear, since no real comparison can be made at the moment. But I would like to see a detailed statement of the benefits under each plan, and the cost in each case.
As we discuss methods of providing medical care for the aged, an interesting program of research is being conducted on a hospital setup that would change much that has been done in the past and should make the cost of care much less.
It was described in an article in the November, 1961, issue of the Modern Hospital. By the end of the year, in Tuskegee, Ala., the first of four prototype atomedic hospitals will be presented for inspection. This is the first step in a program to build a whole electronic hospital, constructed entirely of lightweight electronic material that can be prefabricated and mass produced.
Doctors in the Atomedics Research Center say their purpose is to answer the question, "What is health?"
New scientific developments occur so rapidly that it is hard to keep up with them, and it seems that this plan in Tuskegee will make a real difference in the insurance coverage of medical care for the aged.