The American Public Health Association has declared that national health insurance will not go far enough, and has called for a "national health service" that would put doctors on salary to give Americans their medical care.
In its annual meeting here this week, the 50,000 member organization called for some form of health insurance that would pave the way for a government-directed service that includes "all components" of health care, including doctors and hospitals.
Leaders of the group, which represents most of the nation's public health workers, said yesterday that Americans already get from a sixth to a seventh of all their care from salaried doctors - and federal, state and local governments last year paid 42 per cent of the country's $139 billion health bill.
In short, the APHA officers maintained the nation has begun moving toward salaried and government-directed care and will gradually have to go all the way through national health insurance is needed meanwhile.
A health service that replaces private, fee-for-service care may be "10, 20 or 30 years in earning" but it will ultimately come because it's the only system that will give care to all at an affordable price. Dr. George Pickett, APHA president, predicted in an interview.
If Congress adopts a national health insurance and it costs as much as Medicare and Medicald have been costing a government health service "could come much faster," said Dr. John Romand. APHA president-elect and head of the University of Michigan's Department of Health Planning and Administration.
In his opening speech as the big often-unnoticed health group met. Pickett - West Virginia's chief health officer - outlined "a totally public system," then asked, "Is this socialized medicine?" He answered his own question. "Yes," and the audience applauded enthusiastically.
For this group consists in the main not of privately practicing doctors, most of whom abhor any hint of government medicine but instead of doctors, nurses, social workers and administrators who staff state and local health departments, public clinics and hospitals and many other government non-profit and university units involved in health care.
"These are the people who don't make much money out of healthcare." one member said.
It was one year ago, in an action that drew little notice, that the association drew little notice, that the association for the first time voted to work toward a national health service little different in principle from the British health service, which pays all general practitioners so much a year for each patient and all specialists straight salaries.
Wednesday a task force under Dr. Paul Cornely of Washington - a former APHA president and former public health dean at Howard University further proposed that the APHA back national health insurance as an interim step "to the extent that it facilitates the eventual implementation of a national health service."
Both last year's proposal and this year's were overwhelmingly adopted by the 170-member governing council. representing 28,000 dues-paying members and the state and local health associations, which add another 22,000 affiliates.
Cornely said yesterday, "National health insurance is only a payment mechanism. We have to get the fat out of the system - the fee-for-service excess-profit-making and unnecessary operations and overbedded hospitals and overused technology. We should move toward a unified system under a federal health department.
A national health service bill has been proposed by Rep. Ronald V. Dellums (D-Calif.) but has little support. President Carter has promised a national health insurance proposed next year. But meanwhile, the hospital cost controls he proposed this year - as "essential" before the country can have national health insurance - are bogged down in congressional committees.