Public health and insurance: American addressesNewsholme, Arthur, Sir
History
Public health and insurance: American addresses
Newsholme, Arthur, Sir
Health insurance -- Great Britain; Public health; Public health -- Great Britain
provided under the Act. Every insured person is allowed to choose his
own doctor within a given distance. In practice very few patients
change their doctor at a fixed time each year as they are allowed
to do; and a considerable proportion of insured persons do not
trouble to choose a doctor at all. The free choice of doctors is
rather a sentimental than a real demand. The panel doctor is paid
an annual capitation fee, and hitherto no limit has been placed on
the number who may place themselves on his roll. The domiciliary
treatment given by some doctors is entirely satisfactory within the
limits stated above. Commonly, however, it is as unsatisfactory as
the “club practice” which preceded it, and against which the British
Medical Association inveighed. It involves a continuance of the
mischievous ideal of medical practice of the past, a conception still
held by a large portion of the public to its own detriment, that a
hasty inquiry, a perfunctory examination, and a bottle of medicine,
represent the best that scientific medicine can offer a patient. Had
there been organized a chain of medical services for all needing it,
including consultations and expert assistance when needed, every
patient having the right to call for these when dissatisfied with
his panel doctor, including also hospital provision and nursing as
required, what a different story could now be told!
It is probable that some at least of these additional services will
be added gradually; but it must be noted that the present payments of
the insured will not suffice to pay for them; and that if they are to
be provided,—as they will probably need to be,—out of public funds,
the general public are in equity entitled to these services even
though they are not insured.
If these complete services were provided, the medical treatment now
provided largely at the expense of the community could be made a
means for advancing the public health. This it can not at present
claim to be. For nothing is more certain than that the prompt and
adequate treatment of disease curtails its duration, diminishes its
severity, and prevents its spread to others.
But even such a service would not fulfil its complete possibilities
for good unless it were joined to a system of hygienic supervision of
each insured person and of each insured person’s family, this system
being organically linked up with the wider public health work of the
larger Public Health Authorities.
Public-domain text, read in full here on John Shaqi.
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