A $3 Billion Plan
Unless we do better, two-thirds of allAmericans now living will suffer or die from cancer, heart disease orstroke I expect you to do something about it.—President Johnson, April 17
The 18 physicians and ten otherpublic-spirited citizens whom the President thus exhorted when he namedthem to a special commission reported back to him last week that theU.S. can indeed do something about its greatest killers—but at a price.Under the chairmanship of Houston's famed Surgeon Michael E. DeBakey,the commission unanimously concluded that much needs to be done inseveral categories.
Pay if Possible. The report began with the stark facts: in 1963heart-artery diseases caused 55% of all U S deaths, and cancer 16%.Strokes killed 201,000; diseases of other arteries outside the braincombined with diseases of the heart to kill 793,000. Cancer killed285,000. Many of these deaths were "premature," judged by the fact thatthey carried off people under 65.
'Every day," said the commission, "men and women are dying who need notdie. Every hour, families are being plunged into tragedy that need nothappen."
This, said a commission spokesman, is because "medical miracles are inmany instances available only to the fortunate few who can get to theunique medical institution or specialist who can perform that miracle."To make miracle care available to all, beyond the areas of the 50 or somedical centers now providing it, the commission proposed a network of:
> High-powered regional "centers"—25 for heart disease, 20 forcancer and 15 for strokes—for intensive care of difficult cases and forresearch into better methods of care.
> Community "stations" across the nation—150 for heart disease, 200 forcancer and 100 for strokes, half in existing medical centers and halfin community hospitals, for immediate diagnosis and emergency care.
At both centers and stations, patients would be expected to pay if theycould, either directly or through insurance. In other cases, paymentwould come from the usual welfare resources. Even so, the federaltreasury would have to find $124 million for these networks the firstyear, and the bill would rise to $453 million a year within five years.This program, the commission insisted, is not socialized medicine butan answer to it.
To the Grass Roots. For the long haul, the commission urged that all theaffected community health services be integrated with universitymedical centers. Special emphasis, it said, must be given to gettingthe most recent developments and techniques of prevention and treatmentto the grass-roots level so that the practitioners may keep up and thepeople obtain the best care possible. In addition to the $153 millionalready appropriated for this year, the commission recommended that $56million be spent on another year of intensified research into the basiccauses of the "big three" killers. The commission also asked for $45million for training technicians and $52 million for added facilitiesand resources.
Despite the commission's disclaimers about "socialized medicine," theplan was sure to meet stiff opposition on political grounds. Andbecause of the estimated $3 billion price for the plan's first fiveyears, there was immediate criticism of its costliness. But thecommission said it was not asking for a bit more than the plan wasworth. The annual cost to the U.S. economy from lack of effectivetreatment for men and women in their productive years, said thecommission, runs into the billions of dollars.
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