Page 10


13 SERVER A Journal of Free Voices 250 A Window to the South April 2Z 1973 The health care dilemma Your money or your life Austin A rapidly growing number of Americans are asserting that good health care is the right of all citizens, not just a privilege of the wealthy. The most important social struggle of the seventies may well be the struggle for the definition and realization of this right to health care. Meanwhile the wonders of America’s medical technology are available to only a lucky few. Under the present health care system, some of us are more mortal than others. And we mere mortals had best heed the warning of Dr. Mathilde Krim of the Sloan-Kettering Institute who says, “The poorer you are the less sick you’d better be.” Texas has more working poor than any other state in the nation and it spends less on health care than all but seven states. The infant death rate in Texas is much higher than in the United States as a whole. The infant death rate among the chicano and black poor is much higher than the rate among Anglo infants. The cruel inequities of the health system are dramatically apparent in San Antonio, which is 51.2 percent Mexican-American, 41.7 percent Anglo and 7.1 percent black. In 1968, Texas had 50 percent of all the diptheria cases in the United States, 42 percent of all poliomyelitis cases, 32 percent of all the leprosy cases, 23 percent of the measles cases and 17 percent of the pertussis cases. San Antonio was the only area in Texas in which all five of these diseases were found. Once again, the Mexican-Americans and blacks in Bexar County had higher incidences of these diseases than did the wealthier Anglos, because the poor lack medical and health care services. IN SAN ANTONIO, 75.2 percent of the physicians’ offices are located in the northern sector of the city, the upperand middle-income area. Of the 14 San Antonio hospitals open to the pilblic, two-thirds are found in the wealthier sections. There are no emergency rooms in the predominantly-black East Side of San Antonio, and south of Culebra Street only one clinic provides major medical services to 250,000 inhabitants in the area. Rep. Mickey Leland Most of the figures cited above come from a class action suit filed by a group of black and brown San Antonio citizens against the Texas State Board of Medical Examiners and the Texas secretary of state. The plaintiffs are being represented by MALDEF, the Mexican American Legal Defense Fund. Unable to lure private doctors to their neighborhoods, the group had tried to set up a non-profit health provide group hospitalization and medical and health care. They found that Texas allows only licensed physicians to provide and collect fees for medical service. The suit seeks to overturn Texas laws that limit the creation of consumer-controlled HMO’s. The health maintenance organization is Richard Nixon’s answer to the health care mess. He endorsed the concept in both his 1971 and 1972 health messages, going so far as to say that HMO’s “ought to be everywhere available so that families will have a choice”. as to their health care alternatives. Despite the President’s recent massive budget slashes, he wants to increase grants for HMO development to $60 million next year. The HMO could be one of those rare shining instances when the free enterprise system works in the way public school children are taught to believe it works. Within the framework of an HMO, the goals of the patient, the insurer, the doctor, the medical laboratory and the hospital are all compatible. The patient good, reasonably priced health care when he’s ill. Under the present medical system, however, a doctor only makes a living when his patients get sick. He has no financial inducement to keep his clients healthy. Medical insurance usually picks up the tab only if a patient is treated in a hospital, so both the doctor and the patient are encouraged to use expensive hospital facilities, even when the same treatment could be provided in an out-patient clinic. It is in the insurer’s financial interest to write all manner of sneaky clauses into health policies, clauses stipulating that a policy holder can’t go to the hospital with the same malady more than once a year, that an unwed woman