The Health bulletin [serial] - University of North Carolina at Chapel Hill

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Both have the two principal features which organized medicine
believes are essential to sound government healthcare pro-
grams:
First, it helps those who need help.
Second, it is administered at the state level.
The AAAA believes that a properly administered Title 19
program, with realistic criteria of eligibility designed for economically
disadvantaged persons, plus the encouragement and
availability of voluntary health insurance and prepayment
plans for the solvent provide the best approach to health care.
Together they could take care of all citizens without forcing
taxpayers to pay for care for those who can well afford to
provide their own care.
Physicians, and their professional association, the American
Medical Association, have always believed in medical care for
all, recognizing that the needy might not be able to pay for
it. Care has always been given to those unable to pay.
The definition of "medically needy" is one of the factors
which has both potential for good and for problems. A stan-
dard set too low would exclude some who need help, a stan-
dard set too high would authorize tax care for some who can
well afford to pay their own way. At this writing. Congress
was considering legislation which would set a top limit on
state income standards for the medically needy at about one
and one-third times the maximum welfare grant in the de-
pendent-children program.
Currently New York State has established an income eligi-
bility level of $6000 after taxes for a family of four, if Con-
gressional action is taken on the above measure as proposed,
this $6000 figure would be cut to about $3900. In California,
the same size family would be eligible with an income of
$3804 or
carefully.
less, and even there the program is being watched
New York State's year-old Medicaid program still appears
snarled except in a few areas such as Monroe County (Roches-
ter), where the program administrator has established a close
working relationship with private physicians. In other areas
there are complaints of delay in getting people into the program
and on health-care service itself, which some recipients
feel is slow or inadequate.
Another area which also holds problems as well as promise is
that federal requirement which calls for "comprehensive care"—
the physician orders— to be provided for under Medi-
caid by 1975. While this is a goal long sought for the needy,
it obviously creates financial problems for some state govern-
,ments. Most states can truthfully claim that the needy can
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obtain almost any type of care they need now, but it has been
through a melange of sources, programs, financing, and private
December, 1967 THE HEALTH BULLETIN 13