MICHAEL M. DAVIS. Medical Care for To morrow. Pp. x, 497. New York: Harper and Brothers, 1955. $6.50

• Author: Franz Goldmann
• Published date: 01 July 1955
• Date: 01 July 1955
• DOI: http://doi.org/10.1177/000271625530000148
• Subject Matter: Articles

155

MICHAEL

M.

DAVIS.

Medical

Care

for

To-

morrow.

Pp.

x,

497.

New

York:

Harper

and

Brothers,

1955.

$6.50.

Among

the

many

recent

publications

on

the

sociology

and

economics

of

medicine,

Dr.

Davis’

book

stands

out

as

the

most

comprehensive,

the

most

scholarly,

the

most

courageous,

and

the

one

most

likely

to

rekindle

the

flames

of

controversy

over

national

health

insurance.

The

first

three

parts,

dealing

with

basic

elements

in

medi-

cal

services,

evolution

in

organizations,

and

evolution

in

economics,

present

a

detailed

description

and

an

incisive

analysis

of

the

many

and

varied

forces

that

have

shaped

the

policies

followed

by

society

in

its

ef-

forts

to

adapt

medicine

and

the

related

sciences

to

social

needs

and

uses.

Acknowl-

edging

progress,

Dr.

Davis

nevertheless

is

forced

to

conclude

that

the

present

balance

is

too

uncertain

to

be

durable.

He

believes

the

time

has

come

to

envision

goals

desir-

able

alike

for

medicine

and

for

society

and

to

work

toward

their

achievement.

After

studying

the

present

situation

through

a

microscope

Dr.

Davis

takes

a

telescope

to

scan

the

horizon,

and

what

he

sees

there

is

recorded

in

the

final

part

of

the

book.

Dr.

Davis

is

convinced

that

the

demand

for

comprehensive

medical

care

will

be

per-

sistent

and

growing

in

intensity,

that

the

American

people

can

afford

to

spend

on

medical

care

all

they

need

(p.

322),

and

that

the

long-range

interests

of

medicine

and

the

interests

of

the

public

are

against

the

fee-for-service

method

of

remuner-

ating

physicians

(p.

337).

He

is

fully

aware

of

the

fact

that

the

problem

of

or-

ganizing

payment

for

comprehensive

medi-

cal

care

is

interrelated

with

others,

such

as

creation

of

a

service

organization

provid-

ing

for the

necessary

profesional

personnel

and

physical

facilities

and

for

attainment

of

teamwork

through

group

practice

and

regional

organization

of

hospitals.

He

realizes

the

importance

of

educational

proc-

esses,

especially

the

need

for

changing

the

climate

of

opinion

in

professional

schools.

&dquo;The

basic

issue ...

is

not

the

survival

of

individualism,

but

the

maintenance

of

indi-

viduality

within

organization&dquo;

(p.

428).

Without

a

&dquo;broad

and

frontal

attack

on

the

economic

problem

of

medical

care,

that

is,

the

methods

of

paying

for

it,&dquo;

the

au-

thor

expects

but

&dquo;slight

and

spotty

progress

in

developing

widespread

group-practice

units,

regional

organization,

adequate

sup-

ply

and

distribution

of

needed

professional

personnel&dquo;

(p.

395).

Discussing

the

chief

alternatives

in

developing

group

payment,

Dr.

Davis

is

certain

&dquo;that

we

shall

have

neither

all

insurance

nor

all

taxation,

but

some

of

both&dquo;

(p.

430).

He

favors

na-

tional

health

insurance,

proceeding

by

stages,

and

makes

a

strong

plea

for

&dquo;ex-

pedited

gradualism,

expedited

and

directed

by

those

who

view

medicine

not

merely

as a

healing,

or

even

a

preventive

agent

but

as

one

of

the

chief

creative

and

re-

constructive

forces

which

physical,

chemi-

cal,

biological,

psychological,

and

social

sci-

ences

are

now

marshaling

for

mankind&dquo;

(p.

433).

FRANZ

GOLDMANN

Harvard

School

of

Public

Health

JOSEPH

FLETCHER.

Morals

and

Medicine.

Pp.

xvii,

243.

Princeton,

N.

J.:

Prince-

ton

University

Press,

1954.

$4.50.

This

is

a

study

of

the

&dquo;ethics

of

medical

care,&dquo;

as

distinct

from

&dquo;medical

ethics&dquo;

in

the

ordinary

meaning

of

the

latter

term.

The

author,

who

is

professor

of

Christian

ethics

at

the

Episcopal

Theological

School

in

Cambridge,

Massachusetts,

states

that

little

systematic

writing

on

his

subject

has

been

produced

in

Protestant

or

Jewish

cir-

cles.

He

also

finds

the

treatment

of

such

genuinely

ethical

questions

as

appear

in

professional

codes

to

be

ambiguous

or

evasive.

These

codes,

moreover,

focus

on

the

rights

and

actions

of

physicians,

whereas

the

author

is

concerned

with

the

rights

of

patients.

There

is,

on

the

other

hand,

a

large

and

pertinent

Catholic

literature,

to

which

the

present

study

is

of-

fered

as

&dquo;counterpoint.&dquo;

The

author’s

views

are

founded

on

an

extensive

knowledge

of

the

sources-both

historical

and

contemporary.

They

are

also

based

on

the

belief

that

choice

and

re-

sponsibility

are

&dquo;the

very

heart

of

ethics.&dquo;

Patients,

like

all

men,

are

moral

or

im-

moral

to

the

extent

that

they

are

free.

They

therefore

have

a

right

to

be

treated

as

free

beings;

that

is,

as

persons

rather