Monday, June 20, 2005
Mutual aid and the welfare state
[Susan Olasky , "Healthy alternative," World Magazine, 18 June 2005.]
One New Jersey doctor's charitable efforts underscore the transformation that has taken place in America's health care system:
According to University of Alabama historian David Beito, in 1920 nearly one-third of adults over age 20 were members of fraternal lodges that typically contracted with a general practitioner to provide medical care to members who paid one or two dollars a year for coverage of themselves and their families. For example, on the Lower East Side of Manhattan "500 doctors had contracts with Jewish lodges alone. During the 1920s, there were an estimated 600 fraternal societies among blacks in New Orleans that offered the services of a physician." By the 1930s, though, "lodge practice" faced increasing competition from insurance companies, government programs, and medical associations that "launched an all-out war against lodge practice. . . . Old relationships of voluntary reciprocity and autonomy [gave way before] impersonal bureaucracies controlled by outsiders."
Whether clinics like Zarephath signal a return to mutual aid, as the Ecks would like, depends a lot on forces beyond their control. Will Congress enact policies that encourage innovation and provide incentives for doctors to provide charity care? All doctors aren't like the Ecks, but the existence of only 17 low-cost clinics like ZHC in New Jersey shows both a lack of incentives and the presence of disincentives.
[Susan Olasky , "Healthy alternative," World Magazine, 18 June 2005.]
One New Jersey doctor's charitable efforts underscore the transformation that has taken place in America's health care system:
According to University of Alabama historian David Beito, in 1920 nearly one-third of adults over age 20 were members of fraternal lodges that typically contracted with a general practitioner to provide medical care to members who paid one or two dollars a year for coverage of themselves and their families. For example, on the Lower East Side of Manhattan "500 doctors had contracts with Jewish lodges alone. During the 1920s, there were an estimated 600 fraternal societies among blacks in New Orleans that offered the services of a physician." By the 1930s, though, "lodge practice" faced increasing competition from insurance companies, government programs, and medical associations that "launched an all-out war against lodge practice. . . . Old relationships of voluntary reciprocity and autonomy [gave way before] impersonal bureaucracies controlled by outsiders."
Whether clinics like Zarephath signal a return to mutual aid, as the Ecks would like, depends a lot on forces beyond their control. Will Congress enact policies that encourage innovation and provide incentives for doctors to provide charity care? All doctors aren't like the Ecks, but the existence of only 17 low-cost clinics like ZHC in New Jersey shows both a lack of incentives and the presence of disincentives.
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