A third, and even more fundamental, advantage of a State Medical Service
is that it would help to bring Treatment into touch with Prevention. The
private practitioner, as such, inside or outside the Insurance scheme,
cannot conveniently go behind his patient's illness. But the State doctor
would be entitled to ask: _Why_ has this man broken down? The State's
guardianship of the health of its citizens now begins at birth (is
tending to be carried back before birth) and covers the school life. If
a man falls ill, it is, nowadays, legitimate to inquire where the
responsibility lies. It is all very well to patch up the diseased man
with drugs or what not. But at best that is a makeshift method. The
Consumptive Sanatoriums have aroused enthusiasm, and they also are all
very well. But the Charity Organisation Society has shown that only about
50 per cent. of those who pass through such institutions become fit for
work. It is not more treatment of disease that we want, it is less need
for treatment. And a State Medical Service is the only method by which
Medicine can be brought into close touch with Hygiene.
The present attitude of the medical profession sometimes strikes people
as narrow, unpatriotic, and merely self-interested. But the Insurance
Act has brought a powerful ferment of intellectual activity into the
medical profession which in the end will work to finer issues. A
significant sign of the times is the establishment of the State Medical
Service Association, having for its aim the organisation of the medical
profession as a State Service, the nationalisation of hospitals, and
the unification of preventive and curative medicine.
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