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United Campus Ministry papers, 1970-1972

1971-10-30 Summary Report from Roger Simpson Page 3

-3-

D) Sen Kennedy
- shorter curriculum; increase enrollment; separate special funds; study costs of under gras med. ed; scholarships as needed. HC of 200 million can't be left to a few specialists"
"Highest paid professionals are MD; training at public expensel then into private business: NIH and bio-med. science research only areathat is tops HMC Leg., S935: target is academic centers of HMO. Many bills on this. To reform the HC delivery systems. Tail has wagged HC systems.
- which services are essential? Cost? Capital? Fed. role? Long-term cost? Quality?
-Need more testimony on HMO: on threashold of basic reforms.
History: 1798, Pub. H. Services to control epidemics; Hill Burton to get hospital construction, NIH to get new knowledge. RMP (Reg. Med. Pgm) was to change HC system but stunted in House by AMA. Govt. poured $$$ into doctors, hospital, insurance Co. and no one guarded interest of person.
HMO: only to prime the pump
Need also National Health Insurance: Fed. $$ for HC; national regulatory Bd. to set standares; permit people to have leverage for HC controls.
Must break down rigid system, help to become creative, flexible. Need basic reform of H. industry.

E) David Rogers MD, Dean John Hopkins
"Unity of Health: reasonable quest of impossible dream?"
1. Current statw of art of delivery of HC: state of disarray, much criticism Methods of HC delivery: sick tottering if not mortally ill. Philo. was law of supply & demand: consumer would get what needed nad find ways of paying THIS HAS NOT HAPPENED. Small monopolictic system has controlled HC for all Keeps supply limited.
Unresponsiveness of HC system: illustration of John Hopkins U. attempt to serve population of E. Baltimore: fragmented HC programs block effectiveness
Institutional problem: do we want to be agents of change? Most Inst. designed to obstruct change rather than promote it. (John Gardner) Faculties, adm. become self-serving, self-regulating; not risk taking. Desire to be change agents is not in evidence. "If we don;t change we will be like the Churches in the backwaters of society, relatively unimportant...."
HMO shows up schozophrenia of HC delivery systems. Teaching institutions helped foster the frustration. Where does the med-student fit in? Center for social change? Keep to studies? Must keep academic excellence and become involved in change and become relevant.
   After Flexner report, moved to be scientific med. inst. Lots of academic fallout. Got best students, faculty, yet, became elitist. Lost view of wider problems. Now, just replicating old problem. Face fact 85% of grads go into practive only 15% teach. Med. S. staff: don't know problems of real world. FED GOVERN. : need Sect. of Health. Develop ways of funding HC. combine pub. & private; support pre-paid med. Give rewards for HC and maintenance; hospital care not the answer, must have new ways.
   Proposal: HC Centers in each community. MD not have separate offices, gather into groups. Hosp. have labs, records and equipment. Out patient concent to disappear. One trip for MD and patient; all time there, no dragging around
   “So sensible, simple: will therefore be hard to implement” 
   Our role (AAMC) is critical yet, don’t move - so other sectors will. Are we (AACM) bureaucratic, fat & preoccupied with being right? DO WE HAVE THE CAPACITY TO BE LEADERS? 
   Must re-define U. Hosp.: merge U. Med st science with U basic science. Start training of med. ed. earlier, broader exposure to humanities. Give BS in human biology (Stop pretending we’re doing a good job) Train MD to associate with other vocations. Train HC teams (no more isolation) See HC as encountered by society. Curr. Changes: keep residency under Med. S. (& don’t use resident to solve staff problems) Need multi-track educational systems.

(CONT. OVERLEAF)

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-3- D) Sen Kennedy - shorter curriculum; increase enrollment; separate special funds; study costs of under gras med. ed; scholarships as needed. HC of 200 million can't be left to a few specialists" "Highest paid professionals are MD; training at public expensel then into private business: NIH and bio-med. science research only areathat is tops HMC Leg., S935: target is academic centers of HMO. Many bills on this. To reform the HC delivery systems. Tail has wagged HC systems. - which services are essential? Cost? Capital? Fed. role? Long-term cost? Quality? -Need more testimony on HMO: on threashold of basic reforms. History: 1798, Pub. H. Services to control epidemics; Hill Burton to get hospital construction, NIH to get new knowledge. RMP (Reg. Med. Pgm) was to change HC system but stunted in House by AMA. Govt. poured $$$ into doctors, hospital, insurance Co. and no one guarded interest of person. HMO: only to prime the pump Need also National Health Insurance: Fed. $$ for HC; national regulatory Bd. to set standares; permit people to have leverage for HC controls. Must break down rigid system, help to become creative, flexible. Need basic reform of H. industry. E) David Rogers MD, Dean John Hopkins "Unity of Health: reasonable quest of impossible dream?" 1. Current statw of art of delivery of HC: state of disarray, much criticism Methods of HC delivery: sick tottering if not mortally ill. Philo. was law of supply & demand: consumer would get what needed nad find ways of paying THIS HAS NOT HAPPENED. Small monopolictic system has controlled HC for all Keeps supply limited. Unresponsiveness of HC system: illustration of John Hopkins U. attempt to serve population of E. Baltimore: fragmented HC programs block effectiveness Institutional problem: do we want to be agents of change? Most Inst. designed to obstruct change rather than promote it. (John Gardner) Faculties, adm. become self-serving, self-regulating; not risk taking. Desire to be change agents is not in evidence. "If we don;t change we will be like the Churches in the backwaters of society, relatively unimportant...." HMO shows up schozophrenia of HC delivery systems. Teaching institutions helped foster the frustration. Where does the med-student fit in? Center for social change? Keep to studies? Must keep academic excellence and become involved in change and become relevant. After Flexner report, moved to be scientific med. inst. Lots of academic fallout. Got best students, faculty, yet, became elitist. Lost view of wider problems. Now, just replicating old problem. Face fact 85% of grads go into practive only 15% teach. Med. S. staff: don't know problems of real world. FED GOVERN. : need Sect. of Health. Develop ways of funding HC. combine pub. & private; support pre-paid med. Give rewards for HC and maintenance; hospital care not the answer, must have new ways. Proposal: HC Centers in each community. MD not have separate offices, gather into groups. Hosp. have labs, records and equipment. Out patient concent to disappear. One trip for MD and patient; all time there, no dragging around “So sensible, simple: will therefore be hard to implement” Our role (AAMC) is critical yet, don’t move - so other sectors will. Are we (AACM) bureaucratic, fat & preoccupied with being right? DO WE HAVE THE CAPACITY TO BE LEADERS? Must re-define U. Hosp.: merge U. Med st science with U basic science. Start training of med. ed. earlier, broader exposure to humanities. Give BS in human biology (Stop pretending we’re doing a good job) Train MD to associate with other vocations. Train HC teams (no more isolation) See HC as encountered by society. Curr. Changes: keep residency under Med. S. (& don’t use resident to solve staff problems) Need multi-track educational systems. (CONT. OVERLEAF)