Federal Hospitals BY GEORGE E. SOKOLSKY DESERET NEWS APRIL 2 1949 At a time like this, when socialized medicine is attracting so much interest, it is of value to look at the Hoover task force report on Federal Medical Services. The problem is not a small one. The report says. Four big and some 40 smaller agencies of the government spent about 1,250,000,000 for health and medical services in fiscal year 1948, an increase of five times over 1940, and of 20 per cent even over 1947. In 1949, the Veterans Administration alone will spend as much as all 46 agencies did in 1948 half of it for new hospitals. The United States gives varying degress of care to 24,000,000 beneficiaries about one sixth of the nation It has been estimated that by 1975 if no war occurs there will be need for 250,000 beds and that three quarters of these will be for mental cases. Yet there is no central plan. An administration which for 16 years has been planning, has no fixed responsibility for hospitalization. One government hospital may be short of beds, another short of patients, but they cannot get together. The Hoover task force Recommends. Need For Integration Fundamental to all others is the conclusion that there must be overall planning and that this in turn requires first a clear definition of the extent of the responsibilities and second an organization appropriate to carry out the commitment. Here is an example of what the task force found. In the New York City area we felt that under unified management four Army and Air Force hospitals none of which is professionally adequate could be closed, reducing requirements for medical officers by 80 per cent .but at the same time providing a higher standard of care. We found that the absence of integration of federal hospitals produced a waste of physical plant, and under utilization of scarce military medical personnel; further, that ambitious plans of all but one of the agencies to build new hospitals are likely to make the situation worse. Costs of their planned construction are over 100,000,000. This will double the permanent plant, with no prospect of staffing it, and no satisfying evidence that additional beds in such amount are needed Scarce Personnel The following statement in the task force report is shocking. The current Veterans Administration building program alone will cost 1,100,000,000. The armed forces desire another 200,000,000 for construction. Large Veterans Administration hospitals cost about 20,000 a bed; small ones over 30,000. One is costing 51,000 for a single bed. They are being built at vastly greater cost than the per bed cost of community non federal hospitals nearly half of the 89 new Veterans Administration hospitals are being built or planned in areas where experience has proven that it will be difficult, if not impossible, to secure adequate staffs. The Veterans' Administration is apparently guilty of carelessness and waste. A source for graft is the non service connected use of government institutions. On this subject the report says. As to veterans with non service connected disabilities, there is authorization to hospitalize them only if a bed is available. Yet 100,000 Veterans Administration hospital beds have been built or authorized which serve no purpose except deliberately to make beds available for non service connected cases Potent Force The remedy is a single government hospital service in a newly formed Bureau of Health, with full responsibility, in charge not only of all U. S. government hospitals but of the public health services and of research. It would be empowered to aid medical schools and to pay voluntary and other hospitals for such services as it required of them. The task force report makes this affirmative proposal. First is the need for maximum employment of present scientific knowledge to control disease. But beyond application of present knowledge lies research to find new weapons. Research and public health together since the turn of the century have made it possible to postpone by about 20 years the death of the average newborn child. Medical research has conquered plagues and numbers of mortal diseases. It is today a resourceful, potent force of incalculable humanitarian, national, and world value....(Copyright by King Features Syndicate)