History has clues to medical changes

Posted: Sunday, April 07, 2002

Editor:

I read with interest Mindy Jeffers March 27 guest column, Practices still far from perfect, written as usual in her inimitable style.

While Jeffers arrived on the scene in 1955 at a cost of $75, I made my appearance in 1923. I have no idea at what cost, though it may have been settled with milk, eggs - or perhaps a ham, after they saw what they were getting. I have a copy of the Washington, D.C., Evening Star from that day. I can glean no information from it about medical costs, though the newspaper cost 2 cents.

The mortality rate was not so good in those good old days; lots of babies didnt make it, and life expectancy was around 45 or 50. Kids had a lot of chores and at 13 I had a paper route. My long johns were not adequate, as I carried the Cincinnati Enquirer in the cold winter mornings before daylight. Well, my pneumonia and delirium were treated at home and the doctor came to the house, a quite ordinary thing before 1935. There was no penicillin, so doctors applied salve, cold medicine and a lot of hope and practical medical skills.

The medical circumstances that Jeffers writes about may have started during World War II when antibiotics appeared and common killers such as pneumonia became routinely treatable. The management of hypertension, diabetes, etc. became big business. ... The race was on for pharmaceutical companies as they competed for market share with their various pills and potions .

High-tech advances in diagnostic equipment and assembly line cubicles for patients became the standards ... as time was cut to the bone in the familiar doctor-patient relations, and family practitioners gave way to specializations. The body became an assembly of odd parts requiring different experts.

Now it seems the milk of human kindness has been corrupted by the substitution of government largesse. Medicare went into effect in 1966, and Medicaid soon followed. Private medical insurance became the monstrous necessity, as corruption has fed on itself. Doctors practicing in this culture are beset by opportunists and find themselves having to buy malpractice insurance, the cost of which has to be passed on to the consumer.

Ignorance being bliss, there seems to be nothing to fear as we place our confidence in technology and government institutions to shield us from harm.

Joe E. Cook

Martinez



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