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UNITED STATES OF AMERICA

(FROM OUR OWN CORRESPONDENTS)

A MUSEUM OF HEALTH

AT a ceremony in the Hall of Man at the World’sFair on June 17 a new American museum of healthwas dedicated before an audience of several hundreddoctors and public-health officials. Dr. LivingstonFarrand, president-emeritus of Cornell University,took charge of the proceedings and introduced a

series of distinguished speakers, all of whom empha-sised the importance of health education in forward-ing the cause of public health. Prof. Abel Wolman,the president of the American Public Health Associa-tion, did so by drawing attention to the backward-ness of the United States in applying the discoveriesof science. He pointed out that although it is an

accepted axiom that the individual is the first line ofdefence against disease, America has the distinctionof leading the civilised countries of the world in small-pox, a disease from which the individual can becompletely protected. The organisms of tuber-culosis and syphilis were discovered many years ago,yet, though progress has been made in controllingtuberculosis, the progress of our campaign’ againstsyphilis has been blocked not by scientific ignorancebut by social prejudice. The American people arenot so healthy as they have a right to be, and infact public health has never been the first considera-tion of the state except in times of disaster. Otherspeakers dwelt on the possibilities of the exhibitsurrounding them in the Hall of Man. Dr. John L.Rice estimated that four million out of the seven anda half million persons of New York city would visitthe fair, and asked his audience what it would meanto the city if each of them should carry even oneidea from this exhibit into their daily life. But theexhibit of the fair is to be only the beginning. A

permanent museum housed in the city of New Yorkwith its continuous exposure to the population willresult in a still greater cumulative effect. MayorLaGuardia, twitting Dr. Wolman on his pessimism,prophesied that if he were allowed to continue hisprogramme for sanitary housing, nurseries for poorchildren, and nourishment for the unemployed,tuberculosis would be eliminated in New York cityin the next 25 years. But if this end is to be achieved,the responsibility of the government for public healthmust be recognised. He announced his intentionof building a new court-house for the AppellateDivision and said that the present fine building atMadison Avenue and Twenty-fifth Street would thenbe converted into a home for the Museum of Health.

NATIONAL HEALTH BILL

Last month expert medical evidence was offeredbefore a subcommittee of the senate committeewhich is considering the Wagner National HealthBill. Dr. Arthur W. Booth, who represented theAmerican Medical Association, expressed the opinionthat the enactment of this measure " would provea costly mistake, jeopardising the welfare of the

people and seriously compromising the future develop-ment of the science and art of medicine in the UnitedStates." He said that the projects embodied in thebill had been devised by federal officials and that theydo not represent the wishes of the people. Thehouse of delegates in September, 1938, recommendedthe establishment of a federal department of healthwith a secretary as its head. The bill provides nosuch centralisation of authority. The house of

delegates also required that expansion of health

services should not include provision of medical care,which can be successfully provided by the generalpractitioner. The bill does not, in Dr. Booth’s

opinion, provide any safeguards for the existenceof the private practitioner. The bill does not limit

expansion of hospital facilities to situations in whichneed exists nor does it limit the provision of medicalcare to the poor. Dr. Booth felt that the federalbureaus were given too much power over the states,but when Senator LaFollette asked him to indicatethe specific powers to which he objected he repliedthat he had not read the entire bill.

Dr. Richard M. Smith, chairman of the Committeeof Physicians for the Improvement of Medical Care,urged the need for coordination of all kinds of medicalcare under a single administrative authority, aidedby a single advisory council. In the organisation ofmedical care, he said, it is important that public-health services should be under the control of trainedfull-time salaried experts. The needy should becomeeligible for medical care without delay or indignity.Provision should be made for the support of educa.tion and investigation.

Prof. John P. Peters, secretary of the Committeeof Physicians, said that the committee is in generalsympathy with the bill. They are interested in

strengthening the machinery which can guaranteea high quality of medical care, for this will also pro.tect the public against excessive expenditure. Inhis opinion the bill is intelligently conceived to meeta demonstrated need. The increased costs of medi-cine arise not from the rapaciousness of physiciansbut from the nature of modern medicine. Govern.ment aid is made imperative. The bill wisely leavesdevelopment and administration of programmesto the several states ; it is equally wise in providingthat federal authorities shall prescribe standardsof qualifications for the receipt of grants in aid.

AUSTRALASIA

(FROM OUR OWN CORRESPONDENT)

NATIONAL HEALTH INSURANCE

THE editor of Medical Topics has admirablyexpressed the situation of national health insurancein Australia: "National insurance has Cheyne-Stokes breathing. Signs of approaching death areevident in the act, but no one in the government hassufficient courage to put the poor thing out of its

misery. "For some time it has been evident that the

Australian government wants to abandon the NationalHealth and Pensions Insurance Act placed on thestatute book last year ; but, national insurance

being one of the main points upon which the lastelection was won, such action would require consider-able courage-in spite of the almost national feelingagainst the act-which the government, in an alreadyprecarious position, has felt unprepared to show. InMarch it decided to substitute a medical service planrepealing the pensions provisions and leaving only asystem of health insurance and family medical benefit.It was intended to continue the approved societysystem and the cash health benefits on substantiallythe same scale as originally provided, but the wholequestion of medical benefit was to be discussed firstwith representatives of medical benefit organisationsand of the medical profession and later with theconsultative council of approved societies.

This substitution of a health service for the originalscheme was introduced only at the expense of the