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April 11, 1969 - Image 4

Resource type:
Text
Publication:
The Michigan Daily, 1969-04-11

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I

Seventy-eight years of editorial freedom
Edited and managed by students of the University of Michigan

Community care

for

the medically indigent

420 Maynard St., Ann Arbor, Mich:

News Phone: 764-0552

Editorials printed in The Michigan Daily express the individual opinions of staff writers
or the editors. This must be noted in oll reprints.

FRIDAY, APRIL 1 .1 1969

NIGHT EDITOR: NADINE COHODAS

To Thailand, with love:
Giftsfrom the Pentagon

PREDICTING defeat for President Nix-
on's proposed anti-ballistic missile
system, liberal senators appear ready to
extend their attack on the overblown and
unwise military expenditures which have
accompanied /the cold war - and the hot
one in Vietnam.
This time, the target is likely to be the
magnanimous gift conservative repre-
sentaives and senators a r e hoping to
give a single military corporation. The
inclosed card would read something like
this:
DEAR Northrup Corporation,
Happy birthday! Inclosed find a
check for $62 million so you can re-
tool your Hawthorne, Calif. p 1 a n t
scot-free and start turning out our
new-improved F-5 supersonic fighter
jet. The Pentagon doesn't use them,
but you can get $1.3 million each on
the foreign market. Have fun.
Magnanimously,
Rep. Mendel Rivers
and all the boys in Washington
Caif eataclysm
UNFORTUNATELY, the sages of t h e
mystic cults have failed again. Cali-
fornia is still with us and the April 4
date of destruction predicted by the east-
ern gypsies and the April 9 date of
destruction predicted by 'Jean Dixon
have gone past us and California s t i11,
lives.
However, the Bible Society of the
Greater Southern California Area, n o w
predicts the state will sink April 16. And,
their prediction goes on, if perhaps that
date is missed, it might be April 27, 30,;
May 4, 11 or 15.
Along with the Popular Bluff, Mo.
Society of Occultists, which predicts
California will sink on any Monday or
Wednesday in the next three years, and
the magazine of the Chicago Astrological
Association, which predicts the state will
sink on a day of a half-moon, pit looks
as though so*aebody must have the right.
prediction.
Soon we should expect predictions on,
what predictions are the most accurate.
-J. H.
Business Staff
GEORGE BRISTOL, Business Manager
STEVEJLMAN .. Administrative Advertising Manager
SUE LERNER .............Senior Sales Manager
LJCY PAPP............... senior Sales Manager
NANCY ASiN . . ...... Senior Circulation Manager
BRUCE HAYDON ................Finance Manager
DARIA KROGILS.KI......Associate Finance Manager
BARBARA SCHULZ ..............Personnel Manager

INCREDIBLY, the initial $14 million ap-'
propriation to the air force (w h i c h
would turn all the money over to North-
rup) has already passed the House and
now awaits action by the Senate Armed
Services Committee.
And unfortunately, the committee has-
been notable for its receptiveness to Pen-
tagon-supported spending. But with vic-
tory on the ABM issue in sight,,opposition
to t h e Northrup subsidy appears to be
coalescing.
With the planes slated for foreign sales
- thus eliminating any possible national
security arguments - it is difficult to
imagine what reasons have b e e n put
forth in support of the proposed subsidy.
NOT SURPRISINGLY, the justification
has been meager. W h e n the H use
Armed Services Committee approved the
appropriations bill, they cited the need to
turn out a new version of the F-5 so that
the United States can compete with oth-
er countries in foreign sales.
Furthermore, hawks argued that , the
subsidy was necessary because, without
it, no company would take the risk of go-
ing into production of an item whose sales
could be limited by governmental edict.,
But this argument begs the question.
For there has already proven to be a wide
market for the F-5 among countries con-
sidered friendly to the United States. To
da'te,\some 725 F-5's have been sold or
giveni to such countries as South Korea,
Greece, the Philippines, Nationalist Chi-
na, Turkey, Norway, Ethiopia, Morocco,
Thailand, South Vietnam and Libya.
And the argument that U.S. companies.
cannot now compete in the sale of these
planes on the foreign market seems even
more ludicrous. Surely, the United States
should be negotiating limitations on arms
shipments to troubled portions of t h e
globe rather than worrying about falling
behind in the international military mar-
ket.
I.fOPEFULLY, liberal senators will be
able to sabotage the Pentagon's plans
to subsidize corporate military profiteer-
ing abroad.
But more important, the controversy
.over the ABM - and now over the North-
rup subsidy - m u s t lead to extensive
Congressional re-examination, re-orien-
tation and reduction of U.S. military
spending. In a very real sense, there is
another potential ABM or Northrup sub-
sidy lurking behind each n e w military
appropriations bill.
-MARTIN HIRSCHMAN

By RICHARD FOA
(EDITOR'S NOTE: Richard Foa is
a freshman medical student and a
member of the Student Health Or-
ganization. He is currently serving
on the Policy Committee for the
planning of the Department of
Community Medicine.)
MEDICAL CARE IS notoriously
unavailable to residents of
Ann Arbor. For a large percentage
of the people here there is no
regular doctor-only an emer-
gency room.
As a result, illness often waits.
Fevers ,pass. Bruises heal. Vac-
cinations are neglected because
children aren't ill. Medical prob-
lems become surgical problems.
And small problems unnecces-
sarily become real emergencies.
There is no opportunity for con-
tinuing care when it is needed.
And health is a subject of concern
only when it falters.
The problem is not confined to
Ann Arbor.'Tens of thousands of
people in Washtenaw County
alone are without continuing med-
ical care.
Atthe same time, Ann Arbor
has one of the highest physician
to population ratios in the entire
country.
But the large staff of the Med-
ical Center is not permitted to
engage in private practice. And
the patients of the center are
drawn from the entire state, not
the surrounding community.
THE MEDICAL School is now
planning a new Department of
Community Medicine. The focal
point of the Community Medicine
program is to be a family clinic,.
"a teaching unit providing high
quality health care with oppor-
tunities for top flight research in
the problems of Community Med-
icine." The clinic will provide
comprehensive health care for
3,000 families or about 12,000 peo-
ple. It will be"experimental." And
it will be "a model."
Consequently, many of its plan-
ners feel that the selection of
participants in the program munt
be indifferent to the needs of
the area's medically indigent
since the medically indigent don't
cover a sufficiently broad social
spectrum.
Thus, the University's commu-
nity clinic will not address itself
specifically to the largest health
problem of the surrounding com-
munity.

Both Ann Arbor and the Med-
ical School need this family clinic
and other Community Medicine
projects. But how good a Depart-
ment of Community Medicine; and
how good a clinic; and how good a
teaching program; and how good
a "model" if they are not de-
signed with the best interests of
the community in mind?
SEVERAL CRUCIAL questions
now confront the committees plan-
ning the family care clinic. All of
these questions should be discussed
publicly. And opinions other than
the generally negative reaction of
the Washtenaw County Medical
Society must be expressed.
Some of the questions impor-
tant to the community include the
relative emphasis to be placed on
teaching, service, and research;
the selection of a population to be
served by the clinic; the hours
when facilities will be open; and
the question of community control
over some aspects of the program.
Despite the professional, dogma
that service is an inviolable and
inseparable dimension of medical
instruction, the interests of teach-
ing and research often conflict
with optimal patient care. The
current official preference for se-
lecting- families that will provide
the clinic staff with a full cross-
section of society is a clear exam-
ple of satisfying the preferences
of teaching and research without
regard to community service.
Dogma states that those who
are selected for the program will
receive care, rich and poor alike,
and that this is good on an abso-
lute scale.
But the community would be
better served if preference was
given to those previously deprived
of care, without regard to socio-
economic balance. Furthermore, a
strong emphasis on teaching and
research frequently results" in aj
poor attitude towaid patients.
THE PROBLEM of selecting a
population to be Served by the
clinic revolve around the questions
of whether the basis for select en
will be cross-sectional :or strati-
fied and, then, how various , ocio-
economic groups will be weighed.
A selection strictly from among
the poor strata of society would
undoubtedly be recognized as such
and rejected by the pdor. It is
an unacceptable alternative. The'
clinic should not and could not
become a "Poor People's Clinic."

Oddly, the only strong pro-
ponent of this stratified selection
has been an officer of the Wash-
tenaw County Medical Society who
feels that, by providing compre-
hensive care to any but the poor,
the Medical School would be en-
tering into competition with phy-
sicians in private practice.
A population reflecting a cross-
section of society is generally pre-
ferred. This is understood -to be
a cross-section "skewed, to thjose
with greater need," an uncom-
fortably vague answer to the ques-
tion of who will be permitted to
subscribe to the clinic program.
Picking arbitrary numbers, if a
"true" cross-section would have
10 per cent showing "greater
need" and a "skewed" cross-sec-
tion 15 per cent, such an imbal-
ance would be inadequate. The
group receiving, care must be
weighed far more heavily in favor
of the medically indigent.
The medically indigent in Wash-
tenaw County (and virtually
everywhere else) are not just the
poor; but are widelysdistributed
among the middle classes, among
the retired, and among students.
It would be a needless waste if
a poorer family, unable to get care
except through the emergency
room at St. Joe's or the Uniyer-
sity Hospital, were to be deprived
of the opportunity for continuing
comprehensive care at the family
clinic by a wealthy family from
Barton , Hills already oriented
toward continuing care and able
to choose between one internist
and another.
ONE OF THE poorest argu-
ments that has been offered
against weighting the consumer
group in favor of the medically
indigent is that a number of med-
ical students interested in Com-
munity Medicine are not inter-
ested in working with the poor;
and since the indigent are ,likely
to be poorer such students will be
driven away from the program.
Working with the less advant-
aged would be a more valuable
+ educational experience for an up-
per middle class medical student
than working only with the up-
per middle class.
Regretably, a family clinic in
Ann Arbor will never provide the
exposure that a similar clinic in
an urban ghetto could provide.
More significantly, this argument
places the interests of the stu-

r

0

,0

dent and doctor ahead of the pa-
tients' - and is really tantamount
to refusing to treat the sickest.
THE IDEA LEAST likely to gain
popularity among the Administra-
tion and Faculty of the Depart-
ment of Community Medicine is
that of consumer representation
in the administration of commun-
ity health facilities. For example,
a consumer's union should deter-
mine office hours convenient for
the consumers rather than relying
on the medical staff to set of-
fice hours convenient ,fqr itself
while, requiring that patients use
the hospital . emergency r o o m
when the clinic is closed.
Unfortunately, the lines for this
particular battle have already
been drawn. One of the physicians
instrumental in planning the clin-
ic has stated that it will not be

"a convenience clinic" but should
be open only between 8 a.m. and
5 p.m. This police will probably
severely limit access to the clinic
for the bread-winners of m a n y
families participating in the pro-
gram.
The Medical School Administra,
tion will certainly not relinquish
any final authority over the pro-
grams of the Department of Com-
munity Medicine. They will be,
after all, academic programs of
the Medical School.
But an effective community
medicine program will have to
recognize the voice of its consum-
ers rather than running rampant
over their sensibilities because it
feels it's doing them a favor.
THERE HAS BEEN a lot of talk
about the new Department of
Community Medicine and the
planned comprehensive f a'm i y
health care clinic as "model pro-
grams".
i What kind of models will they
Several other medical schools
have had similAr programs run-
ning for years. Comprehensive
care clinics have been. set up in
Watts, Boston, the Bronx, and in
several other cities. And Com-
munity Medicine is being estab-
lished as a new medical specialty
nationally. The ;Ann Arbor pro-
gram will not'be a first.,
And it is unlikely that a clinic
in Ann Arbor could provide an
adequate model for the solution of
either big city or rural health
problems. But is could become a
model of institutional concern for
the needs of the surrounding com-
munity, a model to be emulated by
the specialists in community med-
icine that it graduates.
That doesn't seem to have been
the history of the University's
Medical School so far. But it
shouldn't be the impossible dream.

LETTERS TO THE EDITOR
The true story of a general studies degree: No tears are

in order

1 4

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To the Editor:
WE HAVE HEARD lamentations
that the proposed new L S
and A degree (Bachelor of Gen-
eral Studies) will not allow a stu-
dent to concentrate in the field of
his choice, but will force him to
forage lightly from many mead-
ows. To rectify the misconception,
I invite critics to read the text
of the *resolution rather than to
follow the words of others who
have not read it carefully. The
graduation requirements are stated
as follows:
Completion of 120 hours with
an overall grade average of C
or better. This shall include 60
hours of work in intermediate
or advanced courses (courses
numbered 300 or higher), and
the average grade of C must be
achieved for these 60 hours as
well. Not more than 20 hours
earned in any one department
shall be credited toward the 60-
hour requirement. Up to 20
hours of the 120 hours may be
elected outside of the College
of LS and A.
The statement calls for a block
of 60 upper-class hours, of which
not more than 20 shall come
from any one department; it im-
poses no restriction on the re-
maining 60 hours. If a student is
sufficiently misguided, he can
satisfy the regulations by com-

strong enough to determine his
own educational plan, this would
be no serious obstacle. Tears are
not in order.
-Prof. George Piranian
Mathematics deparement
April 10
Sheap Confrontation
To the Editor:
fr E SOCIOLOGY STUDENT
Union was ill-used by Marc
Van Der Hout last week, and The
Daily, whether by intent or acci-
dent, by a sin of omission, ag-
gravated the situation.
Van Der Hout's slanderous let-
ter of April 2 constructed an ar-
gument of falsifications leading to
a call to Sociology undergraduate
concentrators to sit-in at a De-
partment meeting on April 3
where an undergraduate proposal
was alledgedly to be discussed. He
asserted that the Sociology Fac-
ulty was unresponsive to student
demands, and therefore student
presence was necessary to assure
that the interests of the under-
graduate would be represented.
In point of fact, the April 3
meeting was a special meeting,
called because a graduate student
proposal had been brought before
the Faculty at its previous regular
meeting, and discussion of that
issue had not been completed. The

Faculty would vote on whether to
open the meeting at which that
proposal was discussed to students.
On April 2, Van Der Hout's letter
appeared.
I attempted to get a letter into
the April 3 issue of The Daily, on
the assumption that if the false
statements in Van Der Hout's let-
ter were cleared up an unfortunate
incident could be avoided. The let-
ter was delivered by hand to The
IDaily, but did not appear.
At noon on April 3, the Faculty
met as scheduled to discuss the
graduate student matters, and the
issue of student attendance at the
next scheduled meeting, when the
undergraduate proposal would be
on the agenda. About 15 student
entered the room, and presented
the chairman with a statement
implying that they expected the
undergraduate proposal to be dis-
cussed, and were going to remain
in the room. The Faculty of the
Department (not the Executive
Committee, as mistakenly reported
in The Daily the following 'day)
unanimously voted to adjourn. In-
terestingly, Van Der Hout did not
attend the sit-in.
THE RESULT of this action
was that neither the graduate
student proposal nor the issue of
student participation in faculty
meetings came before the faculty.

dent press will contribute to this
goal by checking facts before
printing them.
-Prof. David R., Segal
Sociology department
April, 7
Editor's Note: The editorial
directors never received Prof.
Segal's letter of April 3. Had we
obtained a copy, the l e t t e r
would have been printed at the
earliest opportunity.
A test of truth
To the Editor:
I WAS INDEED sorry to n o t e
Prof. Galler's public announce-
ment that. as a member of the Ad
Hoc Committee he views the SDS
case before CSJ "as a clear test
whether a central student judici-
ary can work."
This is typical of the enormous
pressures that have been exterted
on CSJ since the case began, as a
member of the court, I resent any
such effort to sway the process of
adjudication by implicit threats.
Furthermore, Prof. Galler's call
for model behavior on the part of
the court is quite unnecessary. I
must assert my conviction that all
members of CSJ, during the whole
period I have served, have always
fully lived up to all reasonable
standards of' lidicia1 fairvness and

Double standard
To the Editor:
WE WOULD LIKE to make it
clear that we,.are in complete
sympathy with the plight of the
Afro-American in American so-
ciety and in particular with black
students at the University of
Michigan. However, we feel that
the Black Student Union and
black students should take a crit-
ical look at their organization and
the double standard that they
have imposed on campus.
At noon on Good Friday we at-
tempted to attend the memorial
services for Dr. Martin Luther
King Jr. at Canterbury House.
However, we and several others
were turned away at the door be-
cause we were white. We were
merely trying to pay tribute to a
great American who was martyred
for the cause of peace and equality
for all men. We feel that this type
of action is detrimental to the
cause for which Dr. King gave his
life.
We feel that perhaps it is time
for the Back Student Union to
take a closer look at its policies
and to join in the cause of uniting
both black and white students and
not to move toward separation of

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