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 .1cok r..., t S y a t . t t t t c e C ,, ,. .z b ,, i +. i kl" t jJ 7V I t I 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 ,' M / - ' -' .1 'i