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Omnia pro aegroto

Interview with J. Bruce Henriksen, MD:

The Past Is Prologue

The King-Anderson Bill, a 1962 precursor to Medicare, was initially defeated, quite possibly because of the uncompromising stand taken by Dr. Henriksen and his colleagues.

In 1962, both Congress and the country at large were engaged in a heated debate over the proposed King-Anderson bill (a bill designed to help pay for hospital and nursing home care through Social Security for those over 65).

On May 5, 1962, the New York Times reported that 200 New Jersey doctors had signed a resolution stating that they would ``refuse to participate in the care of patients under the provision of the King-Anderson bill or similar legislation,'' but they would ``continue to care for the medically indigent, young and old, as we have in the past.'' Subsequently, similar resolutions were signed by small groups of doctors in several sections of the country. In July, the King-Anderson bill was defeated in the Senate.

The author of the original resolution was Dr. J. Bruce Henrikson, a surgeon who had been in practice for more than 30 years in Pt. Pleasant, New Jersey. He was interviewed in 1965 by Judith Kroeger, RN, with the assistance of Dr. Kendall Kane. The interview was printed by Persuasion magazine, April, 1965, copyright by the Metropolitan Young Republican Club. Excerpts are reprinted here with permission.

- 1965 -

Persuasion. Dr. Henriksen, you have become known nationwide as the doctor who led the New Jersey ``doctor's strike.'' Will you tell us how this strike came about?

Dr. Henriksen. One day here in the office, Dr. Siebert [my junior partner] and I were talking and I said, ``I wonder what would happen if doctors were given an opportunity to say that they would refuse to participate in a King-Anderson type of legislation.'' So I dictated a little resolution [to this effect] and took it down to the hospital. Without any coercion on my part, when I'd see the man in the hall or in the dressing room, I would say: ``Read this. If you agree with it, sign it. If you don't agree with it, don't sign it.'' All of the active members of our staff signed it.

After it was signed, the resolution lay in my locker for some time....[Finally, Jerry Bishop, a writer for the Wall Street Journal, found out about it and published it. Then CBS, NBC, and other newspapers picked up on it.]

Persuasion. Will you explain why you were opposed to this legislation?

Dr. H. We felt it was the beginning of socialized medicine. It is a compulsory tax. There is no alternative to it. Uncle Sam assumes that the people in this country don't have the brains or the ambition to plan for their old age....Of course, as these taxes go up and up and up, then people are more and more unable to pay for their own old age, too....

This type of system will provide poor medical care. With physicians, as with anyone else, one must have an incentive to work. If we are going to be controlled and dictated to by a bureaucracy, then this control removes incentive....

Persuasion. How would you answer the charge that money is your only motivation for practicing medicine?

Dr. H. I would say that there are two important motives, and both of them are selfish. One is money. I've always felt that if I did the best I could for my patients, then I didn't have to worry about the money. It came. The other thing is the satisfaction of a satisfied patient.

When I see a patient, it is to my interest to treat this patient to the very best of my ability....I want this patient back again. This incentive will be removed by government-controlled medicine....

Also, there's the charge that doctors make too much money. The vast majority of GPs putting in their 60 to 70-hour weeks don't make more money than the New York electrician would if he put in the same number of hours with his double time and time-and-a-half. The same forces that will decrease the doctor's standard of living will decrease the standard of living of everyone else in the country....

Persuasion. [How about socialized medicine elsewhere?]

Dr. H. You probably know some examples of socialized medicine...One doctor who went to England for a residency in heart and chest surgery was most impressed with the advanced pathology that he saw when it finally got to the hospital....The GP can't discover pathology until it's too late when he is responsible for 3,000 patients.

Innumerable places it's been said, and also by President Kennedy, that we are practically the only country left that doesn't have a socialized system of medicine. And they make it sound like a very bad and sad thing. And still the Duke of Windsor comes to Houston to have his aorta fixed.

....Probably one of the biggest reasons [for poor quality] is overutilization of services. After all, it's a shame and a waste if you're paying taxes and you don't use this service.

Persuasion. Advocates of socialized medicine say that under free-enterprise medicine there is discrimination in medical care, while under socialized medicine there is equalization of care to all. Do you think that if I have more money I can get better medical care under free enterprise?

Dr. H. No. I think that you can have a lot of money and still pick a dope for a doctor. You might be able to buy yourself a fancy room in the hospital and three nurses around the clock, but your medical care can be just as bad as the next individual's. Well, let me say it less facetiously: I think that as it is now, there's good medicine, mediocre medicine, and bad medicine. Under socialized medicine, it will just all be ``equally'' bad.

Persuasion. If you think that socialized medicine will result in the very bad consequences that you've told us about, then what alternative would you offer to solve the problem that the impending legislation seeks to solve: increasing costs and increasing numbers of patients [who need care]...?

Dr. H. I don't think there is any alternative that is better. I think that what we've got is the best system, and that there are some minor problems that are being taken too seriously. If you stop to think, I suppose a semiprivate room at St. Luke's Hospital [in New York City] runs $38 to $40 a day. What one gets for $38 to $40 is a great deal, isn't it?....

Mostly, people talk about the catastrophic illnesses that occur....That happens, but the vast majority of illnesses in the old people are not too bad. They go into the hospital and have their hernias fixed or their gall bladders out and it costs...$150 for a hernia and $225 for a gall bladder. A 7- or 8-day hospital stay will run maybe $400 or $500 and most can afford that. Also, most of them have insurance of some kind....I think we are paid more frequently by old people than by some of the younger ones, and logically so because an individual in his twenties usually has two or three kids. He's buying shoes and clothes and so forth and can use some help. The elderly individuals have had a lifetime to prepare for their old age, and most of them have. Now with this Medicare thing, there is going to be loaded onto this poor guy with the three kids and the $125-a-week job the business of paying for the hospitalization of 18,000,000 old people, the vast majority of whom can take care of themselves.

People who need help of course should have help....We take care of them in the hospital all the time. We have our ward service, and we operate on these people for free....

Persuasion. Some socialized-medicine advocates argue that health care for all is a right. Do you think everyone has a right to necessary medical attention?

Dr. H. Not more than everyone has a right to a Cadillac, and everyone has a right to a few oil wells. What they earn, they've got a right to. But I've no right to part of your salary which, if I go to the hospital as an old-ager, I'm going to get....

Persuasion. Do you think it's impossible to defeat socialized medicine in the United States?

Dr. H. Yes. The only way to do it would be to get enough people excited enough to write a couple of million letters to the congressmen to say they don't want it. Not form letters, but the kind scribbled on an old piece of tablet with a pencil. But I don't think that's going to be done. As of this moment, we are all living high on the hog. Everyone has enough to eat. We have cars. We're prosperous. But I can't possibly see how this can continue. There has to come a reckoning someday, and I can't help but think that it isn't too far off....

Persuasion. You have not stopped fighting the situation entirely, even though you think the fight is in vain. Are you personally planning to do anything else? I'm thinking in terms of another strike.

Dr. H. I've thought about it, but I can't finance it. I'm not even sure I want to try to save people from themselves. They deserve what they'll get under socialized medicine.

As far as I'm concerned as an individual, of course, I won't practice under socialized medicine. I'll quit. I'll refuse to see all patients. Maybe they'll put me in jail. After all, when this thing first started, there was a bill introduced into the New Jersey legislature which said if we refused to care for a patient, our licenses could be taken away from us and we could be put in jail. (On May 7, 1962, Assemblyman John J. Kijewski (D) introduced a bill to the New Jersey legislature to penalize any physician who refused to treat patients because of the method of payment involved. The bill would revoke licenses, fine, and/or jail offenders.) It would be a police state. No reason in the world why it can't happen.