Abstract
Dear Dr. Park: It is pretty generally agreed that medical practice in this country has been based on the premise of free choice of physician by the patient, and maintenance of a satisfactory, direct, doctor-patient relationship without the intervention of a third party. At present the opponents of tax-supported, government-controlled medical care are convinced that some form of voluntary, prepaid medical insurance constitutes the best means of protecting our free choice of physician and direct doctor-patient relationship principles. Some 40 years ago the beginnings of voluntary, prepaid medical care plans were made in this country. These beginnings were made in the Pacific Northwest. They had their origin here because of the peculiar demands of the local, hazardous industries of lumbering, mining and fishing. Contract practice came into being, and received tremendous impetus from the Industrial Insurance Law which was passed in Washington in 1917. Competition for contracts became so intense during the depression period which started in 1929 that vicious methods threatened the structure of medical practice in the State, and it seemed likely that most of the physicians would be relegated to practicing as salaried individuals under a form of health insurance. It was at this time that the various county medical service bureaus in the State of Washington were revived or organized. In Pierce County (Tacoma) a Bureau had been in continuous operation since 1917, and in King County (Seattle) one had been in operation from 1917 to 1925. These bureaus had been organized primarily to contract for work under the State Industrial Insurance Law, and to guarantee a free choice of physician to the workers who belonged to the Bureau. In May 1933 the King County Medical Service Bureau Society was instrumental in organizing the King County Medical Service Bureau to compete with existing contract groups, and to block a proposal by an insurance company for selling insurance and hiring physicians to render necessary medical care.
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