In 1976, Studs sat down with three doctors working in Chicago’s Cook County Hospital system: Dr. Quentin Young, Chairman of the Department of Medicine, Dr. Robert Maslansky, Director of Medical Education, and Dr. Lambert King, Medical Director of Cermak Memorial Hospital in Cook County Jail. (For those readers who aren’t local, Cook County Hospital is where Harrison Ford as Richard Kimble in The Fugitive sneaks in as a janitor on his quest to find his wife’s killer.)
About a decade earlier, in 1965, Medicare and Medicaid had been signed into law and greatly changed how the “sick poor” in Chicago and elsewhere sought and received medical care. Dr. Young sees a dichotomy developing: the public hospitals, where doctors are paid on a salary, treat patients in order to prevent illness; the private hospitals, where doctors are paid on a fee-for-service basis, treat patients after conditions have already arisen. He tells Studs, “Our [public hospitals’] interests are changing the social conditions that send people to our doors, treating the patient in an early stage, or better yet, preventing the conditions that make his illness take place” as opposed to his understanding of private hospitals, where “all of their interests are in the sickness.”
It is clear that healthcare in the United States will continue to be a major point of contention for voters and elected officials. Many things in medicine have changed since this interview was recorded forty-one years ago, but much of what these three doctors discuss is still very relevant: the balance of “laying of the hands” with tests and technology, the best way to educate new doctors, and the effects of financial decisions on the health of our nation.