Editor:

Re: "Insurance isn't the answer," submitted to the Casper Star-Tribune by Francis William Bessler of Laramie, Sept. 24.

The health care system proposed by Mr. Bessler did exist in this nation for several decades. It was conducted in the public hospitals of the large cities and counties. A few examples of such institutions would be Belevue Hospital in New York City, Boston City Hospital, and Philadelphia General Hospital. There were several other public hospitals in the country. These institutions were financed out of the general funds of the cities and counties. The medical care was administered by faculty supplied by first-rate medical schools. The hands-on care of patents was given by residents and interns, who were in training, with assistance provided by medical students. The health care was first-rate and comparable to that offered in the university hospitals of the same medical schools.

If you will, it was community sponsored socialized health care. It was essentially for the poor and indigent of these communities; however, because the care was excellent and free, some, who were neither poor nor indigent and not proud, took advantage of the care offered. Citizens and physicians in practice today are generally unaware that such health care did at one time exist in our nation.

The financing of health care became available through Medicaid and Medicare programs set up by the states through the passage of Title XIX of the Social Security Act on July 30, 1965. These funds were not available to finance public hospitals because the staffing of these institutions did not meet requirements in the Title XIX legislation. Therefore, the city and county governments were forced to reconsider the governance and financing of public hospitals. A few became university hospitals, some became voluntary community hospitals, many were closed, and a very few added more salaried staff and struggle on today.

Unfortunately for Mr. Bessler, I doubt if there are any large city or county governments which would seek to set up and operate public health care facilities today.

A. JAMES BLAIR, MD, Lander