Barack Obama follows the Socialist Doctors’ dairy health care blueprint for America mapped out in 1934

The Socialist Doctor
VOLUME II. NUMBER 3 MAY, 1934

The Official Organ of the Socialist Medical Association

NESTLE'S MILK Richest in Cream [WTF?]

NUTRITION NEEDS PLANNING
By Dr. Leslie J. Harris (Nutritional Laboratory, Cambridge).

INTEREST in the subject of nutrition is at present almost universal, and opinion as to the needs of the community and the presence of under-nourishment among the working classes varies enormously. Nevertheless, there are certain facts which are indisputable and which demand free publicity. From these basic facts readers can be left safely to draw their own conclusions.

I am thinking primarily of those diseases, mainly “deficiency diseases,” for which modern medical science has now found the remedy- remedies of which there is no inherent shortage in nature, but of which man is nevertheless still kept deprived, solely because of the stupidity and ignorance of a society which fails to apply its knowledge, or to make proper use of its available resources.

It is useful to look back and see how much has been already accomplished, not in any spirit of self-satisfaction, but to give us confidence of how much is possible.

Again compare a picture of any group of elementary school children of thirty or forty years ago, and you cannot dispute the remarkable change for the better in the corresponding group of to-day. The year-by-year improvement in physique can be seen from the reports of the Ministry of Education. In 1927 the average five-year-old child was no less than four pounds heavier than the corresponding child in 1921, and half-an-inch taller. A good achievement for a short space of six years.

But now, if we accept the axiom that Governments are responsible for the welfare and health of their citizens, it seems to me that there can be no halfway house in the process of amelioration. The very first call on the administration must inevitably be the health of the individual; and we should no longer tolerate the position which we know to-day, in which the means of health, although known and recognized, are still beyond the means of many. How anomalous, by this criterion—not because of any lack of knowledge, but rather because of shortage of money! What an astounding sidelight on our civilization will this appear to our more enlightened descendants.

But I err in tending to see the mote only in my neighbor’s eye, and, after all, charity begins at home. When we consider what might be done, and what little has been done, have we in this country so much to be proud of? We know from large-scale and carefully-controlled clinical experiments carried out in orphan asylums and in other institutions, among elementary school children up and down the country, what wonderful improvements result in physique, health, and good spirits when extra milk is added to the child's diet. Yet how many school children in this country are able to receive the full amount of milk which modern science demonstrates to be desirable?

What seems much more to the point is the demonstrable and admitted fact that many working-class people have not available even the limited sum needed for this bare sustenance allowance, and that after paying rent only, and making no allowance for such elemental necessities as clothes and coal. I think attention might be concentrated on this essential point, rather than on the relatively small differences between the two bodies. It deserves to be pointed out, moreover, that the scales which have been put forward seem to be based on the rather unnatural assumption that the un¬employed person possesses so perfect a knowledge of dietetics and nutrition that he is to be able to choose his dietary constituents to the best (or meanest) possible physiological advantage (as well as in the cheapest market).

HOW ARE THE CHILDREN?

THE question of whether a child can be fed on a sum of 2s. or 3s. per week or not is one that can be considered from many angles. It may be discussed from the theoretical aspect by counting the cost of a diet giving an adequate caloric value. It may be considered from the statistics available for the cost as it works out in private homes and in institutions. It may also be discussed from the aspect of obvious results, from the effect on the health of children whose parents cannot have more than a bare minimum with which to provide food.

Further, the observer must necessarily be influenced by what he has come to regard in his own mind as the average, or rather the normal. If he has been working in a poor district for some time, he will quite naturally and unconsciously tend to accept lower standards of what constitutes the normal than an observer in a good-class community, such as a Medical Officer to a public school, where the majority of the children come from well-to-do homes.

Hence the points to be aimed at are the greater use and dissemination of such information on nutrition as already exists, the stimulation of further inquiries, and a much wider distribution of free milk and meals in a planned, directed, and purposive effort to direct is an upward trend towards the optimum for the greatest possible number.
Caractacus.

SOCIALISM AND PUBLIC HEALTH
By Somerville Hastings, M.S., F.R.C.S. (Chairman of Hospitals and Medical Services Committee, L.C.C.)

During the last half-century there has been a steady and continuous improvement in our people's health and a corresponding reduction in mortality rates. It is a little doubtful, perhaps, how long this improvement will continue to be seen, for the privations necessitated by the world crisis and the economy campaign must have had an adverse effect on the national physique and resistance to disease. Still, we have this to our credit, that during the last half-century the expectation of life for the average citizen has been increased by some twelve to fifteen years. Now if we look round carefully for the causes of this decreased mortality, we shall find that it is due much more to diseases which we have prevented than to those that we have cured. By careful supervision of our water supply we have almost completely wiped out those terrible epidemics of typhoid fever that we had in the past; by instruction given in our maternity and child-welfare centers we have to a large extent disposed of those attacks of infantile diarrhea that used to be such a menace to child life; by notification, isolation, and disinfection we have been able to reduce both the incidence and mortality of infectious disease.

The history of Public Health legislation and administration in this country during the last fifty years is for the Socialist both inspiring and convincing. It is the story of how people who did not believe in Socialism and did not want it were compelled to adopt it to obtain not only efficiency, but any results at all, because private enterprise invariably let them down whenever they depended on it.

And people are beginning to ask why should not the principles that have served us so well in connection with preventive medicine be applied to clinical medicine also? If Socialism has been so effective in preventing disease, why should it not help us to cure it as well? And it is not only members of the Labor Party who are asking this.

How can we expect improved results in the treatment of disease when we adopt our present individualistic, disorganized, and utterly chaotic methods for dealing with it?

Minimum Adequate Allowance for Children

The diets were carefully scrutinized, and a selection made of these cards in which the diet appeared adequate without extravagance, rich in vitamins, and embodying at least one pint of milk per day. In this group the average cost per week was, for children one year and under, 4s. 9d. and for children from one to two years, 4s. 9¼ d. A small group of children, from two to three years, gave an average of 4s.11½d.

None of the mothers included anything for cooking, and they were not asked to include any sum for clothes, heating, &c. From reading the diets and analyzing the figures, one is prepared to state that a child cannot be given a diet adequate in every detail at a cost of less than 4s. 9d. per week. A nation which tries to rear its future citizens on less will find itself in later years populated by people who have never had a chance to build a strong, healthy, and disease-resisting bodies.
D. S. M.

AMERICA NEEDS A NEW HEALTH SERVICE

WHILE contending forces are struggling for supremacy in the American business world, quite a large section of the community is taking a very active interest in the need for reorganizing the medical services of that country. A writer in the "Journal of the American Medical Association," early this year, stated that "at least 100,000 persons in the United States sorely need hospital care, but are not getting it. Why? The answer seems to be that only two-thirds of the beds are in use!" He adds, however, as a less satirical reason, that only 2-5ths per cent, of those attending hospital clinics are able to pay the fees.

For such reasons, meetings of the medical profession and of social workers generally, are being held everywhere to discuss what can be done, and the American Academy of Political and Social Science has passed a resolution that America needs "a socialized health service that is adequate, effective, easily available, and cheap, if not gratuitous."

It is an interesting point that the London correspondent of the "Journal of the American Medical Association" goes out of his way, week by week, to produce arguments, based on English experience, against the National Health Insurance Acts, and against the whole idea of a socialized medical service. He constantly reiterates that there is really no support for such a scheme in this country, shutting his eyes to such phenomena as the new L.C.C.

Nevertheless, American opinion is gradually being built up in favor of either an insurance system or a complete free service, and the director of the Milbank Research Fund has declared "that some insurance system should be developed—providing every type of medical service to every member of the family of people having incomes below an amount sufficient to guarantee medical service in every contingency." It is insisted that, while there should be a joint committee of lay people and doctors to deal with complaints, the professional service and personnel should be under professional control.

It is too early yet to say what the medical profession will say to this, but when the situation in America becomes clearer it may be that one of the results of the depression will be some form of State organization of the medical services of the American Continent.
M.O.H.

MOVEMENTS

A committee has also been meeting to discuss the cost of a State Medical Service, and an immense amount of detailed matter has been considered. This is a very big problem, and certain figures have proved difficult to get, but the work is progressing, and it is hoped that at an early date a report will be available.

The third committee has been formed to consider disease in relation to social and economic factors, and have begun on the subject of nutrition. Already the ground has been cleared, but it is obvious that a large number of problems are involved, and the committee proposes to tackle each by asking one of its members to prepare a paper on the subject.
ON-LOOKER.

MILK

MILLIONS of gallons of it! Yet we don't use nearly enough of it in this country. A lengthy report has just been issued dealing with the consumption in Scotland, and this confirms the backward position of the country as a whole. It is shown that the amount of milk was a little less than 0.5 pint per person per day. The consumption varied greatly in different districts, but even the highest did not reach the figure for the United States, which in 1926 was just over one pint per day. An increase in our daily consumption would not only mean a big improvement in the position of farmers, but, as numerous experiments and observations show, a big advance in the health of the nation.

This is only one of the problems offered by the milk question, and the Socialist movement, and the Socialist Medical Association in particular, will have to decide what it is going to do about the production, distribution, and control of milk in this country. The report quoted above mentions that it was found that in nearly all towns the largest proportion of the milk was handled by the co-operative societies. Are we to organize the milk supply through the already existing machinery of the Co-operative Movement or, as has been suggested in some quarters, through a new national and municipal organization?

More important, from the medical point of view, is the question of how milk should be produced to prevent its being, as it can and is, one of the worst of disease-carriers. Should pasteurization be made compulsory or should we go all out for a complete elimination of disease among milk cattle and their attendants? The latter would be a lengthy and. expensive business, and while tuberculosis can probably be got rid of, other conditions, such as Br. Abortus infection, are difficult of elimination, and there will always be some bacterial contamination of even the best milk. This is particularly the case with the milk supply of large towns, and in these cases, pasteurization seems to be the best method of ensuring safety. One thing must be insisted on, namely, that all milk sold should be subject to the closest bacteriological and chemical control.
D. P. H.