Adequacy of Medical Care *

Adequacy of medical care is one of the many ideals that are said to represent our better selves. We are striving for its realization, knowing that to it there is no ready way. As in every field of human endeavor, the abstract objective, visualized by the leaders in thought, needs interpretation and clarification in the light of the needs and potentialities of our time, if real progress is to be made toward perfection. "Adequate medical care has both a quantitative and qualitative aspect," as Lee and Jones9 have stated. Quantity and quality of medical care are parts of an integral whole. They cannot be separated without injuring both. Quantitative adequacy To be adequate in quantity, a medical care program must be broad in scope and well balanced. It must provide for all services needed by the apparently healthy, the acutely sick, the convalescent, and the chronically ill, including care at the home, office, clinic, general hospital, special hospital, or custodial institution, in the amount and for the period required. Type, scope, amount, and period of service taken to. gether make up the inclusive concept of quantitative adequacy ot medical care. To define essentials is one thing; to translate theory into a practical and workable plan is quite another. Of the many complex questions that require satisfactory answers, two will be singled out for discussion: Shall all services desired by the patient be provided by an organized program of medical care or only those services which are "necessary" in the opinion of the experts? Second, is it possible to formulate quantitative standards that express the best scientific thinking? In private practice more often than not the ability of the patient to pay determines what service is rendered and how much there is of it; economic considerations influence decisions on the type, scope, amount, and period of service. Organized programs of medical care, whether financed by tax money or insurance contributions, whether