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Article
February 21, 1948

ORGANIZATION SECTION

JAMA. 1948;136(8):559-562. doi:10.1001/jama.1948.02890250047015

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Abstract

THE SAN FRANCISCO MUNICIPAL EMPLOYEES' HEALTH SERVICE SYSTEM 

INTRODUCTION  Robertson Ward, M.D. President, San Francisco County Medical SocietyIn view of the existing controversy between the proponents and opponents of compulsory health insurance, I believe that a historical review of the situation in San Francisco would be of interest to the readers of The Journal of the American Medical Association.In my opinion this situation is of more than local interest; in fact, it is fundamental to American medicine.Like most compulsory systems, the San Francisco Municipal Employees' Health Service System started out by promising too much for too little—in an attempt to stifle opposition to its compulsory payroll deduction features. And like most systems of socialized medicine, when financial difficulties developed it first siphoned off funds needed for medical services to help defray the costs of bureaucratic overhead. When that failed to balance the books, the system increased

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