Susan Lawrence

Providing medical care for the poor was not a new obligation for physicians when the Depression hit Iowa in the early 1930s, but trying to help the growing numbers of those in need stretched many doctors to the limits of their own resources. The traditional ethics of private practice held that physicians charged their patients on a "sliding scale" roughly linked to their patient's means, and that the financial arrangement between the doctor and his or her patient was as personal and private as their clinical relationship. For the very poor, those classified as "indigent" and supported by county funds, however, physicians had to try to get their fees paid by county boards of supervisors, a process that shaped doctors' understanding of what "government medicine" meant. As more and more people needed to go "on the county" in the 1930s, pride clashed with destitution, and poverty with sickness. In several Iowa counties, the county medical societies responded by adopting "the Iowa Plan" to manage health care for the indigent and to resist the "encroachment" of "government medicine." The American Medical Association applauded the "Iowa Plan"-- to find out why, come to this talk!

Associate Professor of History and member of the Program in Biomedical Ethics and Medical Humanities in the College of Medicine