On a cool, sunny last day of November, President Worth called the weekly luncheon meeting of Charlotte Rotary to order with his familiar joviality. With memories of Thanksgiving feasts yet lively, members were not nonplussed to find, in place of our usual ample buffet, a choice of two soups as the only accompaniment to a salad (plus bread). The reason, explained Jim Adams, was to contribute the cost of our collective meal to Crisis Assistance Ministry, to which the recent collection of members' warm winter clothes has been directed. Thanks to the Sheraton's providing today's lunch fare to us free, a check for over $2,000 is on its way to this valuable community care agency, in addition to 9 or 10 full van loads of clothes. The dining room and kitchen staff were present as the hotel manager spoke of their decision to assist in this way in the impressive project.
     Roger Sarow of station WFAE read us news bulletins. Jeff Searcy welcomed guests and visiting Rotarians. Joining President Worth at the head table were members Winn Maddrey, John Belk, Jim Barnhardt, Leland Park, Bob Freedman (who gave the invocation), and Dick Brigden (who introduced the speaker). In deference to the time spent on our gift of lunch money and clothes, Louis Zbinden (one of four members with names starting with Z), kept his Health and Happiness report short. Don Sanders led our singing of America the Beautiful, unaccompanied, which fit well with the pledge to the flag. Both reminded President Worth that the next meeting, being on December 7, would emphasize Pearl Harbor Day by welcoming as our guests area veterans of that fateful event.
     Rotarian Dick Brigden did us a real favor when he invited as today's speaker his colleague and boss, R. Stuart Dickson, for whom he provided a warm introduction. Stuart was uniquely qualified to speak on the subject he chose — Charlotte as a health care center. A Charlotte native, Stuart grew up in the middle of not only Charlotte's business life, but also the lay leadership of its "healthcare industry." Son of a local pioneer in the investment business and volunteer chair of the Hospital Authority, Stuart received both mantles with his usual cheerfulness and zeal. The family's investment house became a diverse publicly-held corporation, known as Ruddick. The wider community has known Stuart even better for his board leadership of Carolinas Medical Center during its amazing expansion years. His alma mater, Davidson College, has often honored his service in its behalf, as have numerous other regional agencies and causes. Stuart Dickson was a "natural" to take on the topic he chose, which he handled with ease and "off the cuff."
     Tipping his hat to our airport and two top national banks as the unparalleled '"movers" of the economy and "drivers" of change here, he moved quickly to engage our attention with a rapid-fire commentary about local health care. He was able to place the local situation in national perspective, and to speak with inside knowledge about the history and future prospects for this vital part of our economy and personal lives. American health care is the best in the world, but necessarily under scrutiny ("attack"?) for its cost. Nevertheless, we will not settle for second-best when our personal health/life is at stake. ("Having some minor surgery, Pete?" "Hell no! If it's on me, it's major!") We have seen attempts, and successes, at scraping some savings out of the system, but it is hard to see how much more can be done along this line.
     The current situation, which places Charlotteans in the enviable position of not needing to go elsewhere to get almost any type of care or treatment, has a history, which Stuart Dickson sketched. In 1938, North Carolinians — with only an emerging Duke and Bowman Gray as medical training facilities — decided to create a state medical school, assuming at first that it should go in Charlotte, the major population center, and unserved by such. Alumni protestations led it to Chapel Hill. In response. Charlotte doctors, who had combined two modest hospitals into the new "Memorial Hospital," arranged to take medical residents, so as to give it teaching hospital status. To arrange this, the legislature created a Hospital Authority here, and set it up to have a self-perpetuating board of trustees. Stuart attributes much of the progress seen in the most recent two decades to this unique origin and organizational style.
     His wide-ranging and lively comments kept members attentive past the usual closing time, and included some fascinating stories. Did you know that Gen. George Marshall himself came to Charlotte at the start of WW II to muster into the military all the Memorial Hospital physician staff under age 55, to be a type of "MASH" unit? Returning from having seen wounded soldiers getting, of necessity, open chest surgery, young surgeon Paul Sanger was moved to undertake direct heart repair, a rarity then, and to collaborate with friends at Celanese to develop artificial heart valves. "We" were one of four centers where that became a regular practice. Did you know that the "Great Society" programs like Medicare and Medicaid were what elevated the economic status of doctors so highly —  "made them rich" — since former pro bono care was now remunerated?
     "Costs," which remain under attack, do not mean that hospitals or doctors are getting rich any more. High costs are, Stuart counseled, caused largely by the development of miracle machines through technology — which you and I demand access to; and by the "Plaintiffs' Bar," which (for example) throws a $300,000 initial premium for malpractice insurance in the face of any OB-GYN starting to practice in California. Obviously, these costs influence charges levied by the health care industry. What more, he wondered, might be the cost effect of "class action suits" against HMOs and proposed government "policing of medical mistakes" legislation.
     The future? More consolidation wilt have to occur. Economies of scale will require hospital systems to be even larger than the current Carolinas Medical Center, with its allied satellites, even though it is a $2.5 billion enterprise. The government won't consider mergers as restraint of trade, since competition is non-existent in an industry so "managed" by outside forces, he remarked. Venturing a comment on the other major healthcare provider locally, he felt that if his comments about size applied to the larger system they would likewise apply to Presbyterian/Novant. As for doctors, they will never be as a profession in the same economic position they once were under the prevailing fee-for-service structure. There will be lids on earning power. Two unsolved problems he left for us to ponder:
     the 44% of citizens without medical insurance, and the lack of a system capable of dealing with long-term care for the growing numbers of non-indigent people over age 80.

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     Today marks the 58th anniversary of the Japanese attack on Pearl Harbor which catapulted the United States into World War II. Nineteen ships were lost during the attack, and 2300 people died. Our Rotary meeting today honors the memory of those killed and those who survived. Listed below are the survivors who live in the Charlotte area, some of whom join us today to commemorate this anniversary:

Jack Anderson
Kannapolis

Herbert E. Bishop
Charlotte

Ernest Bonner
Huntersville

Joseph N. Carpenter
Gastonia

Alien Christenbury
Charlotte

Charles B. Conley
Huntersville

Robert Maurice Coward (D)
Charlotte

Billie L. Crayton
Charlotte

Henry Grathwohl, Jr.
Charlotte

Joe W. Grice
Lincolnton

Joe Leonard
Lincolnton

Robert J. Hogland
Charlotte

Joseph J. Lagna (D)
Charlotte

Ray H. Marks
Charlotte

William Fred Rudder
Gastonia

Hazel B. Stircwalt
Kannapolis

Albert W. Wallace
Charlotte

Russell E. Walton (D) (Note)
Charlotte

Edgar E. White
Huntersville

(D) deceased Note: Russell E. Walton was a member of our Club 1972-1984.

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POWELL'S OBSERVATIONS

     More occupational hymns — thanks to the senior scholars newsletter:

     Army master sergeant's hymn — "Rise, Shine, You People."

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CLUB ATTENDANCE

Our Club's attendance was 86% for the month of October, which placed us llth out of 42 clubs in the district; the average for the district was 78%. As of July 31 the district had 2880 members compared to 2965 through October.

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