"We don't need a Great Society, we need a self-reliant society," and Medicare erodes that self-reliance, the president-elect of the American Medical Association told a Kirkland House audience last night.

Speaking "in comment, not in criticism," Dr. Milford Rouse, incoming AMA chief, said that citizens have no right to expect the government to provide them with medical treatment.

The Medicare program is also less efficient and more expensive than planned, Rouse added. For instance, out of 686,000 bills received by the Social Security office in August, 430,000 remained unprocessed at the end of the month.

Within the second month of operation, some hospitals were in financial difficulty due to the influx of Medicare patients, he said. Payment of these patients are much slower than those of other patients due to the Medicare bureaucracy. Rouse said that hospitals in Dallas, have to wait for all receipts to be sent to Baltimore, processed, and then sent back.

As for the elderly patients, they have difficulty understanding the workings of the program, said Rouse. He told of a dialogue with a patient:

"They told me everything was free."

"Who is 'they'?"

"Oh, everybody."

Another patient, Rouse said, told him he "couldn't understand what Medicare did at all.

The AMA takes an attitude of "good-humored, vigilant tolerance" towards the program, said Rouse.

Still, doctors should not take time from their practice to help the administration of the program. "We must tole-rate it because it is the law of the land," but "it is not our law, and it is not up to us to help it work . . . it will stand or fall on its own merits or demerits."