Health Care Reform Requires Passage of Clinton PlanColumn by Daniel Stevenson
In the current health care system, 35 million Americans, mainly workers and their families, have no health insurance, and another 35 million have inadequate coverage. Millions of other Americans are fearful of increasing costs for decreasing service or of losing their coverage altogether. No adequate programs exist to provide care for the homeless. Drug prices are skyrocketing while American businesses are losing jobs because health care costs represent a 30 percent handicap in the world marketplace.
That the current national health care system needs to be changed is not the question. Almost everyone agrees that something needs to be done so that needed care is available at a reasonable price to all Americans. The debate rages on, however, about what exactly should be done to remedy the ailing situation. Doctors' groups and other lobbies have prescribed reforms that keep the majority of the current system intact. Some reformers have proposed a strong dose of direct price controls, while others support managed competition. And, Wednesday night, President Clinton announced his long awaited health care reform package.
The president's plan, comprising a synthesis of the better aspects of a slew of concepts into a comprehensive whole, represents the best chance our nation has for practical health reform. Clinton's proposal makes four sweeping changes in the current American health care system. First, it provides guaranteed universal coverage. As a Clinton position paper stated, "Every American will be guaranteed affordable, quality health care. . . No one will be cut off, canceled, denied, or forced to accept inferior care." This universal protection is a must in a society where so many are homeless or unemployed. New rules for insurance companies which include open enrollment and equitable pricing, as well as a comprehensive benefits package, will assist in providing health care for all Americans. In Hawaii, where a similar plan was implemented, 98 percent of the people are now covered by a system of health clinics and insurance reforms.
Second, the administration's plan will control the spiraling costs of care. Health care costs also affect other aspects of the American economy; over a million jobs have been lost since 1980 because of the rising price of care, and the amount that businesses spend on health care now exceeds their after-tax profits. Additionally, the cost of American health care alone has increased the price of cars $1,230, according to the Chrysler Corporation. A health standards board will regulate the prices doctors and hospitals charge their clients. The exponential growth of drug prices will be stopped with reasonable price controls. The president has proposed to eliminate tax breaks for drug companies that raise prices faster than average income and to encourage a change in emphasis in those companies from marketing to research and development. In administrative costs alone, the United States outspends Canada by a 5-to-1 ratio. An estimated $100 billion dollars can be saved just from eliminating fraudulent billing practices and cutting administrative costs.
In a campaign speech, Clinton noted, "Already this year, the average elderly person is spending a higher percentage of their income on health care than they were back in 1965 before Medicare came in." In Germany and France, health spending caps and cost targets have greatly reduced the cost of national health coverage. According to a General Accounting Office report, "Targets and caps slowed the rate of spending increases compared with what would have happened without these policies." Price controls are already in effect in parts of the United States today: at the national level with Medicare fee schedules; at the state level, as in Maryland, which sets hospital rates; and at the local level -- the city of Rochester, N.Y., uses global budgets for hospitals. Reduction in insurance fraud, malpractice costs, and administration costs because of centralization and standardization of forms and plans will also help to reduce spending on health care.
Thirdly, the new plan makes necessary changes in the quality and type of health care. Important preventive and primary care will be provided in rural and inner-city areas; locations where the current situation is woefully inadequate. Additionally, Americans will have the chance to choose the type of care that best suits them. Senior citizens will be able make choices about nursing home health care, personal care, or visiting nurses, similar to a program which Clinton instituted in his home state of Arkansas.
Finally, and perhaps most importantly, the Clinton plan places strong emphasis on health care for children. It will improve on existing health education programs and found new ones. He has proposed to increase Early Periodic Screenings, Diagnosis and Treatment by more than 2,000 percent. In Arkansas alone, Clinton as governor helped reduce the infant mortality rate by 43 percent. Clinton also proposed and passed a program to provide primary and preventive care to all youth in Arkansas, regardless of family income.
With guaranteed universal coverage, effective cost controls, new and better care, and emphasized care for children, President Clinton's recently unveiled health care reform package represents the best cure for our nation's health care malady. Without any reforms, according to the GAO, health costs will continue to escalate while a substantial number of Americans lack access to health insurance. Health care is a right, not a privilege, according to a Clinton position paper; the best way to ensure that right for all Americans is for Congress to pass the President's reform package.