The health care situation in the United States is in dire need of achange. The United States spends more money on health care per individualthan any other nation in the world (14%of its GNP in 1991), and that amountis quickly rising. Virtually everyone, from doctors to politicians,recognize the unwieldy situation of health care in America, and realizethat something must be done. In order to attempt to correct the failures of the current health caresituation, one must understand the problems that led to the deteriorationof the health care system. Perhaps the main problem with health care todayis that there are 37 million Americans without insurance, and another 20million are underinsured Another large problem with the way health care is presently organizedis – as Clinton helpfully points out – waste.
Some common examples are: Paperwork: There are thousands of insurance companies in the US, andeach one has many forms for doctors and patients to fill out. So much so,that doctors spend more time improving their handwriting than healingpeople. Greed and Profiteering: Some drug companies make over 10,000% profit onthe drugs they manufacture. In 1991, the median income of doctors was$139,000 for general practitioners and $512,000 for specialists. Unneeded Surgery and Tests: Possibly 15 to 35% of certain types ofoperations and tests are unneeded. Malpractice Suits and “Defensive”Medicine: Doctors pay high premiums on malpractice insurance which causesthem to charge more.
The reason that these premiums are so high is becausecurrently there are practically no limits to an amount that can be sued forpain and damages. Defensive medicine – procedures done to protect doctorsfrom being sued – is costing this country greatly. Recognizing that waste is one of the greatest causes of the high pricesin health care, Clinton has introduced a plan to revise the health caresystem by eliminating waste, and making sure that every single American canbe covered by a health plan. Clinton’s plan is based on three premises.
First, that there is enoughwaste in the current health care system to cover the costs of his new plan. Second, that his plan will create competition within the insuranceindustry. Last, that his plan can put a cap on insurance prices. The core of Clinton’s plan is to set up regional health alliances,which would buy insurance on behalf of thousands of consumers.
Aseven-member National Health Board will be set up to scrutinize the healthalliances. The health alliances would be limited by the National HealthBoard by having price caps on the premiums, and by assuring that the healthalliances will accept all applicants including those that are high-risk. Each health alliance will have three or four different options (HMO, feefor service, and combination plans) which the consumers could choose from. In the case of the employed, the insurance would be paid 80% by theemployers and 20% by the employees. In the case of self- employed andnon-employed, they would have to pay the full cost of the premiums bythemselves, unless they qualify for government subsidies.
The Clinton plan also will limit what types of operations are covered,and it puts restrictions on how long a person can stay in a hospital,nursing home, or rehabilitation center. It would also regulate the wagesof specialists, and the prices of drugs. Overall, what Clinton’s health care plan will do is put caps oninsurance premiums thereby causing competition between insurers. It willalso greatly reduce the waste by: reducing the paperwork enormously byhaving fewer insurance companies; removing unnecessary procedures byputting limits on the insurance.
It will also decrease greed andprofiteering by putting limits on doctor’s salaries and on drug prices. The Clinton health care plan is not without its faults. One of themajor problems is that it assumes that there is a tremendous amount ofwaste in the current system, but many people say that that is an overassumption. Another problem is that managed competition, (an attempt tocreate competition in the health-care market) might not work in the healthcare industry because everything is covered in premiums, and there is athird indirect party (insurance company), which does all the “buying andselling” of health services.
Another problem, which is not a problem with the plan itself ratherwith getting it passed, is that there are many groups opposed to theClinton plan. Many politicians do not like Clinton’s plan because they feel that itis too hard on small businesses, forcing them to pay 80% of theiremployees’ insurance, and because the Clinton plan does not limit pain andsuffering damages for malpractice suits. All the insurance companies areobviously against Clinton’s plan, because it will put restrictions on thepremiums, and he will force the insurance companies to accept high-riskpatients. Many of the large companies support Clinton’s plan because theyalready pay the insurance for most of their employees’, and all Clinton’plan will do is lower their premiums. But, many small businesses areagainst the plan because they do not currently pay any amount of theiremployees’ premiums, and they feel that the plan will take a large chunkout of their profits and they will be forced to lower wages. The AMA (American Medical Association) is against many things inClinton’s plan, most importantly the imposition of cost controls and thefailure to put financial limits on malpractice suits(In fact 600 doctorsmarched up the steps of Capital Hill “to defend their right to earn sixtimes as much as the average American family, and still play golf onWednesdays”).
In general, no one is happy at the way the health care situation isbeing handled now, but even though everyone accepts the fact that a changeis needed, many people are skeptical about Clinton’s health care plan. Yes,his plan sounds good on paper, but “will it work?” is what many people arewondering. Overall Clinton’s plan is generally good. If it works it will provideuniversal coverage with controlled costs. If it works. The problem withClinton’s plan, and in fact any other plan is that it has to put limits onoperations, research, and tests.
Who is to set these limits that mightdecide whether a person might live or die? Clinton’s plan also does not allow much for freedom of choice ofdoctors. Clinton is pushing the HMO (Health Maintenance Organization) partof his plan, and if one wants to choose his own doctor, he must pay adeductible and 20% of the costs of the visit. Americans, in general, do not want an HMO type system rather they wantto be able to go to the doctor they choose. American people prefer atrusting doctor-patient relationship, if they know their doctor it makeslife much easier.
Clinton’s plan also has a problem in that it does not limit the amountof money that can be sued for for pain and damages in a malpractice suit. If Clinton were to add a clause about limiting the sum of money that couldbe collected for malpractice suits, he would get a great deal more supportfrom the AMA, and from doctors in general. Right now the health situation is America is very grave, and right nowPresident Clinton has a possible solution. His plan does not make everyonehappy, and it will not solve all our health problems no matter howsuccessful it is, but then again no possible plan will resolve all ourhealth care problems. There are many criticisms against Clinton’s plan,but if we don’t try, we definitely will not succeed. EndnotesBibliography1.
A New Framework for Health CareNew York Times, November 14, 1993, Section 4A p. 32. Bradsher, Keith Business Leaders Voice Skepticisms of Health PlanNew York Times, October 8, 1993, p. 263.
Church, George C. Lots of Second OpinionsTime, October 27, 1993, pp. 34-404. Clift, Eleanor “Big Sister” and CriticsNewsweek, November 1, 1993, pp.
25-265. Clift, Eleanor The Gender WarsNewsweek, October 4, 1993, p. 506. Clymer, Adam Growing Consensus On Covering All, But How?New York Times, November 14, 1993, Section 4A p.
17. Cohn, Bob But What Does It Mean For Me?Newsweek, September 27, 1993, p. 378. Cohn, Bob The Power of SinNewsweek, October, 4 1993, p.
519. Eckholm, Erik Moment of Decision for Health CareNew York Times, November 14, 1993, Section 4A p. 110. Eckholm, Erik More Choices, But Also More CostsNew York Times, November 14, 1993, Section 4A p. 1011.
Egan, Timothy Setting An Example For The Rest of The NationNew York Times, November 14, 1993, Section 4A p. 812. Fineman, Howard Clinton’s Hard SellNewsweek, September 27, 1993, pp. 34-3613. Freudenheim, Milt Medical-Industrial Complex’:Who WinsNew York Times, November 14, 1993, Section 4A p.
1314. Gibbs, Nancy Here Comes Dr. NoTime, October 11, 1993, pp. 26-2915. Goodgame, Dan Healthy DissentTime, October 11, 1993, p.
3116. Health Care:Clinton Plan, and The AlternativesNew York Times, October 17, 1993, p. 2217. Kerr, Peter Reshaping the Medical MarketplaceNovember 14, November 14, 1993, Section 4A p.
1118. Kilborn, Peter T. Voices of the People:Struggles, Hope, and FearNew York Times, November 14, 1993, Section 4A, p. 119. Kolata, Gina Catch-22:Lose Health, Lose PolicyNew York Times, November 14, 1993, Section 4A p.
420. Kolata, Gina Will the Nation Be Healthier?. . .
New York Times, October 17, 1993, p. 121. Lewin, Tamar Those With Large Bills See Aid In Clinton PlanNew York Times, November 14, 1993, Section 4A p. 1022. Lowther, William A Prescription for ChangeMaclean’s, October 4, 1993, p.
3923. Morganthau, Tom The Clinton CureNewsweek, October 4, 1993, pp. 36-4524. Morganthau, Tom The Clinton SolutionNewsweek, September 20, 1993, pp. 30-3525.
Pear, Robert Delay on Health Care Reflects Task’s ComplexityNew York Times, October 12, 1993, p. ??26. Reinhold, Robert Amid Mountains of Paper, a War Against a Tideof Red Ink. New York Times, November 14, 1993, Section 4A p. 427.
Rosenthal, Elizabeth Confusion, Errors, and Fraud, In MedicalBills. New York Times, November 14, 1993, Section 4A p. 528. Samuelson, Robert J.
Health Care:How We Got Into This MessNewsweek, October 4, 1993, pp. 30-3529. Rich, Thomas “A Walk In Space”Newsweek, October 4, 1993, pp. 46-4930.
Rich, Thomas Back To Smoke and MirrorsNewsweek, October 4, 1993, pp. 36-3731. Whitney, Craig R. Coverage for All, With ChoicesNew York Times, November 14, 1993, Section 4A p.932.Uchitelle, Louis Companies of All Sizes Tally Effects of PlanNew York Times, November 14, 1993, Section 4A p.13