Organization: Penn State University
Date: Sun, 11 Oct 1992 11:07:47 EDT
From: <DGS4@psuvm.psu.edu>
Newsgroups: alt.politics.bush,alt.politics.clinton,alt.politics.elections
Subject: Re: Health Care [long] -- was Re: I will vote for Clinton if ...
Distribution: usa
 <1992Oct9.232046.12148@u.washington.edu>
 <1992Oct11.074059.28014@organpipe.uug.arizona.edu>

In article <1992Oct11.074059.28014@organpipe.uug.arizona.edu>,
shackeld@helium.gas.uug.arizona.edu (david m shackelford ) says:

>Health care is a very important issue, and both parties are
>talking about ways to improve the situation.  I believe, along
>with most Republicans, that our health care problem would be
>solved best through a combination of competition and assistance.
>It appears that most Democrats prefer a solution that depends
>on increased regulation and massive government funding.

No, the Republicans have proposed minor increases in government involvement
in the market (limits on insurance company practices and prices, vouchers
and tax credits) which, by almost every estimate I've seen, will have almost
no impact on restraining costs and will still leave us with 27 million
uninsured persons in 2005.  The Democrats have proposed a plan which is
shorter on specifics, yet argues that the nation must make a committment
to insuring all citizens.  The plan would supposedly attempt to control
costs first by setting a National Health Budget, using a quasi-independent
agency like the Fed.  Although Clinton said initially his plan would be a
play-or-pay system, his advisors have apparently convinced him to allow the
states to choose how to keep their expenditures within the budget.  Some may
take a more free market approach than others.


>
>Here is the scenario I am afraid of:  Clinton is elected
>President along with Democrat majorities in both the House
>and Senate.  Senator Kennedy sponsors a national health
>care bill totally regulating the health care industry.
>The government would tell us which doctor to see, which
>hospital to go to, which tests could be used, which
>treatments would be allowed.  The system would be similar
>to the VA hospital system or the military hospitals.

None of the Democratic plans, no Democratic senator or rep.,
and in fact, no one in the Democratic party has proposed such a
plan.  If such a plan were proposed, support would be so small
that the proposer would be committing political suicide.


>I've seen the results of such a system first-hand.
>There is a lot of benefit in such a system -- as long as
>you don't need any special treatment.  What if we "cut costs"
>by denying AIDS patients access to their expensive drugs?
>What if we decide chemotherapy for elderly cancer patients
>doesn't meet the budgetary requirements?

Why do these problems concern you, yet the fact that the uninsured are
discharged from the hospital sooner and have higher mortality does
not?  Every system has to make choices about how care is distributed.
Our current system does not appear to produce much bang for the buck
if you look at satisfaction levels and health outcomes.


>There is no proof that this scenario could happen.  I'm
>not trying to say that it would, but it scares me enough
>to seek other options.  The Republican party offers an
>in-between step which reduces the chance of a "1984"-ish
>system while offering some chance for improvement.

While the Republican party does propose an in-between step, a lot
of what they propose has been tried in the states already.  It
hasn't worked.

>The right way to handle our health care crisis is to
>adopt a combination of regulation and funding.  Rather
>than take complete control of the industry, we should
>single out the biggest problems for regulatory and
>fiscal repair, while observing the indirect results
>of these steps.
>
>There are many Americans who need the government's help
>in obtaining health insurance.  We should expand the
>window in which medicare/medicaid type insurance is
>available.  To offset some of the cost of expanding the
>rolls, these programs need to have stricter controls and
>streamlining of administrative function.

In fact, medicare and medicaid have lower administrative costs
than the private insurers.  A number of states have tried to
use Medicaid to exapnd coverage to the working poor.  It didn't work.


>The insurance industry needs to be regulated better.
>Our regulatory system should follow the KISS principle --
>"Keep it Small and Simple".  Regulations should be few and
>to the point.  Common sense should dictate most of the
>necessary regulations.
>
>A vast drain on the health care industry is the need
>for doctors to insure themselves against malpractice.  We
>need to impose legislated limits on damage awards.  I have
>some sympathy for the victims of malpractice, and support
>the doctrine that they are entitled to compensation.  I
>do not believe, however, that multimillion-dollar awards
>are reasonable.  Human life is generally regarded as

A vast drain?  No, both the Bush administration and the AMA
put the total cost of all the effects of malpractice at about
20 billion.  Even if you reduced that to zero you would hardly
put a dent in the rate of growth of NHE.  Besides, the Democrats
have proposed malpractice reform in their plan, too.

>priceless [NO Abortion followups please, this is an attempt
>to discuss health care logically!!], thus the amount of
>the award doesn't really matter.  The judgement that the
>individuals and/or organizations involved were responsible
>is the primary importance of malpractice law.
>
>We need to do something that none of the candidates seems
>to mention.  The medical records system, both of patients
>and providers, is woefully inadequate.  A powerful, secure
>interstate database is necessary to prevent the few quacks
>out there from staying one step ahead of the law.  It is
>also necessary to ensure that when a patient needs care

You're way behind the times.  HCFA and the private insurers
have been working with hospitals and physicians to create such
systems.  It doesn't really matter which candidate gets elected
the future of medical care claims processing and administration
is increased electronic data storage and retrieal.  What is
interesting is that the government has been the leader in this
area.  Private insurers have had to be dragged kicking and screaming
into the negotiations.  While HCFA expects that 100% of all
hospital bills to Medicare and 75% of physician bills to Medicare
will be handled electronically in 2000, the private insurers will be
lucky to get to 50% in either area, because of their resistance to
develop and use standardized billing forms.

>the proper records are available, whether that care is
>given by the patient's personal physician or an emergency
>technician in another state.  [I'm looking for a job after
>graduation and would be happy to lead the effort provided
>adequate compensation is offered! ;-)]

I'm glad to see you taking an interest in the issue, but I see
the party's position quite differently than you do.  Bush's plan
will not restrain costs and will still leave 10% (at least) of the
population uninsured.  Clinton's plan at least has a hope of slowing
costs and covering everyone.  In addition, it will allow individual
states to decide how it will meet cost and coverage goals within
broad federal guidelines.


Dennis G. Shea, Penn State
<<DISCLAIMER>>
Ain't nobody's bizness but my own. I'll be happy to accept all
the credit for anything I've written.  It's funny, however, how
employers only acknowledge the profitable ideas.
Newsgroups: alt.politics.bush