The Clinton Health Plan
The health care situation in the United States is in dire need of a
change. The United States spends more money on health care per individual
than any other nation in the world (14%of its GNP in 1991), and that amount
is quickly rising. Virtually everyone, from doctors to politicians,
recognize the unwieldy situation of health care in America, and realize
that something must be done.
In order to attempt to correct the failures of the current health care
situation, one must understand the problems that led to the deterioration
of the health care system. Perhaps the main problem with health care today
is that there are 37 million Americans without insurance, and another 20
million are underinsured
Another large problem with the way health care is presently organized
is – as Clinton helpfully points out – waste. Some common examples are:
Paperwork: There are thousands of insurance companies in the US, and
each one has many forms for doctors and patients to fill out. So much so,
that doctors spend more time improving their handwriting than healing
people.
Greed and Profiteering: Some drug companies make over 10,000% profit on
the 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 of
operations and tests are unneeded. Malpractice Suits and “Defensive”
Medicine: Doctors pay high premiums on malpractice insurance which causes
them to charge more. The reason that these premiums are so high is because
currently there are practically no limits to an amount that can be sued for
pain and damages. Defensive medicine – procedures done to protect doctors
from being sued – is costing this country greatly.
Recognizing that waste is one of the greatest causes of the high prices
in health care, Clinton has introduced a plan to revise the health care
system by eliminating waste, and making sure that every single American can
be covered by a health plan.
Clinton’s plan is based on three premises. First, that there is enough
waste in the current health care system to cover the costs of his new plan.
Second, that his plan will create competition within the insurance
industry. 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. A
seven-member National Health Board will be set up to scrutinize the health
alliances. The health alliances would be limited by the National Health
Board by having price caps on the premiums, and by assuring that the health
alliances will accept all applicants including those that are high-risk.
Each health alliance will have three or four different options (HMO, fee
for service, and combination plans) which the consumers could choose from.
In the case of the employed, the insurance would be paid 80% by the
employers and 20% by the employees. In the case of self- employed and
non-employed, they would have to pay the full cost of the premiums by
themselves, 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 wages
of specialists, and the prices of drugs.
Overall, what Clinton’s health care plan will do is put caps on
insurance premiums thereby causing competition between insurers. It will
also greatly reduce the waste by: reducing the paperwork enormously by
having fewer insurance companies; removing unnecessary procedures by
putting limits on the insurance. It will also decrease greed and
profiteering by putting limits on doctor’s salaries and on drug prices.
The Clinton health care plan is not without its faults. One of the
major problems is that it assumes that there is a tremendous amount of
waste in the current system, but many people say that that is an over
assumption. Another problem is that managed competition, (an attempt to
create competition in the health-care market) might not work in the health
care industry because everything is covered in premiums, and there is a
third indirect party (insurance company), which does all the “buying and
selling” of health services.
Another problem, which is not a problem with the plan itself rather
with getting it passed, is that there are many groups opposed to the
Clinton plan.
Many politicians do not like Clinton’s plan because they feel that it
is too hard on small businesses, forcing them to pay 80% of their
employees’ insurance, and because the Clinton plan does not limit pain and
suffering damages for malpractice suits.All the insurance companies are
obviously against Clinton’s plan, because it will put restrictions on the
premiums, and he will force the insurance companies to accept high-risk
patients. Many of the large companies support Clinton’s plan because they
already pay the insurance for most of their employees’, and all Clinton’
plan will do is lower their premiums. But, many small businesses are
against the plan because they do not currently pay any amount of their
employees’ premiums, and they feel that the plan will take a large chunk
out of their profits and they will be forced to lower wages.
The AMA (American Medical Association) is against many things in
Clinton’s plan, most importantly the imposition of cost controls and the
failure to put financial limits on malpractice suits(In fact 600 doctors
marched up the steps of Capital Hill “to defend their right to earn six
times as much as the average American family, and still play golf on
Wednesdays”).
In general, no one is happy at the way the health care situation is
being handled now, but even though everyone accepts the fact that a change
is 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 are
wondering.
Overall Clinton’s plan is generally good. If it works it will provide
universal coverage with controlled costs. If it works. The problem with
Clinton’s plan, and in fact any other plan is that it has to put limits on
operations, research, and tests. Who is to set these limits that might
decide whether a person might live or die?
Clinton’s plan also does not allow much for freedom of choice of
doctors. Clinton is pushing the HMO (Health Maintenance Organization) part
of his plan, and if one wants to choose his own doctor, he must pay a
deductible and 20% of the costs of the visit.
Americans, in general, do not want an HMO type system rather they want
to be able to go to the doctor they choose. American people prefer a
trusting doctor-patient relationship, if they know their doctor it makes
life much easier.
Clinton’s plan also has a problem in that it does not limit the amount
of 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 could
be collected for malpractice suits, he would get a great deal more support
from the AMA, and from doctors in general.
Right now the health situation is America is very grave, and right now
President Clinton has a possible solution. His plan does not make everyone
happy, and it will not solve all our health problems no matter how
successful it is, but then again no possible plan will resolve all our
health care problems. There are many criticisms against Clinton’s plan,
but if we don’t try, we definitely will not succeed.
Endnotes
Bibliography
1.A New Framework for Health Care
New York Times, November 14, 1993, Section 4A p.3
2.Bradsher, Keith Business Leaders Voice Skepticisms of Health Plan
New York Times, October 8, 1993, p.26
3.Church, George C. Lots of Second Opinions
Time, October 27, 1993, pp.34-40
4.Clift, Eleanor “Big Sister” and Critics
Newsweek, November 1, 1993, pp.25-26
5.Clift, Eleanor The Gender Wars
Newsweek, October 4, 1993, p.50
6.Clymer, Adam Growing Consensus On Covering All, But How?
New York Times, November 14, 1993, Section 4A p.1
7.Cohn, Bob But What Does It Mean For Me?
Newsweek, September 27, 1993, p.37
8.Cohn, Bob The Power of Sin
Newsweek, October, 4 1993, p.51
9.Eckholm, Erik Moment of Decision for Health Care
New York Times, November 14, 1993, Section 4A p.1
10.Eckholm, Erik More Choices, But Also More Costs
New York Times, November 14, 1993, Section 4A p.10
11.Egan, Timothy Setting An Example For The Rest of The Nation
New York Times, November 14, 1993, Section 4A p.8
12.Fineman, Howard Clinton’s Hard Sell
Newsweek, September 27, 1993, pp.34-36
13.Freudenheim, Milt Medical-Industrial Complex’:Who Wins
New York Times, November 14, 1993, Section 4A p.13
14.Gibbs, Nancy Here Comes Dr. No
Time, October 11, 1993, pp.26-29
15.Goodgame, Dan Healthy Dissent
Time, October 11, 1993, p.31
16.Health Care:Clinton Plan, and The Alternatives
New York Times, October 17, 1993, p.22
17.Kerr, Peter Reshaping the Medical Marketplace
November 14, November 14, 1993, Section 4A p.11
18.Kilborn, Peter T. Voices of the People:Struggles, Hope, and Fear
New York Times, November 14, 1993, Section 4A, p.1
19.Kolata, Gina Catch-22:Lose Health, Lose Policy
New York Times, November 14, 1993, Section 4A p.4
20.Kolata, Gina Will the Nation Be Healthier?…
New York Times, October 17, 1993, p. 1
21.Lewin, Tamar Those With Large Bills See Aid In Clinton Plan
New York Times, November 14, 1993, Section 4A p.10
22.Lowther, William A Prescription for Change
Maclean’s, October 4, 1993, p.39
23.Morganthau, Tom The Clinton Cure
Newsweek, October 4, 1993, pp.36-45
24.Morganthau, Tom The Clinton Solution
Newsweek, September 20, 1993, pp.30-35
25.Pear, Robert Delay on Health Care Reflects Task’s Complexity
New York Times, October 12, 1993, p.??
26.Reinhold, Robert Amid Mountains of Paper, a War Against a Tide
of Red Ink. New York Times, November 14, 1993, Section 4A p.4
27.Rosenthal, Elizabeth Confusion, Errors, and Fraud, In Medical
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28.Samuelson, Robert J. Health Care:How We Got Into This Mess
Newsweek, October 4, 1993, pp. 30-35
29.Rich, Thomas “A Walk In Space”
Newsweek, October 4, 1993, pp.46-49
30.Rich, Thomas Back To Smoke and Mirrors
Newsweek, October 4, 1993, pp.36-37
31.Whitney, Craig R. Coverage for All, With Choices
New York Times, November 14, 1993, Section 4A p.9
32.Uchitelle, Louis Companies of All Sizes Tally Effects of Plan
New York Times, November 14, 1993, Section 4A p.13
