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 National Health Board would limit the health alliances 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 in 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,