Regarding Health Care In The United States?
Our Nation's Health: What Are We Going To Do?
by Emily Ayers
1991-1992 Harry Singer Foundation National Essay Contest
There is no question about it. America needs a new health insurance plan. Taxes alone cannot support the $1.8 billion spent each day on health fees. That figure is staggering, especially since there are still between 34 and 37 million people not receiving any coverage at all. And prices, of course, are still climbing.
So what is our government doing? Making proposals. Politicians are trying to create proposals that will please the public, as well as the American businesses, which provide health insurance for 70 percent of the American people who are covered.
The public's ideas of health care reform is more services for less money...Every reform plan involves fewer services for more money, according to Norm Ornstein, an analyst for AEI.
There are three proposals that appear to be reasonable solutions. The first, dubbed the "play-or-pay" plan is supported by Senator George Mitchell. His plan would force businesses to insure either their own workers or pay a tax that would provide the government with resources to cover the employes' health costs. Mitchell's plan would try to keep costs down by creating health boards to decide what hospitals and doctors should charge. A major strength of this plan is that more people will receive coverage for a relatively low cost. Part of this "reduction" in costs is due to the fact that this plan would eliminate Medicare and Medicaid.
This is strongly opposed by the American Medical Association and the National Federation of Independent Business (NFIB). The AMA is against the Mitchell plan because the controlling of costs would mean less money for physicians. The AMA also argues that the quantity of services would decline and that taxes would again increase. The NFIB opposes the Mitchell plan because it will force many small businesses, like dry cleaners and flower shops, out of business. Many conservatives are against this system because they fear that with the "play-or-pay" plan it will be impossible to maintain the quality of the health care the reduce costs simultaneously.
The second of the three most popular proposals is the "single-payer" plan, brought to us by Representative Marty Russo. His plan is basically a duplicate of the Canadian system, in which there are no private insurance companies and the government foots the bill for the whole country. Supports of this plan are pleased because nearly every resident would be covered, insurance covers all of the hospital procedures, the monthly insurance costs are extremely low (Canadians only pay $32 per person per month), and the quality is consistent. Although this plan seems to be a miracle plan, there are many downsides as well. There can be a fairly long wait for services because everything must go through the government. Even critical surgical procedures are put on a waiting list. The Canadian/Russo plan also does not include dental plans, drug treatment, or optical treatment. It seems as if American would have to sacrifice the benefits of a free market insurance agencies in order to receive the reductions in cost.
Not only is the Russo proposal controversial for voters, but the AMA doesn't approve of this plan, either. They argue that both the Mitchell and the Russo plans are too controlling of physicians; that regulating costs is against the will of capitalism, perhaps unconstitutional. The source of their contempt is the fear of a major cut in salaries, if these plans were every passed.
In 1987, the average annual pay for a Canadian physician was $127,777, compared with $256,000 for a United States doctor, according to The Monterey (CA) Herald.
The Republicans have proposed a less drastic plan through Senator John Chafee. Chafee's plan would give tax credits to encourage companies and businesses to provide insurance for their employees. This plan is estimated to cost a mere $150 billion over five years. It is also the least costly of the three. Ouch. It does have a better chance of being passed, however, because it is the most moderate and the simplest to initiate.
Democrats argue that this system will not affect as many people, as it only provides support for those who have jobs. In his defense, Chafee pointed out that 85 percent of Americans do already have health insurance. People against Chafee's mild solution claim that the goal is not just to insure the maximum amount of residents, but also to maximize the efficiency of the national health care system.
Each of the three plans has pros, benefiting different communities. The Russo plan is clearly the most left-winged of the three, just as the Chafee proposal is the closest to the right. The Russo plan has the most benefits for the public, but it is a matter of convincing people that the plan is worth the sacrifices. The Chafee plan has good chance of being passed merely because it is the easiest to install, but could face some major opposition when the public realizes that it is not nearly helpful enough.
The Mitchell plan is the best compromise of the three. It will enable private insurance companies to still exist, yet it will allow the government to control health care to an extent of becoming more efficient as well as consistent.