As the cost of health care in the United States continues to spiral upward, it is increasingly apparent that something must be done to remedy this situation. There is no certainty about the reasons for this drastic rise in the cost of health care, but the problem is due to more than inflation. Consequently, the government's role concerning health care in the United States is now being questioned.

Presently, Americans spend somewhere in the neighborhood of $500 per capita each year for health care. Medical care alone accounts for more than $700 billion per year. Total health care consumes more than 15 percent of the Gross National Product.

One reason for the high cost of health care is due to the rising cost of liability insurance resulting from the increasing threat of malpractice lawsuits. Doctors raise the costs of services in order to offset the prices that they must pay for liability insurance. They also seek to avoid lawsuits by ordering excessive testing that is often unnecessary. Doctors waste more than $100 billion every year on this type of overzealous testing.

The free enterprise system cannot correct this problem on its own.Therefore, malpractice litigation is one area in which the government should be involved in health care. This is possible by instigating what is called a "means focus" test which was first proven by the United States Supreme Court in the case of Reed versus Reed in 1971. The court upheld that medical malpractice claims should be treated separately from other kinds of liability claims. The court stated that the announced purpose of the Act was to help reduce the cost of medical malpractice claims which, in turn, would reduce the cost of liability insurance and hopefully stabilize this particular insurance market.

The idea is to set up a system in which claims would undergo arbitration procedures to determine the validity of those claims and settle the disputes more rapidly and at less cost than by traditional court procedures. Court action would only be taken in cases of extreme circumstances and this would ultimately reduce the cost of health care significantly.

Another proposed solution that involves the government in the health care crisis is to nationalize and socialize the American health care system. Under this plan, the government would pay the costs of health care for everyone, regardless of their financial conditions. In order for the government to finance such an operation, taxes would be raised significantly. However, the concept of higher taxes is not appealing nor is it something that would benefit the present American economy.

Nationalized health care would require diversion of money to pay for administrative duties rather than using it to accomplish the original goal of providing health care. This can easily be seen by studying Great Britain's system of nationalized medicine. Between 1965 and 1975, total hospital staff grew from 628,000 to 803,000. However, that was due largely to the 51 percent increase in administrative and clerical staff from 45,000 to 72,000. Wards were often closed for lack of nurses, many of whom were caught up in administration. Many complications of centralization have been exposed, and after almost 50 years, the weaknesses of the British system are still being explored. Therefore, the British experiences should be examined carefully before considering centralization of American health care.

While total governmental control is not desirable, minimal involvement by government in the form of national health care insurance could prove to be beneficial.

There are several techniques which, if implemented along with a nationalized insurance plan, could be used to maintain costs at manageable levels. For example, coinsurance is a plan in which the insured person pays a percentage of all the costs they incur, thus providing incentive to keep costs as low as possible. A second plan uses deductibles that cut down on the administrative costs of processing small claims. Indemnity insurance places a dollar amount on well-defined ailments and treatments, such as broken bones and tonsillectomies, therefore eliminating overcharging by physicians. The fourth technique is to provide incentives to reduce costs by lowering premiums for people who take precautions such as avoiding overweight and abstaining from smoking and drinking.

Avoiding rigid criteria for reimbursement can also cut down on costs since they actually invite exaggerated expenses. The providers of health care can be given incentives to exclude exaggerated costs by actually requiring that they provide and pay for the care simultaneously. Health care providers would be reimbursed with regular payments unrelated to the actual provision of care. Finally, the consumer can be given incentives to economize by excluding such items as eyeglasses that do not belong in the insurance scheme.

The fact is that everyone, at some time or another, requires some form of health care. By exploring many of the various possibilities, the United States government could accomplish a lot toward reducing the financial problems associated with health care. In turn, Americans would then be able to spend more time looking for jobs, educating their children, and putting the United States on the road to recovery.

In conclusion, the best solution regarding the government in the health care crisis is continued free enterprise with limited government intervention in the form of national health insurance and specific legislation concerning malpractice lawsuits. It may take time, but a more efficient health care system can be developed by examining various health care systems and the mistakes of other nations. By closely inspecting all possibilities, a more efficient system can be developed that will serve America with a clean bill of health.

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