Clinton’s Health Plan Essay, Research Paper
The health care situation in the United States is in dire need of a change. The United States spends more money on health careper 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 thedeterioration of the health care system. Perhaps the main problem with health care today is that there are 37 million Americanswithout 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. Somecommon examples are: Paperwork: There are thousands of insurance companies in the US, and each one has many forms for doctors and patients tofill 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 medianincome 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 reasonthat these premiums are so high is because currently there are practically no limits to an amount that can be sued for pain anddamages. 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 thehealth 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 costsof his new plan. Second, that his plan will create competition within the insurance industry. Last, that his plan can put a cap oninsurance prices. The core of Clinton’s plan is to set up regional health alliances, which would buy insurance on behalf of thousands ofconsumers. A seven-member National Health Board will be set up to scrutinize the health alliances. The health alliances wouldbe limited by the National Health Board by having price caps on the premiums, and by assuring that the health alliances willaccept all applicants including those that are high-risk. Each health alliance will have three or four different options (HMO, feefor 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 ofself- employed and non-employed, they would have to pay the full cost of the premiums by themselves, unless they qualify forgovernment 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 ahospital, 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 betweeninsurers. 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 limitson 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
amount of waste in the current system, but many people say that that is an over assumption. Another problem is that managedcompetition, (an attempt to create competition in the health-care market) might not work in the health care industry becauseeverything is covered in premiums, and there is a third indirect party (insurance company), which does all the “buying andselling” of health services. Another problem, which is not a problem with the plan itself rather with getting it passed, is that there are many groupsopposed 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% oftheir employees’ insurance, and because the Clinton plan does not limit pain and suffering damages for malpractice suits.All theinsurance companies are obviously against Clinton’s plan, because it will put restrictions on the premiums, and he will force theinsurance companies to accept high-risk patients. Many of the large companies support Clinton’s plan because they already paythe insurance for most of their employees’, and all Clinton’ plan will do is lower their premiums. But, many small businesses areagainst the plan because they do not currently pay any amount of their employees’ premiums, and they feel that the plan willtake 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 costcontrols and the failure to put financial limits on malpractice suits(In fact 600 doctors marched up the steps of Capital Hill “todefend 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 factthat 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. Theproblem with Clinton’s plan, and in fact any other plan is that it has to put limits on operations, research, and tests. Who is toset 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 MaintenanceOrganization) part of his plan, and if one wants to choose his own doctor, he must pay a deductible and 20% of the costs ofthe 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 amalpractice 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 doesnot make everyone happy, and it will not solve all our health problems no matter how successful it is, but then again no possibleplan will resolve all our health care problems. There are many criticisms against Clinton’s plan, but if we don’t try, we definitelywill 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