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What's Right and Wrong With U.S. Health Care
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20341 |
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Section : |
CURRENT ISSUES
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| Issue
Date : |
6 / 1992 |
1,746 Words |
| Author
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James A. Rice
James A. Rice is strategy and public affairs officer for
HealthSpan Health Systems Corporation in Minneapolis. |
The public policy stage seems finally set to move beyond debate to action within the U.S. health services sector. The scope, nature, and timing of this action, however, remain unclear. What does seem clear, though, is that America's tradition of health care pluralism is under siege, from both the political Right and Left. Fundamental precepts of the American health services sector are being challenged in the election year debates of 1992--challenged in ways that could bring significant changes in the fabric of how we choose to finance and deliver health services, even if no sweeping legislation is promulgated.
America's love affair with choice/pluralism
In the U.S. health care experience, one concept, one overarching goal, seems to be simultaneously (a) shaped by the unique American psyche, and (b) shaping the policy debate for health sector reform--pluralistic choice. Choice of physicians, choice of benefits, choice of hospitals, choice in the mix of health insurance deductibles versus premiums, choice of life and death, choices about which level of government and what degree of government is needed in the U.S. health services sector. We pride ourselves on our will and capacity to make available a cornucopia of choices in all facets of our society: clothes, cars, houses, foods, friends, and even theology. It has become clear, however, that not all segments of society have equitable access to these choices. This has become a central issue in the debate being waged over health sector reform: how to afford enhanced access for all people to available U.S. health care choices?
This political, and particularly economic, realities at the close of the 1990s will severally constrain these prerogatives. There will be fewer choices for all of us. Prerogatives of physicians, hospitals, politicians, payers, employees, and patients will be more limited. America's health care pluralism is, and will increasingly be, under siege.
What are our current health sector resources?
The U.S. health sector is one of the largest single components of our economy. It represents the largest and one of the faster growing blocs of employees; and it leverages economic growth and vitality in the broader economy through its consumption of various goods, services, utilities, food, and a wide array of computer and electronic technologies. The government's role has been steadily increasing since the introduction of Medicare and Medicaid in the
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