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The Play or Pay Plan
| Article
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20342 |
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Section : |
CURRENT ISSUES
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| Issue
Date : |
6 / 1992 |
2,357 Words |
| Author
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Dr. Harvey I. Sloane
Harvey I. Sloane, M.D., is currently president of Health Care
for America. He served for two terms as mayor of Louisville,
Kentucky, and has worked as a public health physician with the
Neighborhood Health Centers in Louisville, as well as with
President Kennedy's Appalachian Health Program. |
National health care and universal health insurance have been discussed in this country for well over 50 years. In 1935, President Roosevelt considered putting universal health insurance into the Social Security bill but was dissuaded by the famed surgeon Dr. Harvey Cushing. The Wagner-Dingell Act was the first national health care related legislation introduced in the Senate in 1939. In 1948, Harry Truman campaigned successfully for his first full term with national health insurance as his No.1 domestic priority. But even after his great victory, President Truman could not get that bill out of committee. In the subsequent 43 years, there has been no vote for national health insurance on either the House or Senate floor. The giant lobbying forces of the medical industry have not wanted change. The doctors and the insurance, pharmaceutical, medical equipment, and hospital companies have their won special interest and political force.
However, the stage has changed dramatically in the last decade with the incredible escalation in the cost of health care, the increasing amount of the GNP devoted to it, and the fact that more Americans are without insurance coverage. From being a low-income, minority issue, it is now a middle-income, working American family issue. American families are deeply concerned about losing coverage and going bankrupt because of health care costs. No longer is it an option to support the status quo with minimal reforms. I predict that within the next three to five years, regardless of the party occupying the White House, significant legislation will be introduced and passed to provide universal coverage for all Americans, along with strong cost containment measures.
The question though is, Which way will America go? Will it, like Canada and some other Western nation, adopt a nationalized health insurance program wherein the government is the sole payer? I doubt that America will start with a social insurance system that necessitates an initial outlay of $250-300 billion and is run by the government. Politicians are not hailing Medicare, our government's program for seniors, as an example of cost containment or efficiency.
Or will the country turn toward the market-driven approach? This so-called consumer choice plan that is driven by tax credits and enables the individual to shop in the health care marketplace is a utopian idea that has not been adopted by any other Western nation. In the United States, the health care marketplace is driven by the supplier rather than the consumer. More doctors, more hospitals, and more technology do not reduce costs, but significantly increase them.
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