America's Health Care Revolution
Califano, Joseph A. Jr.
AMERICA'S HEALTH CARE REVOLUTION: WHO LIVES? WHO DIES? WHO PAYS? Joseph A. Califano, Jr./Random House/$17.95 Stephen Chapman assistant for domestic affairs and as Jimmy Carter's Secretary of...
...Some podiatrists had taken advantage of Chrysler's lax approach to get rich, through unnecessary operations and inventive ploys like working on only one toe per visit...
...But, lured by lucrative returns, surgeons perform 200,000 of these operations every year—four times as many per capita as in West Germany, twice as many as in Canada and Australia...
...European women, in contrast, "got it right when they decided to push not only for equal rights in the sphere of work but also for social benefits to ease the family responsibilities of working women...
...2233 University Avenue Rm...
...The difficulties and frustrations the British-born author encountered in academia while trying to raise two Brigitte Berger is professor of sociology at Wellesley College...
...Name: Address: City: State: Zip: TO ORDER BY PHONE: 800-448-8311 Call, for orders only, between 9 AM and 5 PM (Eastern Time) Monday-Friday...
...Califano also does a workmanlike job of tracing the effects of government policies...
...From trying to figure out what went wrong, he has acquired some under-standing of the value of the market and the malignant effects of government programs...
...American women, she contends, are "long on image and short on substance...
...Charge my: ^ VISA ^ Master Card ^ American Express Account # 1111 1111111111111 Exp...
...Hewlett argues that although the 1970s constituted the decade of liberation for a lucky few, the vast majority of women "were left behind to cope with deteriorating economic and social realities...
...Most of the coverage applied not only to employees but to retirees as well...
...He quotes an American Medical Association official who says these are "the toughest times for doctors" in American history...
...And, Califano notes, most large commercial insurers have adopted the idea...
...Other social proumnist for the Chicago Tribune...
...Companies that require a second opinion before approving operations have reduced surgery rates by 20 percent...
...As it is, he resembles a doctor who uses every advanced diagnostic gadget to find out what is wrong with his patient, and then tries to cure him by applying leeches...
...As he knows from history and personal experience, and as the reader knows from the preceding chapters, this is not the case...
...Hewlett's tribulations in this academic center of feminism showed her that the passionately waged battles of "ERA politics" are marginal, if not irrelevant, to the great majority of American citizens...
...Second, it provides some useful history of government involvement, from the regulation of doctors to the creation of Medicare and Medicaid...
...Over forty years, the combination of a strong union, minimal foreign competition, and federal tax breaks had produced a lavish potpourri of medical benefits...
...The Catholic Standard "The Church has a special message for tyrants of any stripe, and every now and then a special messenger comes along to deliver it with special force...
...In 1965, spending on medical care took 6.1 percent of the nation's total income...
...I have enclosed a ^ check ^ money order of $9.95 for each book payable to: Regnery/Gateway, Inc...
...Such a man was Father Jerzy Popieluszko, and this book helps mightily to explain why that was so...
...If Califano ever thinks as hard and as carefully about remedies as he has about causes, he would be a valuable source of guidance...
...Elsewhere, when Califano stops analyzing and starts proposing, he reverts to type, spewing out proposals for government action like grass cuttings out of a lawnmower: Employers should be required to provide health insurance...
...He also welcomes HMOs, which generally can provide care for less than the old fee-for-service arrangement...
...The greatest of these is the huge increase in the demand for medical care, which can be ascribed to federal and state programs that pay hospital and doctor bills and to the tax-free status of employer-provided health insurance...
...A typical hospital maternity stay lasted 3.8 days for Chrysler beneficiaries, compared with less than two days for new mothers at hospitals in southern California...
...So sooner or later the federal governent will have to consider rationing care—refusing to pay for certain treatments for certain patients, as Britain's national health service already does...
...Medical students should get no federal aid unless they agree to spend two or three years in a federal doctor corps, working in places where doctors are scarce...
...225 • Dept...
...This is about as helpful as a placebo...
...The book is useful in several respects...
...and the women's liberation movement is to be blamed for the sorry state of affairs...
...The catchy title of the book and its anti-feminist rhetoric merely serve to conceal Hewlett's real purpose: to attack the "backward and barbaric" social policies under which American women are forced to labor and live, and replace them with a national family policy modeled on Sweden's...
...Sylvia Ann Hewlett reaches this grim verdict in her widely hailed A Lesser Life...
...It serves as a concise layman's guide to a subject of growing importance...
...Is that all...
...care...
...The new Califano places his hopes in the pressures on employers and insurers to reduce costs...
...Move that damn bill out now, before we lose it...
...Joseph A. Califano, Jr./Random House/$17.95 Stephen Chapman assistant for domestic affairs and as Jimmy Carter's Secretary of Health, Education and Welfare, this book, the product of Califano's partial disenchantment, carries the weight of authority...
...Moreover, many of her arguments against the Equal Rights Amendment and her plea for "special rights" for women are well taken and return ThsfWay My Cross FatherJerzy Popieluszko by Father Wrhad J. Wrenn A REGNERY BOOR A LESSER LIFE: THE MYTH OF WOMEN'S LIBERATION IN AMERICA Sylvia Ann Hewlett/William Morrow/$17.95 Brigitte Berger DSO 005 •4 ~ Poland's Communist government felt it had to murder Father Jerzy Popieluszka This collection ~~a0 of his sermons shows why...
...today it soaks up more than 10 percent...
...Medical schools should be forced to teach more about addiction, the prevention of disease, and geriatric 6 Am erican women are locked into a no-win situation...
...The best he can do is to insist that "we have the re-sources, if we apply them effectively, to keep government in its place, to make fewer hard choices necessary, and to concentrate our collective wisdom on those choices we truly cannot avoid...
...they and their children are in bad shape...
...Much of its spending doesn't save the dying, but merely postpones death for a few weeks or months...
...As vice-president for economic studies at the Economic Policy Council of the United Nations Association, aided by a star-studded study panel—R...
...The old Califano probably would have called for federal monitoring of heart surgery...
...Please have your credit card at hand...
...Within two years, thanks largely to the new federal role, the nation's health care costs were speeding out of control...
...His indecision is out of character...
...Date: Signature: THE AMERICAN SPECTATOR SEPTEMBER 1986 41...
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...American women lacked publicly designed, delivered, and, of course, financed family support such as prenatal and child care, job-protected maternity leaves, a national family allowance, and a federally determined wage system that pegs women's work at "comparable worth" to that of men...
...Ads for beer and wine should be banned from television, and print ads for alcohol or tobacco should be forbidden to use pictures of people...
...The elderly present a particularly vexing dilemma...
...ALA Booklist "An authentic and beautiful reconciliation of true patriotism with the Gospel of Christ...
...So what to do...
...Paul, Minnesota 55114 Joseph Califano, Jr...
...AS-9 St...
...Of such nonchalance is disaster made...
...While "in some important ways the women's liberation movement has managed to reconstruct the language and the consciousness of the nation . . . the fact re-mains that they have not made a dent in the wage gap, and many are increasingly unable to reconcile motherhood with their professional aspirations...
...usiness people, government officials, educators and politicians will find a wealth of information and research material within Pravda's pages...
...From 60 to 80 percent of the patients who undergo coronary bypass surgery gain no increase in life span, Califano claims...
...Care was free to employees—they had to pay neither a deductible nor any percentage of their bills...
...Overt triage is not an appetizing option...
...He's right," says Califano, without a trace of sympathy...
...The Way of My Cross by Father Jerzy Popieluszko ------------------------------------ - Regnery Books 950 North Shore Drive Lake Bluff, Illinois 60044 Dear Sir: Please send me copies of The Way of My Cross...
...In tackling the broad issue of American health care, Califano can't be acStephen Chapman is a syndicated col- cused of timidity...
...Elsewhere, the author is less sure of his prescription...
...There are even signs that (perhaps under Lenore Weitzman's intelligent influence) she has begun to understand a few things about the paradoxes of political action: vide her perceptive analysis of measures de-signed to benefit women-such as no-fault divorce—that have backfired and ultimately work to the advantage of men...
...Califano gamely tries to acquaint the reader with most of the essential topics: government programs, private health insurance, the supply and training of doctors, emerging technology, hospitals and nursing homes, the relationship between personal habits and health...
...grams, like welfare, education, nutriCALL TODAY...
...Her unsavory and unexpected experiences as a young faculty member of the economics department at Barnard—a women's college to boot—led her to discover what has been evident to ordinary Americans for quite some time: American feminists, preoccupied with the female body, sexuality, language-policing, and gender politics, have been scandalously antagonistic to women whose values include children and family...
...how to reconcile the physician's impulse to do everything possible to help the patient with the obligation of someone to pay for it...
...Elementary and secondary schools should make health education "as compulsory as reading and mathematics...
...But America's Health Care Revolution raises hopes only to prove sorely disappointing in the end...
...Catholic New York celebrity Betty Friedan as well as family advocates Sheila Kamerman and Lenore Weitzman, Sylvia Ann Hewlett has succeeded in constructing a strategic platform to this end...
...Considering the thrust and scope of Hewlett's argument, it would be a serious mistake to understand A 1#ccer Life primarily as an outspoken and long-overdue indictment of the American women's movement...
...The most illuminating part is Califano's account of his effort to contain health care costs at Chrysler, a task he was given by Lee Iacocca in 1981...
...Medicare's long-term costs far exceed its expected revenues...
...The results were not surprising...
...Besides boosting prices, these policies led to excessive treatment...
...Visa, Mastercard and CHOICE accepted...
...In con-sequence they find themselves "between the devil and the deep blue sea...
...The Myth of Women's Liberation in America, which like other similar ex-poses of American social life is a mixture of truths, superficial analysis, and plain ignorance passing for scholarship and erudition...
...Through some rudimentary measures—requiring second opinions for surgery, scrutinizing hospital admissions, using health maintenance organizations for dental care—Chrysler cut its projected 1984 health care bill by nearly 13 percent...
...Local physicians, who were reimbursed for whatever they chose to charge, practically had a key to the Chrysler vault...
...children considerably shook her faith in the grandiose claims of the American women's movement...
...how to allocate limited supplies of medical goods and services, including life-saving technology and even human organs...
...Eyeglasses, prescription drugs, and hearing aids also cost them nothing...
...Or Write to: tion, and Social Security, get more attention, but none presents more frustrating dilemmas: how to protect the poor without bankrupting the rest of us...
...Coming from someone who has served as Lyndon Johnson's special 40 THE AMERICAN SPECTATOR SEPTEMBER 1986 ethical questions to be faced, he provides few answers...
...Tbld in 1964 that getting his cherished Medicare bill approved by the key Senate committee would re-quire spending an extra half a billion dollars, President Johnson snorted, "Five hundred million...
...But while Califano spends a lot of time poidting out the PRAUDA Unique source material never before available — for who could read the Russian — but now the language barrier has been broken, and this research tool is available 365 issues per year...
...At one point in 1982, notes Califano, "Chrysler was paying health care expenses for 107,000 retirees and individuals who had been laid off, when it had only 61,000 active workers on its payroll...
...is one of the rare architects of the Great Society who has learned something from its failures...
...And they're likely to get tougher...
...Costs had reached $300 million a year by the time Califano arrived, with the total expected to reach $460 million by 1984...
...The contract signed with the UAW in 1985 provided for additional economies...
...O. Anderson (Atlantic Richfield), Douglas A. Fraser (UAW), Henry Kaufman (Salomon Brothers), Gerald Ford, Alice Ilchman (Sarah Lawrence), and other luminaries—generously financed by both the Rockefeller and Ford Foundations, and spiritually guided by movement "A compelling collection...
...When hen writing from her own experiences, Hewlett displays a good deal of common sense and offers some refreshing comments on the fads and foibles of child-rearing and supermomism invented by legions of experts and the media...
...Besides flaunting an obnoxious hostility toward individual choice, Califano acts as if government programs have no costs or unintended consequences, only benefits...
Vol. 19 • September 1986 • No. 9
