A speaker on Ireland:
Fisher, Desmond
than 300 employees, have union representation. would introduce. It is the overwhelming reality of medical care That is the situation organized labor confronts, and this at...
...Senator Kennedy has modified his earlier vored the notion and the AFL feared it as smacking of govern- proposals so that a large part of the program would be adminisment control...
...good offices with President Carter to try to bring about a Governor Carey turned the screw a little more when, a few similar historic shift of emphasis on Northern Ireland...
...political and partly administrative...
...27] This criticized British policy which had Margaret Thatcher will begin to feel the pressure of world "gone beyond delay and neglect and has become a policy of opinion, led by the U.S., and make a new effort to launch a conspicuous tilt in favor of the majority and to the detriment of political initiative on Northern Ireland to put an end to the the minority" in Northern Ireland...
...Humane and affordable health care will require changes in the education of physicians, the organization of hospitals, the conditions of workplaces, the styles and stresses of American living patterns...
...The administration's step- The hospitals, of course, say that no controls are necessary...
...A politically from Northern Ireland...
...Certainly, the Irish government is satisMoynihan and Governor Hugh C. Carey of New York-is one fied that the substance of Mr...
...He referred to it as "a low-key, fact- is that a precipitate British withdrawal, without the prior estabfinding mission" and said it was "something of a private lishment of a solid and agreed political structure, would be trip...
...O'Neill's the answer to all these questions is "Yes...
...O'Neill's visit almost certainly does not presage a two-hour meetings with Mr...
...The statement favored a continuing tragic happenings there...
...Costs in these states were held last year to distortions that are then invoked as arguments against proceedprecisely 9.7 percent-the Carter goal...
...During his Dublin visit, Mr...
...Pressure by Christian tradition produced during the last 15 years...
...O'Neill's remarks were very warmly received by politi- I s S THE PROMISE of genuine historical-mindedness one of the cians in the Republic, with the exception of Senator Conor great unrealized hopes of the Age of Renewal...
...Carter's original proposal provided for manda- Northern Ireland "troubles" which have caused some 2,000 tory controls...
...A larger question is ing to further reform...
...munity...
...This year's gives hospitals until January to limit deaths and 20,000 injuries in the past 10 years...
...It is the overwhelming reality of medical care That is the situation organized labor confronts, and this at a as we have itt right now...
...But we can certainly do Report from Dublin better than our present $200 billion medical show...
...it is the fact that this expenditure returns myriad ways, from wages and working conditions to simple neither what the public wants nor reasonably needs in health human dignity, organized labor in the United States has made a care...
...Now can and Democratic congressmen, many Irish saw him as the the President is back again, this time with a watered-down Precursor, preparing the way for a major bid by President version of his cost-control legislation, and once again his Carter to solve the Northern Ireland problems...
...But when he arrived in limit increases in hospital costs...
...nervous U.S...
...On the other hand, comprehensive health plans like the one A PLAN FOR HEALTH .. . Senator Kennedy has announced may not only be fairer in extending benefits more widely...
...O' Neill had forced Northern Ireland-for a day or two together the Egyptians and the Israelis," it said, "it is surely anyway-into-the forefront of the British election campaign, neither inappropriate nor visionary to suggest that Con- something which all parties had been working hand-in-hand to gressman O'Neill's visit be used to urge him . . . to use his avoid...
...As the administration points out, drawn-out approach allows the existing medical system to much of the cut in the rate of hospital cost-increases has been shape each stage to the status quo, often in costly and distorting achieved because of the mandatory controls imposed by nine ways as occurred with Medicare and Medicaid-costs and state governments...
...These closings, with the resultant mass duplicate tests of marginal value, and high-technology efforts unemployment and community disruption, were decided on by that cure (sometimes) but do not heal or care...
...DESMOND FISHER United Ireland with institutions linking the Protestant and (Desmond Fisher is Commonweal's regular correspondent Catholic communities and protecting the rights of each com- in Ireland...
...days after Mr...
...The administration replies that only its why the hospitals should be subjected to mandatory antiincrementalism stands a chance in Congress and, besides, the inflation controls when other items in the economy from food U.S...
...This year's proposal is similar to This thinking-more wishful than well-founded-is that the compromise bill that remained bottled up in the House Mr...
...Carter is preparing to mount an "Irish Camp David," Commerce Committee last year but which was approved by putting himself forward as the mediator who would end the the Senate...
...There is no cure-all...
...and low-cost regular medical help...
...The second reason for a better debate is the general realization that "high cost" is not a danger national health insurance Commonweal: 324 about the comparative records of private insurers, the Blue plans, and the government in keeping down administrative PART-TIME EDITOR: Commonweal, a biweekly jouroverhead...
...The first challenge to any national health insurance proposal is America's skyrocketing hospital bills...
...Writing and budget...
...coherent account of what it meant to be a Catholic...
...Camp David style intervention by President Carter...
...More and more one criterion and one alone: company profits...
...Someone will pay, in suffering or in dollars...
...Mr...
...government pays a major share of hospital costs through What shouldn't be forgotten, however, is that reform will be Medicaid and Medicare...
...STS A SPEAKER ON IRELAND ...AND A CAP 0N CO PRECURSOR OF DIPLOMACY TO COME...
...O'Neill was even more outspoken...
...remarks...
...Jack Lynch, and the leaders of the other two promised substantial job-creating investment once a settleopposition parties...
...Speaker of the House "Tip" O'Neill does not look the What the President is asking Congress for is legislation to part of a John the Baptist...
...about no-such-thing-as-a-free-lunch cuts both ways...
...Has Dr...
...O'Neill's political courage and statesman- within Catholicism...
...In this suggestion, Mr...
...This does not, however, rule out either a visit to Ireland by Certainly, the politicians in both parts of Ireland and in President Carter (following in the footsteps of John F. KenBritain took it much more seriously than that...
...The point York, N.Y...
...Thatcher...
...Carter's own plan promises to keep even more "off editing ability as well as interest in books, current affairs and the budget" than Kennedy's...
...Has there But the Taoiseach, Mr...
...costly than either continuing the present system or modifying it Contrary to a Newsweek story, which only reflected a general in relatively minor ways...
...Mail resume and samples of published work that medical care which is "off the budget" is either not being (no phone, please) to: Commonweal, 232 Madison Ave., New delivered at all or is on somebody else's budget...
...private trip could hardly succeed...
...And, next day, he paid a surprise visit to ment is achieved, he has been careful to avoid direct involveBelfast where he met privately with the leaders of the four ment in a problem which the British government regards as an main parties...
...O'Neill- nedy and Richard M. Nixon) or behind-the-scenes diplomatic along with Senator Edward M. Kennedy, Senator Daniel P. pressure on Britain...
...the rate of cost-increases to 9.7 percent voluntarily...
...O'Neill's remarks was known in of a group of Irish-American politicians who last St...
...By short of life-and-death decisions like those at Youngstown...
...O'Neill's cheek, ac- Has there been a loss of nerve among the intellectual leaders Commonweal: 326...
...Exemptions would be provided for states like Senator Kennedy keeps warning...
...In the cused him of ignorance, charged him with helping the IRA...
...This was done, obvirational than past ones, at least if it escapes submersion in the ously enough, for political reasons: to defuse the tremendous swampy question, Will Teddy, or Won't Teddy...
...James Hitchcock maintains that the British politicians' Pavlovian response to Mr...
...That is why President AT OVER six feet tall and around 250 lbs in weight, Carter's effort to put a cap on hospital costs is crucial...
...Though he While in Dublin he had a long private session with the called two years ago for a just solution in Northern Ireland and Taoiseach, Mr...
...In disturbs the public...
...important as these are, they still tend to stop ance plans like the one sponsored by Senator Russell Long...
...The public deals with hospitals (which account for twice the amount of the medical care budget going for physi- NATIONAL NERLTN cians' services) and with insurance companies...
...He tried the same thing last Ireland towards the end of April accompanied by 14 Republiyear, but he was defeated by the potent hospital lobby...
...But, as the closings to pay bills or relegated to second-rate care, while other milof the steel mills at Youngstown demonstrate, much more lions are the dubious beneficiaries of unnecessary operations, needs to be done...
...The problem therefore is essentially one of institutional arrangements, not of personal trust in a kindly GP...
...Whether George medicine in the direction of concentrated, high-technology Meany retires this year or not, organized labor in the United practice, to the neglect of preventive care, early intervention States must begin to think in larger, more ambitious terms...
...We think not, and incentives that can turn good intentions as well as selfish ones unions must play a leading part in introducing a social criterion against the best interest of those in need...
...Again...
...The costly and medically ineffective distortion of current medicine .would be backed by federal dollars...
...The new debate has just a chance of being more tered by private insurance companies...
...Moreover by starting with the catasagainst inflation, and it is true that the rate of increase in trophic coverage element, popular among all income groups as hospital costs has slowed from 16 percent in 1976 to approxiwell as with the lobbies, the administration is a little like a cook mately 13 percent in 1978...
...In anwer to that, economist Rashi Fein cites the maxim, hospitals are already astronomical and because the federal "You can't cross a chasm in two steps...
...ES its nose into an intimate "doctor-patient relationship...
...Further, the hospitals have set a starting dinner with dessert: it may get everyone to the table but voluntary goal for 1979 of 11.6 percent...
...He charged Britain with bearing a heavy responsibility for the failures of recent years on the political front...
...Nonetheless, standby it probably won't lead to a balanced diet...
...should hesitate before taking a step that is "irreversi- to steel are not...
...The present spending still leaves tens of millions unable great contribution to industrial democracy...
...guaranteeing hospitals, physicians, and the developers and With more Youngstowns looming in the future, it is more marketers of medical technology the full payment of excepimperative than ever that labor and the community at large tionally high individual bills, it would only further skew have a say in such sudden-death decisions...
...Yet this is the time to remember religion essential...
...10016...
...Garret FitzGerald, expressed the general sentiment when there been a loss of a sense of continuing and vital tradition they praised Mr...
...The attempt to camouflage this as a low-key internal United Kingdom matter...
...Administratively, a controls may be essential...
...And it is not only the relentlessly time when developments such as those at Youngstown make it growing portion of our GNP devoted to medical care that obvious that American labor is facing new challenges...
...But Mr...
...potentially disastrous...
...and it is in- INSURANCE creasingly aware of the role of the pharmaceutical industry and other purveyors of advanced medical technologies in determining what kind of health care is available to whom and at L what price...
...Have Irish-American politicians on the American government to put young Catholics of the post-conciliar period grown up in a pressure on the British government to put pressure on the period when literally no one could offer them a strong and Ulster Unionists would only lead to a dead end, he said...
...Embassy spokesman in Dublin had tried to play Carey was going against the Dublin government's line which down its significance...
...by-step plan offers recurring targets for political opposition by They argue that they are already being successful in the fight the medical lobbies...
...measure is in serious trouble...
...O'Neill MEMORIES AND HOPES expressed his own desire to see Irish unity but agreed that this solution should not be imposed against the will of the people of QUESTIONS ON AMERICAN CATHOLICISM Northern Ireland or at the expense of Irish lives...
...O'Neill had just come from London where he had Mr...
...The Irish people, too, got more than a little satisfaction at lessened regard for history...
...Kennedy's point is partly New York that have their own cost-control programs...
...Does post-conciliar Catholicism have a ship...
...One point where needless confusion may enter the present hospitals fail to reach that goal, mandatory controls would then debate is on the notion of "piecemeal" reform, against which go into effect...
...Both labor's concerns and the public Perhaps this growing sophistication about cost and inceninterest must be taken into account in decisions like those taken tives will even lead the public to apply to medical care what it at Youngstown, and this will require a larger, not a smaller role already knows about household expense: that buying cheap for labor...
...If the The Irish Press, a leading daily paper which reflects gov8 June 1979: 325 ernment thinking, expressed this sentiment editorially...
...Callaghan and Mrs...
...Com- The hope in Dublin is that the new British government under monweal, Apr...
...The British had fumed at Mr...
...Are the Ameri- the public also recognizes that this outcome is due neither to can people really satisfied to let such narrow economic consid- accident nor to exceptional greed but to a system of economic erations solely decide these critical issues...
...One way or another, if there is ever to "piecemeal" in any case simply because no one measure-not be a chance for national health insurance, the time to curb even a comprehensive insurance scheme-is the answer...
...Lynch, and the Opposition leader, been a general loss of and interest in the Catholic past...
...The public knows that medical care is already an affair of large, complex, interacting institutions, with their attendant bureaucracies...
...into such judgments...
...O'Neill's speech, he called for economic sancWhatever the intention behind the O'Neill party's visit to tions against Britain if she did not withdraw physically and Ireland, it stirred things up on this side of the Atlantic...
...But the Kennedy modifications also derived from nal published by Catholic laity, seeks to fill a low-paying, President Carter's wish that health care spending be "off the part-time editor's post (1%-2 days a week...
...Patrick's advance to President Carter and represents his views...
...Over the years American unions have tended to stick may cost you more in the long-run...
...they may well prove far less A debate is beginning on national health insurance...
...Has there Cruise O'Brien, now editor-in-chief of the London Observer, been little in the way of impressive history dealing with the who dismissed them as "absolute rubbish...
...wake of President Carter's historic achievement of bringing But Mr...
...Of course sophistication about cost belief, national health insurance is not "an idea first proposed has to reach the point of recognizing that cost is cost whether it during FDR's New Deal" but dates back to the period before is paid through the governmgnt or through Blue Cross and World War I -when the American Medical Association fa- private insurers...
...The answer is two-fold: because costs in ble...
...And he called Report from Notre Dame on the post-election British government for "an early, realistic and major initiative" to get serious negotiations moving quickly towards a just and workable solution...
...That is the objection many to important but smaller issues like wages and hours, seniority economists make, for instance, to catastrophic health insurand pensions...
...hospital costs is now...
...Day issued a strong statement on Northern Ireland...
...political power of the insurance carriers by cutting them in on The first reason for this improvement is the public's ever the pie...
...It may promise greater efficiency-there is a debate increasing appreciation of the fact that the national health insurance debate has little to do with Big Bureaucracy sticking MARGU...
Vol. 106 • June 1979 • No. 11
