Editorial

...Better that we not let the seriously inadequate become the measure of true reform...

...They have watered down universal coverage, postponed and diluted employer mandates, and given up on real cost-controlling mechanisms Remember managed care7 and its promise of 3 controlling the costs of physician care and hospital treatment...

...Gone Caps on "pain and suffering" awards in malpractice...

...Editor's note we have previously urged the exclusion of abortion from a basic health insurance package (July 16,1993),both the House and Senate bills include such coverage, another drawback to both...

...Gone...

...The House bill prohibits managed-care facilities from limiting the number of doctors available to patients in these plans...

...among the consequences have been a turn to part-time workers, a reluctance to rehire laidoff workers when the economy improves, and ultimately, for some companies, the search abroad for a cheaper labor force As medical care became more expensive, small towns and inner cities saw hospitals close and doctors move to more lucrative areas...

...In defending the Senate bill, Mr Mitchell urged that we "not let the perfect become the enemy of the very good...

...they buy what is given them The failure to create artifical market mechanisms, like health-care alliances, or to go to a single-payer system where the government sets pnces, means the current system will continue unconstrained Ultimately this means businesses and individuals who can now afford insurance premiums will be driven out of the system, making medical-care paupers of more and more Americans Furthermore, allocating more of the nation's resources to health care takes dollars away from housing, education, job training—indeed, from the kind of spending that will create jobs...

...In the face of price increases far exceeding the cost-of-living, doctors, hospitals, pharmaceutical companies, and manufacturers of medical devices professed themselves powerless to contain prices Costs, they said, were driven upward by patient demand, malpractice suits, research, and competition itself After all, why should hospitals share MRI scanners when insurance companies would help pay for them through premium increases'' Key features of President Clinton's original proposal, full universal coverage and employer mandates, were tied to strict cost-controlling mechanisms As a package these would have moved the country toward a more equitable system and done something to curb the costs that were creating inequities Fourteen percent of the gross domestic product now goes to health care, a far higher percentage than any other nation, yet our system not only forces people to lose their medical coverage but is forcing jobs out of the American economy...

...Restrictions on lifetime insurance reimbursement—a current cost-controlling mechanisms of insurance companies7 Gone...

...As well the Senate bill includes payment for politically popular prescription drugs and long-term care, but imposes no caps And so on and so on and so on...

...Congress is about to vote the minimum of reform, while backing off on the cost-controlling measures that made reform necessary in the first place The foxes are buying the chicken coops and Congress is selling them for $26 million in campaign contributions The claims of Gephardt and Mitchell that costs will be controlled by the threat of future government regulation and market mechanisms is a political delusion There are few market mechanisms in health care because there is little "customer" choice...

...Remember regional health alliances...

...and their promise of forcing competition among providers...

...Runaway costs are responsible for many of the inequities of the current system For over twenty years ever-escalating costs have increasingly limited access to medical care by pricing out the working poor, the unemployed, and those with pre-existing conditions...

...That was President Bill Clinton's battle-hardened assessment of health-care reform as he appealed for congressional action dunng his August 3 press conference But what began as a major campaign promise in 1992 now looks like a fiasco built of a thousand compromises, the bills being considered by House and Senate have lost many of the most important original reform measures...

...Heart attack victims do not take bids for an ambulance service, an intensive-care unit, a cardiac specialist...

...Even so, Mr...

...The bills introduced in the House by Richard Gephardt (D-Mo) and in the Senate by George Mitchell (D-Maine) do little to redress the dilemma...

...Clinton declared the provisions of these bills changes for the better over his own original proposal, he even seemed ready to settle for the half-measures of the Senate bill Getting health-care reform that settles for less than he wanted may seem like a sensible political compromise to the president in an election year, but the American people need to be sure that the final legislation doesn't leave us worse off than we were two—or twenty—years ago Why does the health-care system need reform...

...In the 1970s and '80s as insurance premiums moved steadily upward, companies, large and small, found health benefits consuming ever larger portions of their labor dollars...