Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, February 11, 1992 TAG: 9202110384
SECTION: EDITORIAL PAGE: A6 EDITION: METRO
SOURCE:
DATELINE: LENGTH: Medium
BUSH'S RX NO CURE FOR HEALTH CARE
WITH HIS health-care proposals, President Bush is saying to Americans: Take two aspirin and call me next year. He hopes that because he's finally acknowledged a problem that has festered for more than 20 years, voters in November will assume he's serious about it.He's not. George Bush much prefers the status quo to the kind of bold reforms the health-care system demands. His "plan" tinkers at the edges without posing substantial change. The changes he does offer are fuzzy and ill-thought, pale palliatives for the dual diseases of escalating costs and shrinking availability of care.
The centerpiece of the president's plan is a combination of tax credits, vouchers and deductions intended to open the system to some 34 million Americans now excluded. On its face, it would not do nearly enough.
A tax credit of $1,250 per person for a middle-income family would free up only a few hundred dollars a year for insurance. Most of this could soon be eaten up by the steady increase in overall health-care costs that already have made insurance unaffordable for millions.
For a family of four at the poverty level, vouchers would allow them to invest as much as $3,600 a year in health insurance. This at a time when group policies - which have the advantage of cost-sharing - cost about $4,000 per person.
Without strict controls, the voucher plan would open the door for all manner of scams, with mail-order companies using high-flown promises to sell policies to the unwary. Few among us are sophisticated enough to make good decisions on health-care coverage; the lucky are grateful they have employers to do it for them, with the knowledge and bargaining power this requires.
Tax incentives for small businesses, to give them the kind of leverage larger companies enjoy, look useful. But this, too, could be vitiated if there is no accompanying nationwide effort to hold down health-care costs.
The absence of serious cost-containment measures is the greatest failing of the White House plan. The president proposes vaguely to wring waste out of the system and to restrain Medicare and Medicaid payments. The latter puts the decision-making burden back on the states and could result in limiting care for the poor. Before cost curbs, Medicare and Medicaid need overhauling to determine whether they're using their resources to do the greatest good for the greatest number.
It may be easier to pick holes in the president's proposals simply because the flaws are rather obvious. The alternatives - and there are several - have their problems too. There will be no perfect solution, and whatever is chosen will be painful. The people need to know that a couple of aspirin won't alleviate that. The political doctors should tell it straight.