Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, January 27, 1994 TAG: 9402110009
SECTION: EDITORIAL PAGE: A11 EDITION: METRO
SOURCE: DONNA E. SHALALA
DATELINE: LENGTH: Long
Let's not pull any punches: This argument is bogus. It's destined to fail because millions of Americans are experiencing a health-care crisis and they know it. And, frankly, deep down in their hearts, those who deny that there is a problem know it too.
As Congress prepares to begin discussing the details of the president's Health Security Act, let's look at what has brought us to this debate:
A health-care system in which 2 million Americans are losing their health insurance every month - some for short periods and some for long periods of time.
A health-care system that consumes nearly 15 percent of our gross domestic product, while only one other country (Canada) is above 10 percent. Such spending taxes the budgets of American families, businesses and government, and hobbles our international competitiveness.
A health-care system in which the rules are so skewed that insurance evaporates just when people need it most. Even the best-insured Americans cannot be secure in their health-care coverage.
A health-care system in which the employees of small businesses are charged an average of 35 percent more for the same coverage than those who work for medium-size and large companies.
A health-care system in which there is no accountability for quality or cost, leading to millions of dollars in waste and fraud.
As a result of these flaws, the American public has been demanding comprehensive reform of the health-care system. When public opinion experts recently asked Americans to name the single thing Congress could do to improve their lives, health-care reform was the No.1 answer.
Yet, the status quo crowd says we can simply make a few changes around the edges and call that health-care reform. When I hear that, I'm reminded of something Gov. Ann Richards of Texas said: ``You can put lipstick on a pig, give her a purse and call her Monique, but she's still a pig.'' For health-care reform to be genuine, it must address the underlying problems with our system - namely, a lack of security for families and businesses, and costs that continue to rise at two or three times the rate of inflation.
In the past year I have visited more than three dozen communities across the country to discuss health care. People from all walks of life have poured out their hearts and shared very personal stories about the unfortunate and often maddening failures of the health-care system - how it failed them in their time of need. There were stories of families that can't get insurance because a child was born with a chronic medical condition, stories of wives being advised to divorce their husbands to get affordable insurance. There were stories of business owners being told they'd have to cut off one worker from their insurance policy to retain coverage for the rest. These are not imaginary problems; these are signs of a system that isn't working.
In September the president addressed Congress and the nation about health-care reform. Since then, the case for comprehensive change has grown stronger, not weaker.
In December the Employee Benefit Research Institute, an independent, private, nonprofit organization, reported that 2.2 million Americans lost their health insurance for a substantial part of 1992. Since 1991, 3.1 million Americans have been cut off the insurance rolls, many of them for good. Most of the people who lost their insurance worked full-time, usually for small companies that could no longer afford to buy coverage for their workers. And more children lost their insurance in 1992 than at any time since the mid-1980s, when Congress began expanding Medicaid coverage of those under age 19.
This month the U.S. Chamber of Commerce reported that employers' spending on health-care benefits for their workers skyrocketed 220 percent from 1980 to 1992. Later in the month, the U.S. Department of Commerce reported that U.S. health-care spending is expected to jump 12.5 percent in 1994. We are spending more and more on health care but getting less and less for our money.
These are not the symptoms of a system suffering from temporary difficulties. They are the manifestation of a system that is broken and needs to be fixed.
There has been a great deal of discussion about the recent report by the Department of Labor showing that health-care inflation in 1993 slowed to 5.4 percent. Let's remember, however, that medical prices still rose twice as fast as all other consumer prices, continuing a pattern stretching back to World War II. And it is very likely that this slowdown is a temporary reaction to the debate over health reform in Washington. We need only look back at previous national debates over health reform. In 1973, after President Nixon imposed wage-and-price controls and proposed a health-reform plan similar to President Clinton's, the inflation-adjusted growth in national health spending dropped from 9 percent in 1972 to 3 percent in 1973 and 2 percent in 1974. When those controls were lifted and the Nixon reform plan was defeated, health spending grew 5 percent in 1975 and was back to an 8 percent growth rate in 1976. In 1979, while Congress considered President Carter's health-reform plan, the inflation-adjusted rise in U.S. health spending slowed from 5 percent in 1978 to 1 percent in 1979 and again in 1980. Once the Carter bill was defeated, however, health-care spending growth was back up by 5 percent in 1981, 6 percent in 1982 and 7 percent in 1983. Not only were we back where we started, we were worse off.
The Health Security Act enhances the private market's ability to permanently curb its own cost growth. If the current trend proves to be true, it will make our job easier: to ensure that all Americans have a comprehensive set of benefits that cannot be taken away.
We can argue about which is the best approach to resolving the problems that plague our health-care system and the American people. We can debate long and hard how to shape a new system and how to finance it. But we shouldn't waste another breath on the question of what we call this situation. Let's face facts and work together to provide the American people with a solution.
\ Donna E. Shalala is secretary of health and human services.
\ The Washington Post
by CNB