
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: MONDAY, August 15, 1994                   TAG: 9408150014
SECTION: EDITORIAL                    PAGE: A5   EDITION: METRO 
SOURCE: CARLA A. WAKEFIELD
DATELINE:                                 LENGTH: Medium

DEBATING REFORM

AS THE DEBATE over health-care reform rages in our nation's capital, I have watched with curiosity and concern as various plans and their details have been released.

A common thread among the major plans involves certain mandates. As both a consumer of health care and a health-care professional, I have been exposed to the complexities and confusion that government mandates and regulations within the Medicare and Medicaid programs have caused, and to a lesser degree, changes in my own personal health-care plan.

I fear that much of what is being debated will plague the delivery of health care with a disease from which it will be difficult to recover.

A massive overhaul is being called for in Washington, when 80 percent or more of us are completely satisfied with the coverage we have. We have begun to see a decrease in the rise of health-care spending, not with any government intervention, but through ideas implemented in the private sector.

I do not deny that there are people with no or inadequate coverage. There are insurance companies that feel they can follow the rules with scant compassion for the sick people who are dropped because they are too expensive. There are physicians and other professionals who are paying an overwhelming amount of money in malpractice fees to protect them from a public that expects perfection from what will always be more an art than science. We need these areas reformed, no doubt.

But perhaps we need to reform ourselves.

We are a society that will gripe about the cost of medicines, but we pay $110 for a pair of shoes. We have never thought of "comparison shopping" when it comes to matters of health care - and I don't mean just getting the cheapest price, for I am afraid that ultimately we will get only the cheapest.

I have always been willing to pay a little more for quality, and I have always been able to use my own discretion for this. In medicine and health care, quality has many measures. Quality is the one word seldom heard in the debate over health care.

We need to encourage further debate on this matter now. Our representatives in Washington have been hashing out this issue for months. Little has been agreed upon, but a few good bills exist that lay their foundation on those areas where there is consensus.

However, we cannot allow these men and women to rush to pass a bill that we may find, like some medicines we take, hard to swallow later.

Carla A. Wakefield is an occupational therapist at Lewis-Gale Hospital in Salem.

by CNB