Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, August 24, 1994 TAG: 9408240016
SECTION: EDITORIAL PAGE: A-11 EDITION: METRO
SOURCE: Cal Thomas
DATELINE: LENGTH: Medium
That question should be followed by these: Has Medicare produced the results its supporters claimed it would, and will government-mandated ``universal health care'' do likewise?
It should be noted that the bills under consideration in Congress have been written by staff people who, The New York Times reports, ``have years of experience analyzing how to regulate health costs, how to pay doctors and hospitals, how to provide more care to more people.'' But they have no experience in delivering real medicine to real patients.
Edward R. Annis, M.D., does. He's a past president of the American Medical Association and has debated the proper roles between government and medicine for more than 30 years.
In his important book, ``Code Blue: Health Care Crisis,'' Dr. Annis lays out the philosophy and failings of government-managed medicine and blames government for rising costs.
``Under Medicare,'' he writes, ``our system is subject to the perverse incentives of arbitrary price-fixing, utilization review, concurrent review, retrospective review and retroactive denial of payment - making health care the most heavily regulated industry in the history of our nation. Government decides whether or not a patient will be admitted to a hospital, whether or not surgery will be performed, whether or not an assistant will be used in surgery, when a patient will be discharged, and what and how often procedures and diagnostic studies will be performed - all without ever examining the patient. Imagine the bureaucratic enormity of annually monitoring 22 million admissions and discharges at 7,000 hospitals with 467 diagnostic-related groups plus 350 million charges from half a million doctors with 7,000 different encoded procedures.''
The primary cause of high medical costs, argues Dr. Annis, is government regulation, which now accounts for 26 percent of the price of visiting a doctor or hospital. Malpractice insurance adds significantly to the bill. Up to 95 percent of the cost of a child's vaccine can go to legal liability expenses, he says.
Those backing the House or Senate bills argue they will be able to control costs (even though President Clinton has repeatedly promised that health care ``reform'' would reduce costs).
Since Medicare was born 30 years ago, the cost of health care has been driven up. In 1965, when Congress passed Medicare, medical inflation rose just 2.1 percent. But after just one year, medical inflation had shot up to 6.5 percent.
What about the poor and others unable to afford health insurance? Before Medicare, the typical physician, writes Dr. Annis, spent one-fifth of his or her working time caring for the poor; today the typical primary-care physician spends one-fifth of his or her time on regulatory paperwork; the average patient visit necessitates the execution of 10 document pages. In hospitals, typical patient charts now run to hundreds of pages, when they used to take only two or three, all because of government regulation, bureaucratic second-guessing and the threat of huge lawsuits.
Administrative costs are now rising at more than twice the rate of health care in general, making it the fastest-growing component of health-care costs. Look for things to get worse under ``universal health care'' unless the bureaucrats reduce the quality of services available.
Medicare, which pays the bills of even those who can afford their own treatment, has been in crisis almost since the beginning. Four years after implementation, workers were socked with their first quick-fix tax increase. Congress had promised that Medicare Part A would cost $3.1 billion in 1970, but the real cost was $5.8 billion. In the 1960s, the public was told Medicare would cost no more than $9 billion by 1990. The actual cost was $95 billion.
There are ways to fix what is wrong without bigger and costlier government doing damage to the health-care system. The record shows that government can't fix poverty, crime or mail delivery; why should we expect it to fix medicine?
In fact, the administration and Congress are breaking the law by further tinkering with health care. Section 1801 of the law creating Medicare says, ``Nothing in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine, or the manner in which medical services are provided, or over the selection, tenure or compensation of any ... person providing health care services.... ''
If socialized medicine means the effective takeover and operation by government of American health care, then the process begun by Medicare and Medicaid is about to be completed under ``universal health care.'' If enacted, this country's health will decline as government determines who gets care and who doesn't, who lives and who dies.
Los Angeles Times Syndicate
by CNB