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

DATE: WEDNESDAY, April 5, 1995                   TAG: 9504050055
SECTION: EDITORIAL                    PAGE: A-8   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

MANAGED CARE

NEWT GINGRICH has called for a congressional investigation of managed care, and, as a news report suggested last week, the health-insurance industry is shocked. It shouldn't be.

This is the logical next step in the country's schizoid response to health-care needs.

In defeating the Clinton health-care reform plan last year, administration foes drummed up fears about patients losing the right to choose their physicians. Yet the marketplace that Clinton's critics prescribed as the panacea for lowering the fevered rise in health-care costs was, even then, pushing insurers and employers into managed-care plans. Managed-care plans tend to restrict consumers' choice of physicians.

They also restrict doctors' and hospitals' choices in delivering care.

There are market reasons for this. Increasingly sophisticated health-care options and technology have grown so expensive that insurers can no longer afford to give doctors a blank check. There has to be some balancing of costs against benefits. If the government wasn't going to provide it - and the public decided most emphatically that it was not - then it was going to have to come from "the market." Business.

Bean counters make for cold care-givers. But some brake on medical expenditures was necessary.

Is it hypocritical now for Gingrich to suggest that there might be some brake needed, too, on the bean-counters? That the big, bad government should examine the system and, if it is found wanting, suggest remedies? In light of all the anti-regulatory hyperbole he's been pumping out, yes.

That doesn't mean he's not right, though. Doctors and nurses complain increasingly that quality of care is suffering under the tender mercies of the actuaries. No doubt it is. Has it declined beyond acceptable levels? Perhaps patients can ill afford carte blanche on either side. It warrants scrutiny.

Better that Gingrich abandon political dogma if, in doing so, he can narrow the reality gap between what Americans want - excellent care for everybody - and what they are willing to pay - not one red cent more.

by CNB