The Virginian-Pilot
                             THE VIRGINIAN-PILOT 
              Copyright (c) 1996, Landmark Communications, Inc.

DATE: Saturday, April 20, 1996               TAG: 9604200002
SECTION: FRONT                    PAGE: A13  EDITION: FINAL 
TYPE: Editorial 
SOURCE: Patrick Lackey
                                             LENGTH: Medium:   80 lines

A SURE-FIRE WAY TO CUT HEALTH-CARE COSTS

Complete the following sentence with one word: ``Health-care costs are out of. . . .''

Congratulations for choosing one of three possible correct answers: control, sight or whack. Health-care costs are as sure to rise as a helium balloon in an updraft.

What to do?

One solution is simple and effective, but requires spending up front.

We need to pay every pre-med student $48,000 a year, minimum, with free tuition. Pre-med students have it tough. They can't enroll in History of Basketball 101. They must take courses like Organic Chemistry and Calculus Made Difficult. And if they're to gain acceptance into med school, they have to get all A's, unless their fathers are doctors.

Pre-med students may gaze longingly out laboratory windows at carefree fine-arts students entwined on the lawn. But the doctors-to-be know they have to stifle their envy and concentrate on test tubes and flasks.

Yes, pre-med students would earn every dime of that $48,000. While studying hard, they could live fairly well. If they found time for a weekly movie, they'd have money for a ticket and popcorn.

After undergraduate school come four grueling years of medical school. Again, we need to pay each student $48,000 a year, with free tuition.

How is my plan saving money? Please read on.

Under our present system, the medical students run up back-breaking debts while falling behind on the rent. They kill themselves to acquire the necessary knowledge to save our lives. And what is their reward? They're paupers haunted by debts. They naturally feel sorry for themselves. They wish for more.

The least we can do is pay them $48,000 a year during medical school. Many have families by now or want to have families. They should not be treated as a form of sub-citizen.

Finally, the students graduate, and their reward is a residency of three years or more, with hours so long the modest salaries hardly equal minimum wage. Again, they should be paid $48,000 a year. The residency should be less concentrated, perhaps extended from three years to four, so each resident has ample time for sleep and recreation and a family life.

As things work now, the residents are worked around the clock. Their bills mount. Their old cars break down. Life seems barely bearable. The residents wonder if a farmer's mules had it better. (Probably so.) The residents dream of the day they finally get what they deserve for their sacrifices and suffering.

A hospital patient is treated by a sleep-deprived resident distracted by debt and given to daydreaming about the Lexus he'll buy once he's a real doctor making real dough.

No, we must pay these people $48,000 a year and treat them like human beings.

Finally the residencies are completed and the young doctors go out into the world.

We should pay them $48,000 a year for their entire medical careers, with adjustments for inflation.

At first they'll scream and holler, of course. They'll protest that doctors deserve far, far more. They'll note that doctors in some specialties are accustomed to earning small fortunes, certainly six digits a year - and the first digit isn't a one. They'll hold out soft hands and mumble about healing.

We might say, ``OK, you crybabies, we'll pay you $60,000 a year, tops. That's a lot. If you can't live on that, you're an idiot and shouldn't practice medicine anyway.''

When they insist that's not enough, we'll say, ``But look how easy you had it in school.''

Then we'll slap our thighs and guffaw obnoxiously.

Oddly enough, as insurance companies turn more doctors into hired hands like most of the rest of us, my doctor-payment plan, originally intended as a joke, may start to strike doctors as reasonable or even desirable. MEMO: Mr. Lackey is an editorial writer for The Virginian-Pilot.

by CNB