The Clinton Health Plan


The health care situation in the United States is in dire need of a
change. The United States spends more money on health care per individual
than any other nation in the world (14%of its GNP in 1991), and that amount
is quickly rising. Virtually everyone, from doctors to politicians,
recognize the unwieldy situation of health care in America, and realize
that something must be done.

In order to attempt to correct the failures of the current health care
situation, one must understand the problems that led to the deterioration
of the health care system. Perhaps the main problem with health care today
is that there are 37 million Americans without insurance, and another 20
million are underinsured

Another large problem with the way health care is presently organized
is - as Clinton helpfully points out - waste. Some common examples are:

Paperwork: There are thousands of insurance companies in the US, and
each one has many forms for doctors and patients to fill out. So much so,
that doctors spend more time improving their handwriting than healing
people.

Greed and Profiteering: Some drug companies make over 10,000% profit on
the drugs they manufacture. In 1991, the median income of doctors was
$139,000 for general practitioners and $512,000 for specialists.

Unneeded Surgery and Tests: Possibly 15 to 35% of certain types of
operations and tests are unneeded. Malpractice Suits and "Defensive"
Medicine: Doctors pay high premiums on malpractice insurance which causes
them to charge more. The reason that these premiums are so high is because
currently there are practically no limits to an amount that can be sued for
pain and damages. Defensive medicine - procedures done to protect doctors
from being sued - is costing this country greatly.

Recognizing that waste is one of the greatest causes of the high prices
in health care, Clinton has introduced a plan to revise the health care
system by eliminating waste, and making sure that every single American can
be covered by a health plan.

Clinton\'s plan is based on three premises. First, that there is enough
waste in the current health care system to cover the costs of his new plan.
Second, that his plan will create competition within the insurance
industry. Last, that his plan can put a cap on insurance prices.

The core of Clinton\'s plan is to set up regional health alliances,
which would buy insurance on behalf of thousands of consumers. A
seven-member National Health Board will be set up to scrutinize the health
alliances. The health alliances would be limited by the National Health
Board by having price caps on the premiums, and by assuring that the health
alliances will accept all applicants including those that are high-risk.
Each health alliance will have three or four different options (HMO, fee
for service, and combination plans) which the consumers could choose from.

In the case of the employed, the insurance would be paid 80% by the
employers and 20% by the employees. In the case of self- employed and
non-employed, they would have to pay the full cost of the premiums by
themselves, unless they qualify for government subsidies.

The Clinton plan also will limit what types of operations are covered,
and it puts restrictions on how long a person can stay in a hospital,
nursing home, or rehabilitation center. It would also regulate the wages
of specialists, and the prices of drugs.

Overall, what Clinton\'s health care plan will do is put caps on
insurance premiums thereby causing competition between insurers. It will
also greatly reduce the waste by: reducing the paperwork enormously by
having fewer insurance companies; removing unnecessary procedures by
putting limits on the insurance. It will also decrease greed and
profiteering by putting limits on doctor\'s salaries and on drug prices.

The Clinton health care plan is not without its faults. One of the
major problems is that it assumes that there is a tremendous amount of
waste in the current system, but many people say that that is an over
assumption. Another problem is that managed competition, (an attempt to
create competition in the health-care market) might not work in the health
care industry because everything is covered in premiums, and there is a
third indirect party (insurance company), which does all the "buying and
selling" of health services.

Another problem, which is not a problem with the plan itself rather
with getting it passed, is that there are many groups opposed to the
Clinton plan.

Many politicians do not like Clinton\'s plan because they feel that it
is too hard on small businesses, forcing