Dear President Clinton

Article Abstract:

Health care reform is one of the most pressing issues facing President Clinton and the government. The complexity of the health care crisis, however, requires a major overhaul in the finance and organization of health care delivery and not some quick, superficial solution. Three changes to the current health care system are needed. First, health insurance should be separated from employment. Linking health insurance to employment leaves many uninsured and hurts both workers and employers. Second, medical technology must be controlled. Allowing technology to proliferate with no regard for reasonable costs and estimated benefits is the most significant factor behind skyrocketing health costs. Furthermore, technology so far has largely been directed toward saving one life, whatever the cost, instead of focusing on prevention for the larger population. Third, in an aging society, the health care system cannot afford to meet the almost unlimited demand for health care among the aged without considering reasonable cost.

Management, Medical economics, Medical care, Cost of, Health care costs

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Health system deregulation: some aspects of health care system reform need not be held hostage

Article Abstract:

It may be possible to reform certain parts of the US health care system without resorting to new legislation. Medicare coverage varies depending on the region of the country and the setting in which health care takes place. Standard rates would simplify matters considerably. Requiring carriers to pay claims solely on the basis of the Medicare claim form would reduce the cost of sending for medical charts. Processing claims electronically could save up to $42 billion by the year 2000. Federal health insurance forms such as those used for Medicare, Medicaid and the Federal Employee Health Benefit Plan should be standardized. A uniform certification form would eliminate the necessity of submitting multiple certification forms for each health care service provided. The Clinical Laboratory Improvement Act of 1988 should be streamlined so that its regulations are less burdensome. Antitrust laws that prevent the merger of health care delivery systems should be relaxed.

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Managed Competition That Works

Article Abstract:

Managed competition is the type of health care reform supported by President Clinton. This strategy aims to control health care costs while ensuring access to care for all. The proposal as it stands now would depend on altered tax incentives and market forces to contain costs. These measures, however, ignore the increasing demand for health services and the growing stratification according to income in access to health insurance. 'Managed Competition That Works' is a proposal to reform not only the provision of services but also the financing of the health care system. This plan would set community spending levels but would not restrain specific services, encouraging communities to be creative and efficient in distributing their resources. It would establish a single trust fund similar to Social Security, and then distribute health care vouchers, adjusted for age, sex and health status, to everyone.

Medical policy, Health policy

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