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- THE WEEK, Page 22SOCIETYDoctors' Cure
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- A new health-care proposal from an influential physicians' group
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- Few people dispute that a way must be found to provide
- medical coverage for the more than 35 million Americans who have
- no insurance, and fewer still that the U.S. desperately needs at
- the same time to control the runaway growth of health-care
- costs (1991 total: $700 billion). The American College of
- Physicians has waded into this widening crisis with a dramatic
- plan for accomplishing those inherently contradictory goals. The
- society of 78,000 doctors has concluded that the only way to fix
- the U.S. health-care system is to set a budget and stick to it.
- Most surprising, the organization concedes that doctors' fees
- should be regulated. Says Dr. John Ball, executive vice
- president of the group: "We doctors are willing to make the
- first move."
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- The plan is a "pay or play" system that would replace
- Medicare and Medicaid while ensuring universal coverage as well.
- Employers would either cover their workers or pay a fee to a
- taxpayer-supported government system. This government plan would
- also cover the unemployed, people older than 60 and Americans
- with high-cost illnesses, under a so-called global budget, with
- total annual spending to be set by Congress. While the proposed
- system resembles the Canadian plan, it would not prevent people
- from choosing their own doctors.
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- The plan stirred immediate debate. The Clinton campaign,
- which has offered its own pay-or-play system, applauded the
- proposal. The Bush Administration, which opposes fee regulation,
- attacked it. By far the sharpest criticism, though, came from
- the 271,000-member American Medical Association, which says the
- program would inevitably lead to medical rationing. Said Dr.
- James Todd, executive vice president of the A.M.A.: "Pay-or-play
- and global budgets are contrary to the American way." Perhaps,
- but then, so is a system that currently forces millions of
- American workers and their children to go without medical
- coverage -- a form of rationing in itself.
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