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-
- THE U.S. - DOES THE PRESCRIPTION NEED CHANGING?
-
- By NORMA GREENAWAY
- Southam News
-
- WASHINGTON - In a city where conferences and seminars are a dime a
- dozen, it's often tough to attract a crowd.
-
- Not so recently. Dozens of government, business, labor and health
- care representatives packed a small Capitol Hill townhouse for a
- policy forum titled, Canada's health care system: Hazardous to your
- health?
-
- See <03health> for a history of Canada's health care
- See also <28health>
-
- They heard about a shortage of organ transplant facilities north of
- the border, the long waiting lists for open-heart surgery, and
- about a two-year-old Windsor boy who died four hours before he was
- finally slated for cardiac surgery in Toronto.
-
- ``I don't know why the hell you'd want our health care system,''
- declared Michael Billet, head of Heartbeat Windsor, a private group
- that helps Canadians obtain needed surgery in the United States.
-
- In the next breath, however, he added: ``I wouldn't want your
- health care system, either.''
-
- Surveys indicate most Americans agree there is something wrong with
- their system. The upshot is a growing clamor for changes to their
- patchwork quilt of health-care programs, a mix of expensive private
- insurance and government plans for the poor, disabled and elderly
- known as Medicaid and Medicare.
-
- Two issues are driving the reform efforts. The first is
- skyrocketing costs which have pushed up premium payments for
- businesses and individuals by as much as 100 per cent in the past
- few years. The second is that 34 million Americans, almost 15 per
- cent of the population, have no health insurance, according to the
- latest federal statistics. Some 50 million are considered
- underinsured.
-
- Critics say it is unforgivable so many Americans lack basic
- coverage in a country that spent about $670 billion, or almost 12
- per cent of its Gross National Product, on health care last year.
- By contrast, health care spending in Canada accounted for about
- nine per cent of GNP last year.
-
- While there is broad agreement the U.S. health system is sick,
- there is no consensus on a cure. Indeed, one of the only subjects
- of agreement between opponents and proponents of major reform is
- that a government-run health care plan like Canada's probably won't
- fly in the United States.
-
- ``I personally like the Canadian model,'' said Ron Pollack of
- Families USA, a private lobby group for elderly Americans. ``But I
- have serious doubts as to whether we'd ever adopt it.''
-
- A Canadian-style national health care program is seen in many
- political, business and health circles as too expensive and too
- disruptive to implement here. Opponents, such as the American
- Medical Association, argue Americans have less faith in their
- government's ability to deliver services than Canadians do.
-
- They also say a national program would wind up reducing money
- available for specialists, thereby eroding the advances the United
- States has made in treatments and medical science.
-
- Analysts expect more modest reforms aimed at achieving universal
- coverage through a continued mix of private and public programs.
- The role of government would be bigger than it is now, but it
- wouldn't take over the system.
-
- A national bipartisan commission, popularly known as the Pepper
- Commission, recommended last year a $350-billion, five-year federal
- plan designed to guarantee universal access to health care for the
- working poor through either public or private insurance. The money
- would also be used to improve medical coverage for the elderly.
-
- For the most part, though, business would be required to either
- provide private health insurance or contribute to a new public
- plan.
-
- Several proposals are floating around in the U.S. Congress, and
- some 30 states are looking at plans for broadening health insurance
- coverage. Also, dozens of labor, business and citizens groups have
- formed lobbies to press elected state and federal politicians to
- get behind the reform efforts.
-
- Both the Republicans and Democrats have task forces on health care,
- and Senate Majority Leader George Mitchell has promised to
- introduce legislation soon that will provide universal coverage.
- Mitchell's legislation, still being written, would apparently be
- along the lines of what the Pepper Commission recommended.
-
- Optimism that all the talk might translate into action stems from
- growing evidence the issue has caught the attention of middle-class
- Americans.
-
- ``This issue is no longer an issue for the poor,'' said Pollack of
- Families USA. ``Now it's a big issue for business, a big issue for
- labor, a big issue for seniors who can't pay for long-term care and
- for families with children.''
-
- Steffie Woolhandler of the Physicians for a National Health Care
- Program said no legislative action is expected this year. She and
- others say their main goal now is to make health care reform a
- major issue in the 1992 presidential and congressional elections.
-
- ``The good news is that if there is enough public interest and
- pressure, the Congress is going to have to act,'' she said in an
- interview. ``The bad news is that they're going to have to be
- pushed.''
-
- The push is increasingly coming from constituents feeling real
- hardship, Woolhandler said. More and more elderly people are being
- wiped out financially with health bills, and increasing numbers of
- Americans suffering from such diseases as diabetes, cancer and AIDS
- either can't get anyone to insure them, or are being forced to pay
- exorbitant premiums, she said.
-
- A fresh Gallup poll of chief executives of the country's largest
- companies found that 91 per cent of those interviewed favored
- reform, although 66 per cent opposed a universal, government-run
- health care system. Most favored unspecified adjustments to the
- current employer-based insurance structure.
-
- Business complains it is being overwhelmed by rising health care
- costs that are forcing companies to stop providing coverage or to
- shift more of the costs to employees.
-
- The shifting of costs to workers has sped organized labor into the
- camp promoting national health insurance legislation. In February,
- the AFL-CIO's executive council effectively endorsed the idea of
- forcing employers to either provide medical coverage for their
- workers or pay a tax into a government insurance program.
-
- ``Everybody agrees the time is ripe for serious reform,'' Ray
- Abernathy, a spokesman for the Service Employees International
- Union, said in an interview. ``But it's all very mushy right now
- because there are 1,001 ideas out there but no consensus.''
-
- Bill Custer of the Employee Benefits Research Institute here
- agreed. ``There's a lot of smoke, but how much fire is there
- remains to be seen.''
-