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<text id=94TT0164>
<title>
Feb. 14, 1994: What You're Not Being Told
</title>
<history>
TIME--The Weekly Newsmagazine--1994
Feb. 14, 1994 Are Men Really That Bad?
</history>
<article>
<source>Time Magazine</source>
<hdr>
HEALTH CARE, Page 22
What You're Not Being Told
</hdr>
<body>
<p>By Janice Castro
</p>
<p> Lawmakers may be fighting over the best way to achieve health
reform, but there is also plenty of argument over just what
it is that President Clinton has proposed. Anyone who reads
his 5-lb., 1,342-page Health Security Act may be surprised to
see what's in it:
</p>
<p>-- Choosing your doctor: The White House says that Americans
will have more choice in health care.
</p>
<p> That's not entirely true. For starters, no one will be able
to choose not to buy health insurance--which means that millions
of young Americans will lose their ability to postpone buying
insurance until they feel they need it. More important, while
the bill says that patients should have the option of paying
extra to choose their doctors, it also gives states the right
to eliminate such choices; states could offer residents a single
health plan and a limited list of the doctors they may see.
For that and other reasons, millions of Americans could find
that they could no longer see their physicians under their new
insurance plan.
</p>
<p>-- Feeding the bureaucrats: The President insists that his plan
will be a private insurance system with less government bureaucracy
than exists today.
</p>
<p> Actually, the Clinton plan calls for a vast, multilevel new
federal and state bureaucracy with enormous power to regulate
all areas of medicine. The Federal Government will decide, for
example, which benefits can be offered, which new technologies
and procedures will be made available to Americans, and how
many medical students can pursue each specialty. The majority
of students will be funneled into primary care; the limited
training slots for cardiologists, neurosurgeons and the like
will be awarded in part according to racial quotas, based on
how "underrepresented" each ethnic group is in a particular
field.
</p>
<p>-- Rationing: The plan promises "health care that is always
there," but there may not be enough to go around.
</p>
<p> Doctors and hospitals say the rigid insurance caps would not
leave them enough money to give patients what they need. Moreover,
the plan cuts Medicare spending even as the Medicare population
is growing. The only way to make ends meet will by to cut back
on medical services. The danger is that patients may be denied
critical help.
</p>
<p>-- Fixing prices: The White House Press Office stated last week
that "there are no price controls in the President's plan."
</p>
<p> In fact, the plan is riddled with price controls. The government
would be able to decide how much the alliances could spend on
health care through a system of tight controls on insurance
premiums. The government would also set prices for new drugs.
Alliances would have the power to slash doctor and hospital
fees in order to meet the rigid new budget limits.
</p>
<p>-- Who will pay? The White House insists that its plan will
require no "broad new taxes."
</p>
<p> Since the Clinton plan will for the first time require employers
to pay most of the cost of health benefits for their workers
and will define which benefits must be made available, it is
difficult to call the resulting payroll costs anything but a
new tax. In addition, large companies that choose to operate
their own health alliances for their employees will have to
pay an extra payroll tax of 1% to support the benefits of other
people who are enrolled in the local public alliances. Urban
residents will be subsidizing the inner-city poor, the unemployed,
the elderly, the disabled and others through more expensive
new private insurance premiums. Finally, many economists agree
with Senator Daniel Patrick Moynihan, the chairman of the Senate
Finance Committee, who says the Clinton system might run out
of money; in that case, Congress would have to come to the rescue
by raising taxes.
</p>
<p>-- Preserving jobs: The Administration says that the Clinton
plan will create jobs.
</p>
<p> Yet the plan gives companies every reason to fire workers: estimates
run as high as 2 million jobs lost. Small companies say they
will not be able to survive without layoffs. And because the
Federal Government (translation: taxpayers) would pay part of
the cost of benefits for part-time workers, employers say they
would replace full-timers with part-timers, and part-timers
with temps. After all, under the Clinton plan, the companies
are not responsible for providing benefits to temps.
</p>
<p>-- Universal coverage: President Clinton insists that his nonnegotiable
bottom line is universal coverage and that his plan will achieve
it.
</p>
<p> It won't. Trouble is, in order to reach universal coverage,
everyone must buy insurance under the plan. Many of the uninsured
have no job; some have never had a job. A requirement that employers
provide benefits will not reach those people. The Federal Government
can require people to buy insurance, but no one knows how it
can actually make many of them do it.
</p>
</body>
</article>
</text>