Reforming the nation’s health care system is neither the Clintons’ brainchild nor an idea of recent vintage. During his ill-fated 1912 run for the White House, Teddy Roosevelt first surfaced such a notion. During the ensuing eighty-one years, no fewer than four of Bill Clinton’s predecessors made an effort to improve the delivery of health care to Americans … only to have each effort frustrated by alliances of special interests who benefited under existing systems.
In his recent address President Clinton assured the American people his prescription would “fix” the health care mess and provide universal “security, simplicity, savings, choice, quality and responsibility”. Unfortunately, the president’s proposals have been long on rhetoric but, thus far, short on meaningful specifics.
Nevertheless, while a large majority of Americans remain happy with their current health coverage, the public, by an overwhelming majority, has embraced the gospel of health care reform.
Clearly, no one can argue with a goal ensuring all Americans have access to basic, quality medical care, regardless of employment status or medical history. Our health care system should also place a premium on preventative medicine, including routine physicals, monograms, PAP and PAS tests, and childhood immunizations. Incentives should be developed to encouraged the pharmaceutical industry to make patented prescriptions available at prices affordable to all, irrespective of individual economic means.
Finally, should health care mandates be enacted, they must ensure all Americans are treated equally … no second class citizens. Specifically, neither Congress nor any other coven of governmental bureaucrats should bestow a higher level of benefits on themselves than is provided for the population as a whole.
However, even if all of the above goals can be achieved … four fundamental questions still remain which the proponents of health care reform must be required to answer.
First, what type of vast bureaucracy must be created to administer and regulate a nationwide health care network?
If history is any measure, a cost-efficient governmental agency is an oxymoron. From the findings of the Grace Commissions to Al Gore’s report on reinventing government, America’s federal government, frequently saddled by archaic and often contradictory regulations and counterproductive contractual terms negotiated with its public employee unions remains a paragon of inefficiency.
Second, where are the monies to come from to pay for the program?
Nearly everyone, including some insiders, who have closely examined the Administration’s figures now express serious reservations. Even one of America’s newest Nobel laureates in economics predicts few, if any, of the major savings advertised by the President are apt to occur.
Again, with history as our guide, it’s difficult, if not impossible to identify a single federal program which remained within its advertised budgetary constraints.
Third, can public behavior which increasingly exposes Americans to health risks be modified, or at least curbed?
Until we stop pandering to the tobacco and gun lobbies, both indirectly placing huge requirements on our health care system, neither demands not costs are likely top be reigned in. Then, too, more effective substance abuse education programs must replace current heavy-handed, but relatively ineffective emphasis on police enforcement activities.
Finally, if all, or even major elements of a government-mandated health care program fail to live up to their advance billings, who will the American people hold accountable … and what consequences will those responsible for such failures pay?
In the past, governmental program failures have been ignored or “patched-up” with new legislation (as with cable regulations) by the same pols who created the mess. Such remedies are generally more costly and the public is left to suffer the consequences of their inability and/or incompetence.
In this all-important debate, the public must be guaranteed that whatever plan is ultimately passed it must approximate the cost effective nature being touted by its advocates. It should also contain provisions for a return, in whole or in part, to something resembling our existing system if it falls substantially short of its promised goals.
It’s time our elected representatives put their jobs on the line. Health care is too important an issue to every American to simply give politicians and bureaucrats a blank check. Public office should not provide a safe haven from incompetence or inability.
