Doing nothing is no longer an option - health care reform - Editorial

Nation's Business, Nov, 1993

What if Congress decides that health-care reform is too complex, too controversial, too risky politically--and defers action?

The answer is in the accompanying chart. Health-care costs will continue to soar, intensifying all of the problems the nation now faces. Many businesses will be hard-pressed to continue coverage of their workers. The ranks of the uninsured will swell. The problem of cost shifting, in which medical providers charge the insured more to cover costs of the uninsured, will become even greater.

A do-nothing response to the present health-care crisis is clearly not an option, and President Clinton deserves recognition for moving the health-care issue to the top of the national policy agenda. That does not mean, however, that his proposals deserve unquestioning approval. While some of its components would deal effectively with major problems of the present system, others could only make them worse.

And the Clinton plan is not by any means the only one pending. A Senate Republican group has a plan. Reps. Jim Cooper, D-Tenn., and Fred Grandy, R-Iowa, have offered a compromise that is receiving much serious attention. Suggestions have also been advanced by other members of Congress and private groups.

Universal coverage through shared responsibility among government, employers, and employees should be part of a compromise plan. The president's proposals include this approach. His other positives include subsidies to help small businesses and low-wage workers afford health insurance, portability, guarantees against cancellation, administrative streamlining, and a 100 percent cost deduction for the self-employed.

Cause for concern, however, are his recommendations under which employers would be required to pay a disproportionate share of employees' insurance, and his proposals for a huge new bureaucracy and for government-mandated caps, rather than market forces, to hold down premiums. In addition, the president's estimates of savings and revenues could prove very unrealistic.

Because of those and other drawbacks in the president's proposals, Congress should construct a reform plan from the best aspects of all of those recommended, not just focus on his.

The lawmakers are, after all, crafting what could well be the most far-reaching social program in the nation's history.