Mr. Clinton's crisis - Bill Clinton's misleading arguments for reforms to end the alleged health care crisis in the US - Editorial

National Review, Feb 21, 1994

"I KNOW there are people here who say there's no health-care crisis," said President Clinton in his State of the Union address. "Tell it to Richard and Judy Anderson." Richard Anderson, Mr. Clinton related, lost job and insurance, his wife had a cerebral aneurysm, bills piled up to $120,000, and the Andersons were forced into bankruptcy.

This is a genuinely sad story. But it is neither evidence of a "crisis" nor reason to support the Clinton plan. First, Judy Anderson recovered. Indeed, she got first-rate care despite lacking insurance. Emergency rooms provide care to all comers, and non-profit hospitals--88 per cent of all U.S. hospitals --must by law take any patient needing care. The Andersons' problem wasn't with care but with insurance.

Second, the insurance trouble could have been eased by enhancing the "portability" of coverage between jobs--a simple reform that President Clinton would oppose if it were voted on tomorrow. Why? Its salutary effect would undermine sentiment for his more grandiose designs.

Third, according to Ambrose Evans-Pritchard in the London Sunday Telegraph, the Andersons are a bad example. Mr. Evans-Pritchard writes that the hospital where the operation was performed has a $2- to $3-million fund for hardship cases that the Andersons eschewed. "They declared bankruptcy almost immediately, which allowed them to clear older debts that had nothing to do with the illness."

So we can tell the Andersons there's no crisis. How about "the 58 million Americans who have no coverage at all for some time each year"? Not too long ago the Clintons talked about "37 million" uninsured. The jump (is this the health-care inflation the Clintons warn about?) comes almost entirely in the phrase "some time each year."

As Irwin Stelzer points out in Commentary, half the uninsured have insurance again within six months, and only 15 per cent of the uninsured stay that way for more than two years. Try about 5.5 million chronically uninsured. But even that overstates it. About 37 per cent of the uninsured are under the age of 25; for them insurance plans are often a bad buy. Take out all those who choose to go uninsured, and perhaps 3 per cent of the population can't get insurance (but they can get care). Not a crisis.

Can we "tell it to the 81 million Americans with those pre-existing conditions" that can make getting insurance impossible? Again, their problem is solvable with a quick package of insurance reforms--but the President isn't interested.

"To the small businesses burdened by skyrocketing costs of insurance"? Health-care costs are growing, albeit at the lowest rate in twenty years. But this is what you expect when quality of care improves. Bypasses, angioplasties, CAT scans--all cost money, and save lives. Why do we spend 14 per cent of our GDP on health care when, say, Japan spends 7 per cent? Because, as Fred Barnes writes, our care is better: "Japanese get assembly-line treatment from doctors who see on average 49 patients a day." So we'll tell small businesses, too, that there's no crisis, although we do think there should be fast reforms to make it easier for them to buy insurance in pools or tax-exempt trusts, thus increasing their bargaining power and lowering costs. Mr. Clinton, apparently, doesn't.

The wrangling over the word "crisis" has a significance that's quite simple: No crisis, no Clinton revolution in health care.

Bill Kristol and his Project for the Republican Future have convinced increasing numbers of Republicans, including--sometimes, at least--Bob Dole, of the connection. And if there's no crisis there's no need for a GOP comprehensive solution either. Now even Phil Gramm, who has a overhaul plan of his own, has introduced an incremental bill.

So the GOP wants real reform, now. Clinton is after something different--a government takeover of health care justified by the alleged dire straits of most Americans. A crisis? Tell it to the 80 per cent of Americans who are "somewhat" or "very" satisfied with their care.