European Stars and Stripes (Newspaper) - November 11, 1991, Darmstadt, Hesse Monday november 11,1991 the stars and stripes Page 13 commentary William f. Buckley or. Health care system needs Market principles or inti v Tel amp _ .1. A i suddenly thanks to the voters of Pennsylvania health care has emerged As the Issue that especially engages the voters. What evidently sparked the Issue was a line repeatedly used by triumphant Harris of namely if criminals have the right to a lawyer working americans should have the right to a that is one of the great non sequitur in political history there is no prosecutor in town demanding a death sentence for sick american but never mind. The present system is a mess and getting Messier and a new York times lbs news poll informs us that the nations Heath care system needs fundamental changes in the opinion of the majority. The majority is right. In a perfect political world the perfect response of president Bush would be to address senator Wofford and invite him to Institute within Pennsylvania such a system As he thought Ideal a on the understanding of course that Pennsylvania would finance that experimental system. This Isnit to suggest that Pennsylvania should in any Way be penalized. After All any system adopted through congressional action will end up costing pennsylvanians at least As much As their Home system would Given that Pennsylvania is 20th in the nation in per Ca pita income. But inevitably we will take Federal action and the first thing to do is to attempt to import Market principles into the picture. The National Center for policy analysis led by president John Goodman with the help of or. Gerald Musgrave president of economics America inc Are entirely convincing on the direction we should be travelling. Here Are the major Givens in the situation 1. The current system is drowning in bureaucratic Contention and individual self indulgence. What medical treatment should be taken when for How much and How much is reimbursable Are decisions being made by insurance companies employers doctors health plans and patients. That is too Many players. The individual in consultation with the doctor of his Choice and with reference to out of pocket Cost should make the critical Wicker 2. The relative indifference within the Field of Medicine to Gross Price differences establishes that the most valuable corrective of the marketplace a Competition a is not playing its role. That is one reason Why Medicine is increasing in Cost by about 15 percent in an average year having arrived now at an annual Cost of $750 billion or almost 12 percent of the Gross National product. In Dallas for example. Hospital a will get you a Complete blood count for $11. Hospital g charges $33.25. On the other hand. Hospital a charges $2s for a routine urinalysis whereas Hospital g will give Vou one for $ 11.75. Crazy ? yes crazy. What do blood counts and urinalysis have in common they Are mostly paid for by health plans. By contrast cosmetic surgery in t covered by health plans a and such surgery is vigorously competitive. 3. The primary target of Reform has got to be unnecessary Medicine. A family can buy $1 million Worth of coverage for $150 per month a but with a $5,000 deductible. If the family says Quot no $5,000 is too much reduce that to $300,&Quot the monthly payments increase to $550. It does no to take All that Long for a family to save $5,000 in premiums at the rate of $400 per month. Just Over one year will do it. We need to head in the direction of less unnecessary health care and greater attention to health maintenance. As Musgrave Points out if you rent your car or your House to somebody you Are going to make that person take out insurance a statistics demonstrate that far More damage is done to automobiles and houses that Are rented than to those that Are used by owners. A health plan can be seen As a form of rental a the plan pays for whatever you do or fail to do to maintain your own health. But your relationship with the health plan is better understood As one in which you pay the insurance. And what you want to pay is As Little As possible. All of the above leads to the enunciation of what has been called a mus grave a Iron Law of Public that Law says Quot the Economizer must Benefit from the 0. We re agreed on the diagnosis then the patients Pine and Well continue the same treatment Haftl Kif his economizing. A when you elect not to visit the doctor to administer to a head cold or elect not to go for a cat scan when there is no imperative need to do so when you travel to Hospital a for your blood count rather than to Hospital g. Which charges three times As much the savings realized by your husbandry should be yours. C Universal press Syndicate Cuomo Wofford Bush and term limitations if Mario Cuomo decides to run for president a a question not yet settled in is mind a he almost certainly will not resign As governor of new York even though he would feel it necessary to wage time consuming campaigns in most state primaries. Cuomo is a very close to a decision that he will not quit As governor even if he enters the presidential race. After nine years in office and facing a the hardest part of his tenure a the states and new York City a deficit problems a he cannot a imagine dropping it Here and saying there a something More the question is a crucial part of the governors larger decision because he stayed out of the 1988 presidential race largely on grounds that he could not both govern new York and wage a Strong National Campaign. Gov. Michael Dukakis of Massachusetts the 1988 democratic nominee is widely considered to have been handicapped moreover by his dual role and responsibilities in an election year. Cuomo is not considering the possibility that he might retain the governors office and enter Only a few selected state primaries a such As those in new York and California. This strategy would be a a offensive to voters in his opinion since other candidates would be entered in most of the state contests if he did not do so he might be thought to be seeking a special rules for himself. Besides a number of the state primaries take place Early in 1992 a a a whole Bunch of them in a Brief period in March. Its at least possible that the outcome of the nomination race will he determined then a Well before the California and other primaries. In explaining some of the pros and cons he is weighing Cuomo did not mention the smashing Victory of another democratic Liberal Harris Wofford in the Pennsylvania senatorial race a though that event could hardly be absent from his deliberations. Pennsylvania has numerous Blue Collar voters and democrats who defected to Ronald Reagan and George Bush so Wofford a aggressive Campaign and his defeat of former governor and attorney general Dick Thornburgh encouraged the idea that president Bush also might be vulnerable in 1992. The Pennsylvania upset seems to teach democrats at least two lessons. One is that they need to Quot set the agendas next year As Wofford did in making National health insurance and economic recovery the dominant issues the other related lesson is that the democratic presidential nominee should press an attack on Bush on these and other popular questions and not allow himself or herself to be forced on the defensive. Wofford a Campaign could be seen to be catching fire in recent weeks so his Victory was not the most surprising result of the 1991 elections. Thai distinction goes to the defeat in Washington state of a Radical measure to limit the terms of stale and Federal legislators the limitations if approved would have been retroactive so that the slates entire congressional delegation would have had to step Down in 1994. Pre election polls had suggested that 60 percent of Washington a voters favored term limitation but after a Strong opposition Campaign by speaker Tom Foley and others the proposition lost by about 54 to 46 percent. This decisive setback seems bound to restrain what had appeared to he a rising political tide that might have had term limitation measures on the ballot in about 17 Stales next year. Some form of term limitation already has been approved in Oklahoma California Colorado and several municipalities. Opponents of term limitation in Washington and elsewhere have argued that this drastic step would shift Power to the executive Branch nationally and in the state throw out Good legislators with bad restrict the Freedom of voters to choose and retain officeholders they like. Some think the movement represents at Root a rep Uhli can Effort to break the democrats hold on Congress and state Legislatures. The Washington result suggests something less frequently mentioned a that term limitation would shift congressional Power from Small states to Large. A Small slate often wields outsize Power because one of its House members serves at length and becomes chairman of a committee. Thai would not be Likely under term limitation throwing congressional Power to the sheer numbers of Large slate delegations. A Lutfiu now Portt tunes
