European Stars and Stripes (Newspaper) - December 22, 1992, Darmstadt, Hesse                                Tuesday december 22. 1992 commentary the stars and stripes b Page 13health care reforms face labyrinth of costs in the i warred ___1.1 Thanh s matter of health care Reform an old threshold question can be discarded. The question is o Long whether the United states will have some what form Wilh Nake sum acc the it Lue lion now is Bill Clinton As president elect has promised to of he uni m of the a a my Ester pro a Lem by Midsummer. His Bill will have two Broad Aims. Clinton will propose measures to control staggering increases in the Cost of Nealton care and to guarantee health insurance coverage to All americans. Cost controls pharmaceutical manufacturers Felt a cold wind monday when their emissaries had an audience with Clinton a people. Apparently the Clinton Camp made no direct threats of out and out Price controls product by product but the manufacturers Felt something ominous in the air. Prescription drugs reportedly represent a fairly Small part a about 7.2 percent a of total spending on health care but that part is a highly visible and painful part. Domestic drug prices have soared in recent years far beyond the. General increase in inflation. As a political matter the drug manufacturers u an Irros St ble target. We May confidently expect that the Clinton Bill whatever else it attempts to do will give the pharmaceutical Industry a very bad headache. As for other costs who knows the doctors protest that their fees have not risen inordinately their expenses for rent nursing staff and malpractice insurance have been steadily rising. But somebody has to pay the doctors. Hospitals plead not guilty doctors and patients demand the most modern diagnostic equipment and the equipment costs a Fortune. Hospitals Are labor intensive. Maintaining a staff of nurses orderlies and record keepers strains every hospitals budget. Somebody has to pay for Hospital care. Private insurers say they re not to blame if our hypochondriac people insist upon buying so much treatment there a not much they can do about it. Policyholders have to pay for the coverage they buy. Government agencies notably those administering veterans care and medicaid say they have Cut benefits to the Point at which they can be Cut no More. Taxpayers must foot the Bill. So much for the first part of Clinton a problem. It will take draconian measures a measures that will be James j. Kilpatrick widely resented in one forum or another a to get a handle on costs. An acceptable plan to achieve Universal coverage presents As Many difficulties. The latest buzzword on Capitol Hill is a managed Competition a an oxymoronic construction in a class with a partial  Many conservatives will like the idea of Competition its the idea of management that worries them. Washingtonians have just concluded an annual rite of Competition for health insurance. Federal employees May choose among a dozen different plans. Blue Cros Blue shield has a program of course but so do Many other carriers. The mail handlers Union for example promises a great High option dental  the postmasters Benefit plan promises a a a wellness benefits for All  Federal employees have a window every year Between nov. 9 and dec. 14, in which they can shift from one Carrier to another. The Washington Post reports that Only about 5 percent of the covered workers actually shift their coverage but the option plainly has an economic effect. Under the Spur of Competition the carriers offer a wide variety of Protection. In 1993, the government will pay $1,675 for an employees Basic individual coverage $3,630 for a family. Those who want More will pay More from their own resources. Some workers want a deductible feature. Some want chiropractic coverage. Some want pharmaceuticals. The approach makes sense. The heritage foundation a conservative think tank has been pushing a program that is modelled in part upon the Federal employees plan. A number of moderate democrats Are promoting the a Jackson Hole plan a which would require All carriers to accept All applicants without regard to pre existing medical conditions. To this Day Clinton has not made it Clear How he would handle the estimated 35 million americans who have no coverage at All. They May be too Young for medicare or too Well off for medicaid. As part time employees they May be excluded from employer plans. Clinton has not asked for National health insurance in the British or Canadian pattern. No one knows exactly what he will request but this much is certain it wont come cheap and somebody will have to pay. C univ Oral Pross  squandered by journalists run amok As a Young reporter i tried to train myself to be a Good observer a person who could stay out of the Way watch and later recount what i had seen. I wanted to be a Fly on the Wall a an unassuming creature with enormous eyes. But today a reporters especially those working for to networks have grown too restless to stand aside and merely relate events As they unfold. Journalists interject themselves into the Story and change the outcome. In Somalia to Crews put on an almost comical display of their insensitivity As marines were hitting the beaches. Instead of following troops on their missions to anchors were planted on the Shore with lights burning and cameras rolling a completely altering the course of events. Every newspaper photo i have seen since the marines landed has included a photographer or cameraman in the background. Apparently Mogadishu is so jammed with journalists they have no Choice but to photograph each other. These reporters Arentt flies on the Walls a they re cockroaches crawling on top of each other and multiplying rapidly. Not Only Are reporters changing the natural course of events they Are becom Marilyn Geewax ing More determined to deliver news when it suits their own schedule not when the Story is ready to be told. On election night just moments after the polls were closed television viewers were informed by network anchors that Georgia a electoral votes would go to Arkansas gov. Bill Clinton. In fact the vote was so close that it Wasny to until the next Day that election officials could say Clinton indeed had squeaked by. Newspapers now routinely write stories about government reports before the news occurs. If the labor department is due to release an inflation figure Friday Check most papers thursday for a preview of what May or May not happen. Holding off for an accurate Story saturday would be too old fashioned. The most offensive version of this pre reporting occurs when facts and fiction Are blurred by those who write to docudrama scripts based on news stories. Look what happened with Amy Fisher the 18-year-old Sociopath from Long Island n.y., who shot a woman in the face. The criminal was sentenced dec. 1 a she a hardly had time to warm up her prison cot. But i read that As Many As three to movies about Fisher will air in january. Facts and pseudo facts were laced together and filmed As a docudrama Long before the Case was closed in court. Reporters assigned to cover Juicy murder trials now know that if they can simultaneously work up a Good to script they can sell the fictionalized Story a and not even have to wait for the real ending to unfold. This mishmash of news pre news reenactments and dramatizations is disheartening to anyone who thinks real journalists matter in a democracy. People Are being conditioned to distrust reporters because they realize much of what they see and read no longer is real. When i watch footage of marines in Somalia i want to know in a seeing a True bit of history not a staged event arranged by the Pentagon for Lazy reporters. By carelessly interjecting ourselves into the news by covering staged stories or by profiting from dramatizations we journalists May be surrendering the Only thing we Ever really had to offer a our credibility. C Cox news service