Target Health-Care Reform

Article excerpt

I COMMEND President Clinton for bringing the issue of health-care reform to the forefront of public debate. But his speech last Wednesday night to Congress only marks the beginning of what must be a long and protracted review of his plan.

At the core of this review is the issue of how much we want the federal government to dictate every aspect of health care in the United States. In the final analysis, a health-care reform plan for this country must envision the government as a partner to the public, not as a manager: The very aspects of our nation's health care in need of repair are those currently managed by the federal government, namely Medicaid and Medicare.

The Clinton administration envisions a powerful federal entity that will coordinate with state planning boards on the delivery of health care in the given state. Employees will receive their health care through a payment, or tax, on their companies that will be mandated. The revenues will flow to these state boards, which will decide what kind of coverage is adequate and will determine who the providers will be.

Whether it is a wage-based premium, payroll tax or any other form of tax, saddling employers with the cost is the surest way to lose jobs, slow the economy, and fail to solve the need to reform the health-care system. The National Federation of Independent Business and the National Restaurant Association estimate job losses under the Clinton plan would range from between 1 million and 3 million jobs over five years.

There is, however, an alternative to a government-run plan: an option that seeks to implement "targeted reform" to preserve the best elements of our existing system while working incrementally at areas needing reform. Under this plan, I believe we must:

* Ensure portability and greater access to health care. …