Newspaper article The Christian Science Monitor

An Alternative to Managed Care Backers of `Single-Payer' Plan Hope That a Compromise Will Emerge from Hillary Clinton's Health-Care Task Force

Newspaper article The Christian Science Monitor

An Alternative to Managed Care Backers of `Single-Payer' Plan Hope That a Compromise Will Emerge from Hillary Clinton's Health-Care Task Force

Article excerpt

WHILE much of Washington is buzzing about President Clinton's forthcoming health-care reform plan, another idea, called a single-payer plan, is sneaking into second place. Also known as the Canadian-style plan, it already has enough support in Congress, and wide grass-roots appeal, to be a major player once the national debate over health-care reform gets under way in earnest this summer.

The single-payer system, in which private insurance mostly would be eliminated and the government would pay for everybody's care through higher taxes, is favored by 74 Democrats in the House of Representatives and five in the Senate, and interest in it is growing.

Rep. Jim McDermott (D) of Washington introduced a single-payer bill in the House even though President Clinton asked members of Congress to delay doing so until after his plan is released, probably in June. "There is an enormous groundswell of support out there" for a single-payer system, Representative McDermott says.

Single-payer proponents from the grass roots let the White House know of their views recently by sending a million "pro-single-payer" postcards to 1600 Pennsylvania Avenue. "Our strategy is to build as big a force as possible," while the president is still hashing out the details of his plan, says Edwin Rothschild of the consumer advocacy group Citizen Action, a leader behind the push.

Besides Citizen Action, the single-payer system is backed by many large unions - including the Teamsters, the United Auto Workers, and the International Ladies' Garment Workers' Union - and some senior citizens' organizations.

Proponents of the single-payer plan say that it would save money, simplify billing, and expand coverage to all Americans. Opponents - including many Republicans, the American Medical Association, and the insurance industry - say it would put many people out of work, would encourage people to overuse the system because it would be "free," and is at odds with the United States' free-market traditions.

Many opponents of the single-payer plan favor the president's managed competition system. But the president's plan was dealt a major blow last week when the Congressional Budget Office (CBO) reported that it was unable to determine how much money managed competition would save. By contrast, the CBO reported earlier that the single-payer system would slow rising costs and possibly save $14 billion, while increasing benefits and coverage.

The CBO report opened the door for a proponent of the single-payer plan, Rep. Fortney (Pete) Stark (D) of California, a key player in the health debate as chairman of the Ways and Means health subcommittee. He attacked managed competition as a "Unicorn" - or mythical creature - that would not work and would not pass Congress. Rep. Dan Rostenkowski (D) of Illinois, the powerful chairman of the full Ways and Means Committee, also has indicated he does not like managed competition. …

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