Newspaper article The Christian Science Monitor

Reforming Health Care Two Critical Questions Are Missing from Debates over Proposed Changes

Newspaper article The Christian Science Monitor

Reforming Health Care Two Critical Questions Are Missing from Debates over Proposed Changes

Article excerpt

ALTHOUGH it is difficult to draw all the threads of health-care reform together, what portends to be the largest change in one major aspect of our lives since the introduction of Social Security demands our thoughtful consid- eration and involvement.

After hours of television talk about President Clinton's health-care proposals, which now appear to be only one starting point in the congressional debate, two important questions have been overlooked: First, why should the system be connected with, or paid for, by one's employer? Second, is this to be a coercive system, or one that merely makes health care more available to those who want it?

On the first point, health care came to be financed by one's employer over the past generation as a bargaining tactic.

It was partly a fringe benefit, sometimes meant to tie the employee to his present job; it was partly a way to avoid limits on outright wage increases, particularly during World War II. Yet, the availability of medical care bears no logical connection with one's employment history, unlike Social Security, which is closely tied to one's wage history over his or her working life.

Moreover, many of the people who currently are not covered by any health insurance are in the category of either the chronically unemployed or the several million who are at any one time involved in a job switch.

There is no valid argument for continuing to tie the plan to one's employer, other than the obvious and dubious one that if the employer pays most of the bill, its true cost is hidden from the public, at least for while.

If we are talking about real reform, the first step should be to disconnect its financing from the workplace.

Second, if this is to be a coercive program (as I understand the president's intent that "every American must be covered"), then call it a government program and include it in the general budget. …

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