NEW YORK - Can any amount of health care be too much?
We Americans, with our renowned capacity for wretched excess,
historically would have answered that question with a resounding
""No!'' But now, with an estimated $420 billion a year going just to
pay off the nation's health-care tab, an unusual coalition is forming
around the idea that enough's enough - and that some medical bills
these days would make you sick.
In the forefront of this movement are some of the leaders of
corporate America, which in 1984 shelled out $87 billion for group
health insurance alone. Suddenly, cost-consciousness about this
vaulting bill is everywhere.
It is, at best, a deeply sensitive issue - and few companies want
to appear as heartless skinflints, consigning their employees to less
than adequate care. Everybody (including the top corporate officers)
wants to feel secure about the help that will be forthcoming if
But the feeling that the price of implementing that care has
burgeoned out of proportion to the added benefits has led to major
new cost-cutting efforts - involving both the carrot and the stick.
Medical sources say many companies, in order to trim their
health-insurance premiums, are not just paying for second and third
medical opinions, but also influencing which opinion the patient
accepts. Corporate America not only exhorts doctors and hospitals to
keep treatment to the necessary minimum, but also is beginning to
refuse to pay fully for days and procedures they feel are
unwarranted- even if the patient's doctor insists that the treatment
Here are some specific examples of recent changes in corporate
- IBM workers must pay 40 percent of the first day's room charge
during a hospital stay, plus a variable deductible of $150 for those
earning $50,000 or less and .75 percent of annual salary for the
- Quaker Oats doles out cash bonuses to its employees if the
annual medical bill for its work force is below the company's
- Lockheed requires new employees to enroll in less-costly
health maintenance programs (HMOs) rather than traditional
arrangements with a personal physician.
In fact, many would-be patients are surrendering frequent doctor
visits to avoid increasing out-of-pocket expenses caused by
less-comprehensive coverage and higher deductibles. …