National Health Care: Law, Policy, Strategy

By Donald L. Westerfield | Go to book overview

10
Obstacles Faced By Small
Businesses

The imprint of the special interests on health care legislation throughout the 1980s and into the 1990s is indelible. The maneuvering and posturing of the hundreds of special interest groups and their lobbyists have created chaos in the legislative committees of Congress.1 The legislation that actually became the law, as discussed in the previous chapter, reflects a cut-and-paste hodgepodge of amendments designed more to placate powerful special interests and help ensure re-election than a carefully designed strategy to provide the best health care possible to the widest range of citizens at the lowest possible cost. This has resulted in undue burdens on small businesses, gaps in health care coverage for elders and the underprivileged, and spiraling health care costs.2

Political debate on the floors of the U.S. Senate and the U.S. House of Representatives reflect the difficulty in obtaining a consensus measure from the fragmented congressional committees. This is magnified by the activities of the professional staff contingents of each of the congressmen and congresswomen, who have professional backgrounds and aspirations which are often at variance with the member of Congress for whom they work.3 Even to the constituencies for whom a legislative measure was designed, the resulting public law seems to be like the description of the old-fashioned hoop skirt--"covers all, touches nothing." Of over thirty legislative health care proposals discussed in chapters 5 through 7 of this book, it is unlikely that any of them will be passed in a form acceptable to the health care providers, insurers, health care administrators, or especially those who are desperate for health care insur

-115-

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National Health Care: Law, Policy, Strategy
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Figures and Tables xi
  • Preface xiii
  • Part I - National Health Care Issues 1
  • 1 - Introduction 3
  • Notes 11
  • 2 - The Uninsured and Underinsured 13
  • 3 - Underwriting, Impaired Risks," and Pooling" 29
  • 4 - Play or Pay" and Subsidies" 43
  • Part II - Health Care Proposals in Congress 53
  • 5 - Major Universal" Plans in Congress" 55
  • 6 - Pay-or-Play" Proposals in Congress" 67
  • 7 - Health Care Reform Proposals in Congress 79
  • Part III - Special Interests, the Law and Political Posturing 91
  • 8 - Special Interests and Legislation 93
  • Notes 100
  • 9 - The Law--Federal Mandates 103
  • 10 - Obstacles Faced By Small Businesses 115
  • Part IV - National Policy and Strategies 127
  • 11 - Other National Models 129
  • Notes 140
  • 12 - Rationing Policies and Strategies 143
  • Part V - A National Health Care Plan 151
  • 13 - Workers Compensation 153
  • 14 - Proposed National Health Care Plan 161
  • 15 - Between Now and 2000 A.D. 171
  • Bibliography 177
  • Index 197
  • About the Author *
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