Clinton's invented crisis

Mona Charen

May 18, 1993|By Mona Charen

IT IS unfair to say that the Clinton administration is staffed by people who have never actually made anything. They have manufactured a crisis -- which they now propose to "solve."

I refer to the administration's plans on health care. Declaring the situation to be a crisis doesn't make it so. Are there discrete problems and inefficiencies which could profit from careful reform? Absolutely. But to say that a system which provides the highest quality care in the world (bar none) and which three-quarters of the American people declare to be satisfactory (far more than find Mr. Clinton agreeable at the moment) is in crisis is to engage in the politics of hysteria -- not to say deception.

Infant-mortality and life-expectancy figures are often thrust under the noses of the system's defenders to bolster the "crisis" argument. By such measures, the United States lags behind other industrialized nations. But those numbers prove nothing about health care; they are indexes instead of our costly social decay. Homicide and suicide cut into our life-expectancy rates. And maternal drug taking, drinking and smoking swell the numbers of high-risk infants.

But if you measure how well the health-care system serves seriously ill infants or gunshot wounds (or anything else, for that matter), the United States is at or near the top of the heap. That's why people from all over the world, including Canada (whose socialized system is so admired by liberals), vote with their feet when they are gravely ill and come to the United States for treatment.

The other great red herring in the health-care debate is the 37 million uninsured. As Fred Barnes has pointed out in the American Spectator, "having no health insurance in America is not the same thing as having no health care." The uninsured do get treatment. They just tend to get it from hospital emergency rooms instead of doctors' offices. Who pays? We do. Those of us with insurance are charged more for services to cover the costs of those who have none.

The uninsured do use health care more sparingly than most, but there's a good reason for that beyond their lack of coverage. Most belong to a class of people who don't need as much health care as the general population. Why? Because they are disproportionately young and therefore healthy. Sixty-four percent of the uninsured are 39 or younger.

Is this an ideal system? No. Does it cause injustice in many cases? Yes. But it is not the Dickensian world of Tiny Tim.

Well, if the uninsured aren't the problem, and life expectancy isn't a problem, and the quality of care in the United States is excellent, what are the real problems that need addressing?

Stuart Butler of the Heritage Foundation has been giving this a great deal of thought during the past decade. An Englishman, Mr. Butler is a graduate of the British National Health Service -- a system he would walk on hot coals to avoid in the United States.

Mr. Butler's argument may strike some as non-conservative, since he believes in mandates to insurance companies, but he is attempting to insert competition and consumer choice into a system which provides little of either.

The great problem with America's health system, Mr. Butler says, is its marriage to employers. The employment-based system presents the problem of "portability," where people fear to change jobs lest they lose health coverage. The system also winds up subsidizing the wealthy at the expense of the less affluent. And it shields consumers from the true costs of services they are buying, leaving no incentives to economize.

Mr. Butler and the Heritage Foundation propose a national health insurance system based on the Federal Employee Health Benefits Program, where costs have not grown nearly as much as in the rest of the industry. Consumers would choose from among a wide selection of plans, joining groups that suited their needs. The poor would receive a refundable tax credit. All Americans would be covered and would understand better what they were buying.

The Heritage plan improves upon a good system. It doesn't attempt what the Clinton plan seems determined to do: fix what ain't broke.

Mona Charen is a syndicated columnist.

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