Why Clinton Faces A Tough Sell On Health CareAmerica's...

LETTERS TO THE EDITOR

January 30, 1994

Why Clinton Faces A Tough Sell On Health Care

America's health insurance agents could have told the Clinton White House what it just now seems to be recognizing: The selling of health care reform to Americans is going to be just as important in the coming months as nailing down the specifies of the reform plan itself.

The insights of health insurance agents are the product of many years of hard-earned experience, reflecting what has been learned in working with millions of small employers, self-employed individuals and others. While Americans often have very different ideas about the specifies of what they want when it comes to health insurance coverage, almost all demand answers to the same questions:

* Will I make my own choices?

American health care has been built on a foundation of one-on-one relationships between consumers and doctors, hospitals and health insurance professionals. In spite of recent growth in health maintenance organization-style health care, a strong majority of Americans oppose any steps that would sever the relationships of trust that they have established with various professionals. A 1993 opinion survey conducted for the Harvard Medical School shows that roughly 70 percent of Americans want no limits on their choice of doctors, hospitals and insurance agents.

The health care reform plan released by the White House runs counter to the insistence most Americans place on choices in their health care. Even though the untested model of "managed competition" promises lower costs as a result of pooling the buying power of many, such potential gains are possible only if those who are lumped together in exclusive "regional alliances" are willing to live with fewer health care options. The experience of health insurance agents is that Americans want more health care choices, not fewer.

* Will I get quality health care?

The "quality" question poses a threat to the success of health care reform. With the exception of some of the healthy young, agents find that very few Americans moving from one plan to another are willing to sacrifice the extent and nature of their medical services. Consumers don't think about the quality of their health coverage in national terms. They focus on the personal level and want to know why they should sacrifice the quality of their own care in order to play some minute role in meeting abstract national goals.

* Will you take care of my personal needs?

Selling health insurance is only part of the work of an agent. Considerable amounts of time and effort are devoted to the one-on-one tasks of enrollment, education about benefits, periodic reassessment of needs and, most important, serving as a liaison between the consumer and insurance company. Today, most Americans wisely rely upon a professional when it comes to health care, whether the expert is a doctor, surgeon or insurance agent. They not only demand personal attention to their needs, they quite literally need it.

Any American who has dealt with the Internal Revenue Service or Social Security Administration will be wary of a new era of "800 number" health care. Even if Clinton-style monopoly health alliances deliver lower costs to small employers and individuals, it is not apparent how consumers will suddenly become proficient at what they are unable to do today: navigate the tricky waters of health care.

The plain truth is that "managed competition" would see consumers stripped of the health insurance agent as ombudsman and left on their own to fight "City Hall" in the form of a health alliance. Mr. President, that's going to be a tough sale, one that most Americans will reject outright.

Cherie Jenkins

Westminster

The writer is president of the Carroll County Association of Life Underwriters.

Recycling Mysteries

There are several issues of recycling which nobody ever mentions. Why is it that only plastic marked with the numbers 1 and 2 are acceptable? Of those, why are only things with small neck-openings? Why no broken glass, or glass other than bottles?

Because of these rules, I am forced to trash many 1s and 2s because our hauler will only collect this narrow range of items. And of course, all the 3s, 4s, 5s and 6s go to the landfill, along with a mountain of Styrofoam which nobody seems to want.

If recycling becomes mandatory, who is going to police it? Will the haulers have to paw through everybody's garbage? What will they do with the coffee can filled with grease? Will they sue me when they cut their hand on a broken bottle which was in the trash because it was disallowed from recycling? Will I go to jail for trashing a piece of newspaper which was used to wrap garbage?

I'd like to see somebody do a thorough analysis of recycling and provide some answers to these questions.

Emily Johnston

Westminster

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