Medical Care MoneyNeal R. Peirce, in his June 6 column...


June 14, 1994

Medical Care Money

Neal R. Peirce, in his June 6 column, "What Else Can We Try?", made one very important observation. Many states are making their own independent changes in an attempt to improve the inadequacies of our present medical care delivery system.

In a few years we should be able to judge which of these alterations are beneficial and which are not.

Since the present arrangement is so complicated, contains so many vested interests and the costs of many of the suggested changes can only be guessed, this slower approach is better than immediately locking us into a federal program which might only later be proven to be disastrous.

Unfortunately, Mr. Peirce failed to address two vital problems with our present system: the need for tort reform and the tremendous cost and waste of medical care dollars now absorbed by our medical insurance system.

In a country that is generally acknowledged to provide the highest quality of care for those who can afford it, it is inconsistent that we should also have the highest incidence of and highest cost for medical malpractice.

No one should object to those injured by sloppy practice being compensated.

However, the stimulation of questionable suits which require costly defense, the high percentage of the awards siphoned off bythe legal profession and the billions of dollars wasted by the practice of defensive medicine, all must be eliminated if we hope to alleviate the excessive costs of our present medical care delivery system.

Also, insurance companies with their costs of advertising, excessive paper work, profits and waste are estimated to consume 20 percent to 25 percent of all of the dollars devoted to medical care.

It is reported that one large medical insurance carrier in the state of California bought out another at the cost of billions of dollars. When this becomes an economic reality, it is obvious that entirely too much of the money supposedly earmarked for medical care, and which should be paying hospitals and other medical providers, is being improperly diverted into the pockets of non-medical people.

Until we address these inequities, as well as those alluded to by Mr. Peirce, we shall not really solve our delivery system dilemma.

We don't need to spend more of our gross national product on health care. We need to spend it more wisely.

Marion Friedman, M.D.


The writer is chairman, Manpower Advisory Committee, Maryland Academy of Family Physicians.

Clinton Is Doing Pretty Well

The headlines about President Clinton reversing his stand on most favored nation trading status for China were all I could take. When will the unjustified, inaccurate, ludicrous criticisms of President Clinton stop?

He has been lambasted for indecisiveness regarding Bosnia and Haiti, for some investments he and his wife were supposed to have made 15 years ago, for the unsubstantiated and marginally believable accusations of a questionable woman, and now for China.

Bill Clinton was elected to (1) strengthen the economy, which had become moribund under George Bush, and create jobs; (2) reduce the budget deficit, which had reached the gaudy figure of $290 billion in the final year of the Bush administration; (3) find some sort of resolution to the nation's crisis in health care (with nearly 40 million Americans having no arrangement to pay for health care); (4) break gridlock in Congress, pass legislation that helps individuals and families, and solve problems instead of indulge inmindless pandering to ideological groups such as the Christian right.

How has President Clinton done so far?

Well, the gross domestic product grew at 3 percent in 1993 and the first quarter of 1994 (average for 1981-88 was 2.9 percent).

A net increase of over 3 million jobs has occurred since January 1993. The budget deficit has been reduced sharply (to an estimated $165 billion for fiscal 1995).

Health care? President Clinton has either proposed or initiated the discussion on several viable plans, and if it were not for the stonewalling crust-heads in the Republican Party, one of them ,, probably would be benefiting us as law now.

As for congressional gridlock, the president has steered through Congress the Family Leave Act, the Brady Bill, several initiatives protecting a woman's right to reproductive freedom and the North American Free Trade Agreement.

Why are we so suddenly so concerned with President Clinton's personal life, with his wife's personal investments, with reversing himself on China?

Mr. Clinton was never a pristine virgin; we knew that when we elected him. If laws were broken in Mrs. Clinton's investments, it seems to me that they were broken by those who managed the investments for the Clintons.

As for China, Mr. Clinton realized that much more economic and eventually social good comes from keeping the Chinese and U.S. markets interacting, rather than by separating them.

He deserves praise for this, not criticism.

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