Watch out, here come the big spenders, again

January 09, 1998|By Cal Thomas

WHAT does a liberal big-government Democrat trying to portray himself as a moderate ''the era of big government is over'' Democrat do with a budget surplus when he sees his heir apparent challenged by the left wing of his party? If he is Bill Clinton (and he is), he calls for more government spending (which he has) rather than a refund to America's overburdened and overtaxed workers.

The president wants to significantly expand some of our most costly social programs by offering Medicare benefits to younger retirees and restoring food stamps to immigrants who recently saw that aid cut off. The apparent objective is to dampen criticism heard recently from House Minority Leader Dick Gephardt, who suggested his party was in danger of selling out the poor, and bolster Democratic Party stock with immigrants and Hispanic citizens.

Medicare growth

Expanding Medicare to even more recipients without fixing what is wrong with the program might be a good way to further Mr. Clinton's goal of nationalized health care by other means, but it would put new burdens on taxpayers. He does everything he can to prevent reducing government's cost in order to plead the ''need'' for all of the taxes (and more) the government gets. Funny how the government can never afford spending cuts, but it never asks whether taxpayers can afford to pay more!

If the administration and Congress genuinely wish to help people who need medical insurance, they should support measures that would reduce the federal role in health care and allow the free-enterprise system to provide better care at less cost.

Because most employers, rather than families, currently determine the health insurance plans available to workers, the understandable consumer response is to ask government to guarantee access to a doctor of his or her choice. Because health insurance purchased by employers is a tax-free benefit, but individual coverage must be purchased with after-tax income, most people do not actually ''own'' their health plan. Instead, the employer owns it, which is why it has been so difficult for people when they change jobs to carry their insurance with them.

Providing choice

As the Heritage Foundation noted in a recent report, private enterprise, not the federal government, produces the desired results of expanded health insurance coverage. One example is the Buyers Health Care Action Group in Minneapolis-St. Paul. It was formed by a group of employers frustrated by the lack of choice among commercial insurers in the area. Only three large insurers provided coverage for 80 percent of people with employment-based plans. The health care action group represents 39 self-insured employers, covering about 400,000 employees, retirees and dependents in Minnesota, Wisconsin and North and South Dakota. Participants in the group may choose from among 15 ''care systems'' -- integrated teams of clinics, hospitals and doctors that contract directly with the BHCAG. There are different premium levels from which to choose, with employers typically making a defined contribution on behalf of their employees and with each employee responsible for the difference in cost, depending on the plan chosen.

Between 87 and 97 percent of those enrolled in the BHCAG Choice Plus plan report being ''satisfied'' or ''very satisfied'' with their care system. Contrast this with the top-down regulatory approach of the federal government.

Sadly, many members of the Republican Congress want to join the president and his big-government health-care minions in their ''reform'' efforts. In the House during the last session, there were more than 200 co-sponsors to Rep. Charlie Norwood's (R-Ga.) Patient Access to Responsible Care Act of 1997.

Health care doesn't need federal micromanagement. Expanding choice, not expanding the currently flawed system, is the best way to improve access to and quality of health care.

Cal Thomas is a syndicated columnist.

Pub Date: 1/09/98

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