National Health Insurance

The Medicare program, budget deficits and maneuvering for the next presidential race have once again come into intense and very public conflict. The partisan fight has left the country bewildered by a mix of crisis talk, fact-throwing and ideological name-calling.In May, President Clinton publicly rejected the suggestion of House Speaker Newt Gingrich that Medicare's forecasted budget be reduced substantially (about $270 billion) to "save" the valued but beleaguered program. The president also has rejected the "remedy" of a bipartisan national commission proposed by Senate Majority Leader Bob Dole, an announced contender for the Republican presidential nomination.

I'D BEEN invited to Australia to help launch a new government policy on age and to talk about my book, "The Fountain of Age." But since I am also known as an American feminist, I was asked by women in Sydney and Melbourne, "What on earth are they doing to Hillary in your country?"I was myself unable to figure out why it had suddenly become a crime for an American to have made $100,000 on the commodities market 17 years ago -- this is a capitalist nation, after all -- though some men may still resent that a woman acting on a smart tip could turn $1,000 into $100,000 in that high-risk market.

Health care insurance reform may be an idea whose time has come, but it is not a new idea. Nor is it an American idea. National health insurance has existed in Europe since the late 1880s, when it was put in place in response to pressure from an activist labor movement. Germany was the first country to have a national health insurance plan, and the other European countries followed.As this country moves forward in the examination of our latest health insurance reform proposal, it is helpful to look at the history of this effort in the United States.

WASHINGTON -- At the same time the administration i planning to do away with federal employees' health insurance program, one of Washington's most influential think tanks is touting it as a model health care system.The President's Task Force on National Health Care Reform, which is crafting a national health insurance strategy, is likely to propose dissolving the Federal Employees Health Benefits Plan and folding its 9 million participants into the new system, says task force spokesman Robert Boorstin.

Palo Alto, California. -- From the White House to Main Street the focus is on managed competition as the answer to the U.S. health-care system problems.Missing in this rush to judgment, unfortunately, is any serious consideration of national health insurance.Proponents claim managed competition will make insurers, hospitals and doctors more innovative. There will be incentives to form new health-care networks competing for patients through the better quality at lower cost they offer. Consumers' bargaining power will increase as they can shop around for alternatives if they are not satisfied.

Robert M. Heyssel has spent two decades at the helm of the Johns Hopkins Hospital.He came from Vanderbilt in 1968 as associate dean of the medical school, worked on community health issues and was involved in the origin of the concept of the health maintenance organization in the then-new city of Columbia.He became executive vice president and director of the hospital in 1972, then gained the title of hospital president in 1982.Dr. Heyssel, who will be 64 this week, will retire July 1, to be succeeded by James A. Block, who comes to Hopkins from the University Hospitals in Cleveland.

Health system in Canada a model for U.S.I am writing to express great disappointment in your editorial, "Presidency on the line" (Jan. 29). You very accurately noted that President Bush, in his State of the Union message, spurned the "pay or play" plan for national health insurance in favor of a tax credit plan. You also correctly quoted the president as saying that Americans will reject "a nationalizing system which will restrict patient choice in picking a doctor and force the government to ration services arbitrarily."

Manchester, N. H.-- WHEN Sen. Bob Kerrey launched his candidacy for the Democratic presidential nomination, his supporters billed him as the next John F. Kennedy, complete with charisma. He was young, 48, boyish-looking and a Vietnam war hero whose exploits were at least a match for the PT-109 saga.In the following weeks, however, he seemed to turn the charisma spigot on and off, sometimes impressing crowds, more often leaving them lukewarm as he struggled to produce an effective message.

Sag Harbor, New York -- The worst moment of parenting for me -- and I assume for many American fathers and mothers -- was trying to explain to sons and daughters that they were on their own when it came to health insurance and health costs.They had to take care of themselves when our health plans cut them off after college. They were, if they did not have their own health insurance, we told them, just one accident or illness away from welfare, because any open-ended medical problems could take everything their parents had earned over a lifetime -- a house and some savings, not all that much.

WASHINGTON -- Jolted by Tuesday's regional elections, when voters around the country registered discontent with the status quo, Republicans and Democrats on Capitol Hill are scurrying to capitalize on the public's displeasure.Just two days after Sen. Harris Wofford, D-Pa., trounced former Bush administration Attorney General Richard L. Thornburgh in Pennsylvania's Senate race, Senate Republicans lined up behind large-scale plan to overhaul the nation's health care system.Similarly, as Democratic power brokers contemplated bruising setbacks in New Jersey, Virginia and Mississippi, House Democratic leaders closed ranks yesterday around a new soak-the-rich plan to cut taxes for middle-income workers.