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September 1994 | February 1995 |
Health Care Reform It looks increasingly likely that there will be no health care reform this year, and any plan adopted now would probably fall short of providing universal coverage. Much of the opposition surrounding the proposals so far has focused on financing through employer mandates. Single payer, which League prefers, has not even been discussed. Changes have occurred in health care delivery systems in anticipation of national reform. Managed care plans have emerged, particularly in California, but in Hawaii and other states as well. There may be cost savings, but many are concerned that the quality of care will suffer as third parties insert themselves into the decision-making which has traditionally been reserved to patients and their physicians. More and more, physicians are having to seek permission from insurers to admit patients to hospitals and to keep them there as long as necessary or to provide certain treatments. Unfortunately insurance companies and managed care systems tend to be more concerned with their profits than with the quality of care that patients receive. The health reform proposals which have surfaced so far have raised concerns about the future financing of medical education, medical research, and teaching hospitals, which now receive federal subsidies. Managed care could destroy the academic medical centers and lower the quality of medical care in this country. Reform, when it does come, will have to include measures to protect these teaching and research institutions. Elizabeth Adams, M.D. |
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