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EDITOR'S
NOTE |
| Illustrations by Malcolm Garris |
August 13, 1998 If you’re looking for a lot of interesting discussion on the topic of health reform during the upcoming elections, get ready to be disappointed. Most candidates aren’t really talking about health care much this year. Despite the sense of widespread anti-HMO feelings, and the competing patients’ rights bills in Congress, and amid much turmoil in the system, the hot issues seem to be education, saving social security, and gun control. Is that because health care is gradually reforming itself? I think so. People are slowly adjusting to the end of the 20-year period of blank-check medicine, when just about everything was covered and there were few rules. We’re becoming more consumer-savvy about health care, and we’re learning to seek a reasonable balance between what we pay for coverage and what we get. And while legislation that has affected health plans has been plentiful and popular, the new laws haven’t been overwhelmingly far-reaching. Bit by bit, the changes have been making plans more palatable. And overall, costs, while inching up, are finally under control. Gradually, people are accepting the notion that there will be limits to what will be covered by their health plans. I know that’s true for our family. We clung to a fee-for-service plan until the monthly and out-of-pocket costs just didn’t make sense any more. Now we’re enrolled in a large HMO. While I grumble every once in a while, I have to say we feel well-covered against catastrophe and have relatively easy access to nurse practitioners and physicians when we need them. It’s not perfect, but we’ve found a balance between what we want in coverage and what we’re willing to pay. That’s happening in household after household. As a society, we’re beginning to accept the fact that every time we get a new legislated benefit or mandate, there’s a cost. A recent study by the Congressional Budget Office of the Democrats’ Patients’ Bill of Rights suggests reforms would raise premiums by about $200 a year for an average family. Depending on your point of view—and your budget—the reforms may or may not be worth it. The Health Insurance Association of American says that increase alone would result in a minimum of 800,000 people losing or not gaining private health insurance. Similar costs would undoubtedly be associated with the Republican bill, too. It’s not to say there won’t be all kinds of big healthcare issues in the next few years. But right now it looks like we’re in the midst of slow evolution, not revolution. Health care’s off the hot seat, and I’m glad. A healthcare system as complex as ours could have been seriously damaged by a broad attempt at a quick fix. Barbara
Bronson Gray, MN, RN |
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