NATIONAL HEALTH PLAN IS NOT THE ANSWER; WOULD YOU WAIT TWO YEARS FOR YOUR OPERATION?

Hysterical ravings by National Health Care advocates are reminiscent of my youngest son's declaration that "his life was over" when puberty, the need for glasses, and orthodontic braces, all confronted him at the awkward age of thirteen. My industry's approach to the weighty problem of health care is similar to the sage advice that parents have given their thirteen-year-olds for ages.

We acknowledge that there are problems:

-$700 billion price tag for health care in 1991;

-34 million plus Americans without health care.

But we remind all concerned that 85 percent of Americans experience the modern miracles of the world's greatest medical technology.

Self-inflicted injuries

What causes our current system to cost too much and fail to reach everyone? Look to the medical profession, insurance industry, every employer, you and I and our neighbors. Fifty percent of our current medical expenditures go to treat self-inflicted injuries and illnesses. The disastrous result of glamorizing smoking, permitting epidemic drug/alcohol abuse and adopting a junk-food/couch-potato way of life, is an overdue bill.

Discouraged accountability

In a brief period of two decades, the insurance industry with the urging of employers and employees, created all-encompassing benefit packages. This moved Americans from generations used to paying their own way (and recognizing the cost of doing so) to our current situation of expecting everything to be paid for by someone else. We offered a blank check which an ever-expanding, medical industry gladly filled in. Now, we're presented with the bill that accompanies such an inflationary system. Not only aren't we used to paying the bill, we aren't sure we can afford it.

The "lottery" syndrome has also hit our medical care system. Midday TV is filled with law firm ads promising to champion workers compensation and malpractice law suits. An increasing cost of malpractice insurance and the defensive medicine practiced to offset frivolous lawsuits and unreasonable judicial awards represent a big portion of every medical bill. Without some tort reform, this cost goes unchecked.

Finally, we come to the price of a miracle. Americans have always wanted the best in life. Medical technology in this country has responded. Billions are spent on research and development. The miracles we enjoy from this free enterprise have an expensive price tag.

National plan: no answer

Why won't the "easy" answer of a National Health Care Plan solve our problems?

- Do you like the idea of a government employee treating your illness or injury?

- Do you like the idea of being told you will wait 2 years for your operation?

- Do you like the idea of being told you are too old (high risk candidate) to qualify for an operation?

- Do you think a National Health Care Plan will be any better run than the government services for which you are now taxed?

Even the most optimistic view of a National Health Care Plan does not address a workable cost control mechanism. National Health advocates plan to save money by wiping out the bureaucracy of the private health insurance industry and substituting ... the bureaucracy of government. Nationally, the insurance industry spends 90 cents of every premium dollar for the cost of actual medical care. Part of the other 10 cents goes to cost-containment efforts our industry has worked hard to build in the past decade.

National Health advocates offer government-set fee schedules for physicians, hospitals and other institutional health care providers. Canada, the model of socialized medicine has such fee schedules. Their answer to the pressure of cost on these caps is rationing, delaying, or denying care and a 50 percent income tax rate.

Growing up

If we carefully address each cause of the current crisis, we can eliminate some cost; and control the inflationary trend of the remaining medical costs. At a reasonable price, insurance premiums and tax-based subsidies will cover the cost of medical care for all Americans.

As with growing up, solutions to the complex issue of health care can not happen overnight. A measured approach may not provide the "easy" answer; but, carefully considered in an overall policy, the pieces can represent a lasting, affordable solution. Most important, a measured approach could preserve features envied by the rest of the world.

My son is still some distance from being a self-sufficient adult, but designer glasses and straight teeth have improved more than just his social life.

Gary Johnson is Regional Manager of Blue Cross Blue Shield of Missouri.