Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!news.media.mit.edu!americast.com!usa-post Newsgroups: usa-today.issues From: usa-post@AmeriCast.Com Organization: American Cybercasting Approved: usa-post@AmeriCast.com Subject: issues Fri, Apr 3 1992 Date: Fri, 3 Apr 92 05:43:48 EST Message-ID: 04-03 0000 DECISIONLINE: Issues & Debate USA TODAY Update April 3-5, 1992 Source: USA TODAY:Gannett National Information Network Here are some of the issues and topics being debated across the nation Friday morning in USA TODAY: Health; Wives; Neuharth. TODAY'S DEBATE - HEALTH CARE: USA TODAY'S OPINION: While Congress and the White House fiddle with health-care reform, the states are burning the midnight oil. Virtually every state has decided not to wait for federal action and is surging ahead with reforms. Plans range from Hawaii's requirement that employers provide health insurance to Florida's use of school districts to establish low-cost group insurance rates for the poor. The lesson: The federal government should admit short-term defeat on national reform and focus on helping states experiment with novel approaches. The states are so eager that all the feds have to do is get out of their way. One good way is to cut down on federal rules that thwart experimentation. Example: A state wants to try a "managed care" plan for the poor, in which choice of doctors is restricted in exchange for lower fees. Federal rules say every Medicaid recipient must have access to his or her chosen doctor. The state would need a waiver from that rule, which now can take years. Another helpful move: Suspend the rule that reforms must pay for themselves the first year. OTHER VIEW: JULIANNE MALVEAUX, a San Francisco writer, economist and lecturer: USA TODAY's editors have put their hearts on their sleeves and their brains on vacation in suggesting that states be allowed to experiment with the health-care and health-insurance system. I understand their motivation - 37 million people have no access to health insurance. If state adjustments can make health care more accessible, more power to them. I just don't think state experiments will make health care more accessible; instead, I think the quality of health care will vary widely by state, possibly causing people to decide where to live based on the health care they can get in a given state. State variations in health services also would move us away from the more comprehensive goal of making health care and insurance available for every American. ... We've already seen patient dumping from one state to another. Two years ago, a Florida man with AIDS was given a one-way bus ticket to San Francisco, where it was perceived that he could get better care than in his home state. The abandonment of an Oregon Alzheimer's patient at a race track in Idaho last month was another form of dumping. Both of these cases illustrate the need for national health insurance, not weak half-measures that avoid the issue. VOICES ACROSS THE NATION ON THE FIRST LADY GETTING TOP JOBS: NEW MILFORD, N.J., Aileen Caringal, 19, college student: I don't think there's anything wrong with it. A lot of first ladies have done a lot of important things for their husbands. And if a woman is capable of doing the job, there's no reason she shouldn't have it just because her husband is president. NEW ORLEANS, La., George Singleton, 31, facility attendant: A president should go for the most qualified person for the job. If his wife didn't have the experience, she shouldn't get it. She's going to be busy with the other things she has to do as first lady. She won't have time to do any other job. That would wear a person out. PEORIA, Ill., Linda Griepentrog, 43, editor: I think they could if they're capable, although I don't think they should be appointed only on the basis of a personal relationship. I don't see any real conflict of interest as long as they're qualified to hold the position. Each person should stand on his or her merit. RIDGECREST, Calif., Mike Whalan, 51, photo lab technician: Historically, they haven't, with the exception of Eleanor Roosevelt and when President Wilson's wife more or less ran the administration. There is the chance for conflicts, and would she follow his policy or would she be strong enough to formulate her own? TOPIC - NEUHARTH: AL NEUHARTH, founder, USA TODAY: All the baffle and bull being peddled by much of the New York press might make you think Tuesday's primary there is the most important of the campaign. Don't buy it. Despite all the pimping by its press, New York simply is not where it's at anymore when it comes to political clout. The Empire State, and especially The Big Apple, have been on a five-decade decline. The slide, from 1942 to 1992: Then, New York state had 10% of the USA's population. Now it has 7.2%; Then, it had 8.5% of the electoral votes for president. Now it has 6.1%; then, it had 8.5% of the delegates to the Democratic national convention. Now it has 6.2%. ... While New York has fallen out of the race, most of the rest of the USA has raced onward and upward. Especially across the Sun Belt from Florida to Texas to California. Even in much of the Midwest and most of the Northwest. ... The Big Apple's local press is the screwiest segment of its society. Radio and TV talk shows sell mostly sleaze. The three tabloid newspapers practice a journalism of distortion, despair and defeat. ... As you watch Tuesday's primary results, remember that New York is just a somewhat sinful little sideshow. The main event in this election-year circus is under the big tent west and south of the Hudson. Issues & Debate Editor: Michele Coleman. (1-919-855-3491) Making copies of USA TODAY Update (Copyright, 1992) for further distribution violates federal law. This article is copyright 1992 Gannett News Service. Redistribution to other sites is not permitted except by arrangement with American Cybercasting Corporation. For more information, send-email to usa@AmeriCast.COM