Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!americast-post Newsgroups: americast.wpost From: americast-post@AmeriCast.Com Organization: American Cybercasting Approved: americast-post@AmeriCast.com Subject: ... The Order of Business ... = Date: Thu, 5 Nov 92 05:01:45 EST Message-ID: <7.1992Nov5.050145@AmeriCast.com> OF ALL THE necessities that now come crashing in on Gov. Clin- ton, the most urgent is to get started on health care reform. It's not just that he's promised it. If he can't get health spending under control, he'll be unlikely to make much progress with all the other promises. Health care reform is the place to begin. Democrats speak of a triad of imperatives - getting the economy growing again, dealing with the budget deficit and changing a malfunctioning system of health care. As the Senate majority leader, George Mitchell, observes, the three are tightly tied. Medicare and Medicaid, the two big insurance programs that the federal budget supports, are now on a track that will keep them rising well over 10 percent a year through the 1990s, the Congressional Budget Office warns. Sucking up money at that speed, they alone will divert money from investment in economic productivity in sufficient amounts to slow growth significantly - and push up the deficit. But, as experience has shown, trying to curb Medicare and Medicaid alone doesn't work. Costs simply get shifted to other insurance plans. The whole system has to be changed. If these rises in spending were bringing commensurate improvements in people's health, they would be worth the sacri- fice in incomes and jobs. But it's hard to show a relationship between them and any benefits. Health insurance costs over the past two decades have eaten up more than half the total gains that working people have earned in wages and benefits. (Other fringe benefits have taken most of the rest.) That helps explain why cash wages have hardly risen at all since the early 1970s. If the Clinton administration hopes to get American productivity and wages moving strongly upward again, it's going to have to find ways to bring down health costs. Starting with health care also makes sense as a matter of polit- ical tactics. If Mr. Clinton were to start by trying to speed up the economy, leaving health care until later, he would immediate- ly be caught in a highly polarized quarrel inherited from the failed Bush administration. Turning to health care is likely to be much more productive. There the left already sees that unlim- ited public spending is solving nothing, while the right ack- nowledges the need for new and different kinds of regulation to make the market work efficiently. Restraining the surge in health spending can provide some of the money and budgetary flexibility that Mr. Clinton will need for his other plans. No doubt there will be plenty of experts to tell him that reforming health care is much too complicated to permit fast action. The reality is exactly the opposite. If the next president doesn't act quickly, he may lose his opportunity to act at all. 02:07 11-05C9999----- Copyright 1992, The Washington Post. This story is from the Washington Post's Capitol Edition On-Line and is not to be ar- chived or redistributed. For more information, send-email to American Cybercasting Cor- poration (usa@AmeriCast.COM)