Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!usa-post Newsgroups: usa-today.issues,americast.usa-today.issues From: usa-post@AmeriCast.Com Organization: American Cybercasting Approved: usa-post@AmeriCast.com Subject: issues Fri, Nov 6 1992 Date: Fri, 6 Nov 92 05:29:35 EST Message-ID: 11-06 0000 DECISIONLINE: Issues & Debate USA TODAY Update Nov. 6-8, 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, First Lady, Neuharth. TODAY'S DEBATE - HEALTH CARE: USA TODAY'S OPINION: When George Bush was defeated Tuesday, so was any chance for his plan to leave health care reform mostly to the marketplace. Also dead for now is any chance for a purely government-based health-care plan. There is no consensus behind that kind of massive redistribution of $300 billion in health-care money. Instead, Bill Clinton's health care plan ... will almost certainly move to center stage. That offers a new chance for the public to get the cost control and guaranteed access to insurance that it wants. Clinton has latched onto a version of "managed competition," an artful blending of market-based and government-based reform plans. It relies on market forces to make insurance companies compete on the basis of quality and cost. It uses government to rein in the remaining cost of providing medical care and to guarantee universal coverage. No other country has ever tried managed competition. ... It deserves a try, but only with an addition. Clinton needs to add to his proposal a provision that will ensure states can continue to conduct their own experiments with health-care reform. The states have demonstrated more flexibility and more innovation on health care than the federal government has. Hawaii already guarantees universal coverage ... and Vermont would like to experiment with a "single-payer" or government-financed plan. If the states can be used as laboratories to test some of the more radical proposals, supporters of the extremes ought to be more willing to climb aboard the Clinton plan. ... Some in Congress will still push for a government-run health system or for keeping the government out. ... This is the time for a health-care plan that doesn't go to extremes. OTHER VIEW: HARRY SCHWARTZ, a Scarsdale, N.Y., writer who specializes in medical topics: If we're lucky, Bill Clinton will just forget about his campaign promises on health care. But if Clinton bulls ahead and tries to deliver on this issue, he will plunge our health care system into confusion and probably doom many Americans to an early death. Clinton made two key health-care promises: One was to reorganize all our health care into a small number of competing health-maintenance organizations. The second was to impose and enforce a national lid on health-care spending. Both would be major reorganizations of our system, changes that would be bitterly fought by health professionals and millions of patients. If I'm happy with my doctor, whom I pay for every visit ... why should I be bulldozed willy-nilly into a huge national HMO with the compassion of the Internal Revenue Service and the efficiency of the post office? And that lid on health-care spending is simply fantasy in the short run. There is no organization that even collects the necessary statistics, let alone has the capacity for deciding how much any one doctor, hospital or whatever should spend. Moreover, I may have spent $200 on health care this year when I've been healthy, but if I get cancer or AIDS or a stroke next year, I may have to spend $50,000 or more. Is Clinton going to stop me and others like me meeting our needs? He could set off a revolution. The truth is that our health-care system, with its 250 million patients, its 600,000-plus doctors and its many thousands of institutions is just too big and too complicated to be revolutionized overnight by a new administration. VOICES ACROSS THE NATION ON HILLARY CLINTON'S ROLE AS FIRST LADY: PARADISE VALLEY, Ariz., Victoria Kosack, 42, homemaker: She should set an example for the rest of the country and support her husband. Everything she does reflects on all women. She shouldn't take a major role in policy. I'd like her to take a little of the good traits of the first ladies of my generation, like Pat Nixon and Rosalyn Carter. ATLANTA, Ga., Anthony Jennings, 26, business owner: She should play a role like Barbara Bush and go to the inner cities. Things have changed since I grew up in the projects; crime and drugs are rampant. She has a feel for helping children and families. She's much younger so she can relate more than Barbara Bush did. HAWTHORNE, Calif., Mireya Arias, 30, law school grad.: She should be the one who goes out there and represents the president's message of hope. I don't think he will appoint her to the cabinet. If he does, I wouldn't disapprove, but I'm sure she'll be too busy. ANN ARBOR, Mich., Michael Cooperman, 20, student: Being the first first lady with a post-graduate degree and a very successful career, it's important she encourage young women to pursue their dreams, especially since many are just beginning to fill important positions that traditionally have belonged to men. LONG ISLAND, N.Y., Marilyn Fitterman, 53, N.O.W. state president: She is Bill Clinton's best friend and also one of the top 100 attorneys in the country. This should make her an extremely valuable confidante. I hope her influence parallels that of Eleanor Roosevelt's, particularly in the social issues. Right on Hillary! TOPIC - BABY BOOMER POLITICIANS: Al Neuharth is the founder of USA TODAY. WALK OFF THE STAGE BEFORE THE SPRIGHTLIER AGE COMES AND SHOVES YOU OFF. - Alexander Pope, 18th century English author. Finally, the baby boomer generation is grabbing center stage. About time. Because they're not babies anymore. ... From a nonpartisan perspective, election of Bill Clinton, 46, and Al Gore, 44, should be cheered by oldsters as well as by youngsters. Any person in his or her 30s or 40s should be excited about the transition. Eager at the challenges and opportunities. ... Anyone in his or her 60s or beyond should sigh with relief. ... Unfortunately, human nature has many oldsters hanging on to power too long. ... Others usually see the signs first when it's time for a leader to leave. On July 26, 1991, I suggested in this column why George Bush should bow out: "He's riding sky high in popularity at home and abroad. That's destined to go downhill in a second term. Quit while you're ahead. With all your marbles intact. Especially when you're 67 and have health problems." In 1987, after a coast-to-coast BusCapade which included interviews with all 50 governors, I wrote that Bill Clinton, then 41, headed the list of the Democrats whom might make it to the White House in 1993. The youth movement and its inherent inclination for change have been under way for a decade. Not just in politics. ... There is no longer any status quo, anywhere in the world. All of us of any age can benefit from that transfer of targets and of leadership. All those grown-up kids who will be running the country need to keep in mind this guiding principle of Changes 101: Preserve the best. Improve the rest. Issues & Debate Editor: Kate Coughlin. (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