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 Wed, Apr 8 1992 Date: Wed, 8 Apr 92 05:46:40 EDT Message-ID: 04-08 0000 DECISIONLINE: Issues & Debate USA TODAY Update April 8, 1992 Source: USA TODAY:Gannett National Information Network Here are some of the issues and topics being debated across the nation Wednesday morning in USA TODAY: Health; Perks. TODAY'S DEBATE - HEALTH CARE: USA TODAY'S OPINION: If you're old and ill, you'll spend about $30,000 a year to stay in a nursing home. To get government help, you'll first have to spend almost every cent you have. Despite the pain that causes, long-term care of the infirm elderly and disabled is the waif of the health-care reform movement. Basic medical needs now look so high-priced and complicated, long-term care has been left to fend for itself, a crisis that will grow as the baby boom ages. The stalling must end. ... States would like to try using Medicaid funds to provide community and home care. Others want to pair private long-term care insurance with public funds. They have to dance a merry jig to get federal permission, and then they are often refused. This is bad public policy. Instead, the federal government should encourage state experiments and use the knowledge gained to find national solutions. ... The number of people over 65 will double in the next 38 years to one-quarter of the population ... States are eager to find a better way to offer long-term care at lower cost. The federal government should let them. OTHER VIEW: JOHN C. GOODMAN, president of the National Center for Policy Analysis, Dallas: Government needs to undo the damage it's doing in health care and get out of the way for a different, workable approach. Ideally, informed patients, advised by their doctors, would decide the trade-offs between money and health-care expenditures. Instead, patients have little say or incentive to worry about costs. About 95% of hospital bills and more than 80% of doctors' fees are paid by private and public health insurance. When a patient spends $1, 76 cents is paid by someone else. Why? The tax code. It subsidizes health-insurance premiums paid by an employer, but taxes dollars destined for medical savings. It encourages expensive, low-deductible health insurance. If the law were changed to treat all health-care spending equally and to allow tax-free deposits to medical-savings accounts by individuals or employers, control of health-care decisions and costs could be moved where it belongs - to the patient. ... Using medical-savings accounts could cut the nation's health-administrative costs by $33 billion a year. More prudent buying by patients could save another $207 billion. Best of all, patients would have a financial self-interest in eliminating waste and reducing costs in the medical marketplace and would acquire greater control over how their health-care dollars were spent. VOICES ACROSS THE NATION ON BUSINESSES CUTTING BACK ON PERKS: LAKE JACKSON, Texas, Paul Riordan Santos, 38, sales assoc., actor: Where I work, as incentive for employees, we get what amounts to play money to use in our stores. Money is as scarce as hens' teeth these days. There used to be employee breakfasts, lunches and workshops; we're not seeing that very often anymore. DEVON, Pa., Christine Tozzi, 27, restaurant owner: In a recession, the only way to make it is to cut back. I get so mad when I see government workers getting special privileges. If I can't afford to give perks to my employees who do a great job, why should I pay for perks for government workers who do such a lousy job? MELBOUNE, Fla., Marvin Richardson, 50, contract cost monitor: In any environment, whether it's business or government, there are some privileges that go with the higher responsibilities. That's not to say they should be taken to excess. In some cases, they have been taken to excess, in government and business. CARBONDALE, Ill., Rosemary Nelson, 35, homemaker: What gives government employees the right to have special privileges? They should pay for what they get. If I have to use a gym, for example, I have to pay, so why shouldn't they? In the private sector, that's a different matter. There, perks can be tolerated somewhat. ST. JOSEPH, Mo., John Robertson, 52, realtor: Our business is doing so well that it's the other way around. We're getting more perks. But I prefer to call them incentives instead of perks, because they motivate people to do a good job. Take away incentives, and you'll have a negative atmosphere in your business. 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