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Show Bunge City Nets’ | DECEMBER 23, 1994 See i INTER PAGE 16. ee en MOUNTAIN HEALIR CARE Health Care Reform: Where Did It Go? Is It Coming Back? Legislative proposals will focus on preserving parts of the system that work well and targeting specific areas which need reform. - STEVE KOHLERT SENIOR VICE PRESIDENT INTERMOUNTAIN HEALTH CARE Americans felt uncertain about the level of OQ aTTaNe involvement. hy did federal health care reform initiatives break down this year? Hevw will this breakdown affect health care in uring themselves and the Intertnountain area? Many sumers and businesses). Market pressures are bringing these questions. The following IHC Dialogue column is based on insights from a number of health care experts who were close to the process in our nation’ capital. shortcomings of our system, finding consensus on specific According to these experts, fed- remedies is extremely challeng- eral health care reform broke down this year for a number of reasons. ing. 2. PERCEPTIONS OF AN EXCLUSIONARY PROCESS When the president decided to The process of drafting the administration’s reform legislation was perceived as exclu- tackle health care reform, no sionary by critics. Ira one fully realized how complex Magaziner, the White House's DEADLINE point person, organized more Although most Americans than 60 teams who worked to seemed to agree on develop solutions in broad philosophical a very short time © frame. While the issues, legislators and their constituents effort involved many iiacanwensr brilliant minds and - struggled with specific POC Pesce proposals. Everyone sought public comSRY ment, there was not agreed health care MaKe aT enough time to foscosts were incteasing ace far too fast and various ter a wide sense of populations were ownership in the clearly falling through _ plan. Critics the cracks, but to reform a sevaccused the administration of enth of the national economy working behind closed doors in a hundred days proved too and of excluding input from those with practical, day-to-day tall an order. We learned that while its easy to point out the experience in health care. - and difficult it would be. Doctors, hospitals, and-insurance companies are recontig- working together to meet the needs-of their customers (con- _teaders have called in asking 1. ABIG TASK AND A SHORT It is important to remember that considerable reform has already taken place in the marketplace. 3, POLITICS | 4. OUR VIEW OF GOVERNMENT Like it or not, the American Regardless of political affilia- legislative process is political. Each party wants the credit for good outcomes. Not only is it tion, Americans tend to be dis- critical for political forces to - compromise; legislators also need consensus on the basic principles to serve as the foun- ability to manage programs and trustful of government and skeptical of the government's enterprises. Much of the . debate focused on the role of costs into line. Medical inflation has dropped to around five percent annually. The rate still needs to drop, but this is a major shift from the days of double-digit increases. While federal reform has stumbled, state and local initiatives - are continuing to move for- ward. For example, a number of legislative efforts are underway in the Intermountain West which will address specific issues such as insurance reform. dation for legislation. government in a reformed health system. The administra- The need for reform was artic- tion said the proposed legisla- We believe the national discus- tion would not represent a dramatic enlargement of government’ role in health care, and critics said the opposite. Consequently, Americans felt uncertain about the level of government involvement, and this proved a major obstacle to widespread support. ‘ We see no cause for discouragement. Progress is still progress, whether it comes incrementally or all at once. Please call or write if you would ulated, but the American peo- ple never reached consensus on the principles. Is basic health care a right? What price are we willing to pay for basic coverage for all? What are acceptable methods of financing coverage? Are certain limits to access acceptable if we cannot afford it all? Do we take a shotgun approach and reform everything, or do we take a rifle approach and focus on specific issues? As individuals and as a nation, Americans never came to grips with these basic—and extremely thorny—issues. WHERE DO WE GO FROM HERE? Health care reform will be on the national agenda again in 1995. A number of experts have said the White House and sion on health care has been good for all parties involved. like to see other issues addressed in-this column. THC DIALOGUE ON HEALTH CARE 36 South State Street Salt Lake City, Utah 84111 1-800-889-3337 Congress will attempt reforms that are less sweeping than the legislation proposed this year. INTERMOUNTAIN HEALTH CARE IHC |