Dear Bill: We have the best plan!

Dear Bill: We have the best plan!
by Larry Elder

To:

President Bill Clinton

From:

Ms. Hillary Rodham Clinton

Re:

Healthcare Task Force

Note:

Confidential Memo - For Your Eyes Only!
Bill: Bad news. Forget about a healthcare plan this year. Learned a great deal over the last several weeks about our so-called healthcare crisis in America. I will share my thoughts, but be warned that you may not like them.

OK, 35 million Americans don't have healthcare insurance. But guess what. This does not mean they are without healthcare. Through government-supported healthcare facilities, poor people do get treatment. They often line up in crowded emergency rooms, but they get treated, and the overall quality of the care is good.

On the other hand, 215 million Americans do have healthcare insurance. Hope this doesn't get out, but some task forcers question the wisdom of scrapping a system that performs fine for 85% to "save" the other 15%.

Another thing: I just rechecked our preelection Polling data. Only 20% or 25% of Americans cited healthcare as a primary concern; most cared more about the economy. But now polls show a majority of Americans concerned about healthcare. Could it be that ABC, NBC, CNN, and C-SPAN's "healthcare crisis" bombardment stirred up dissatisfaction with a system most people liked? Odd that the same poll found that people were quite satisfied with their own doctor. (Nobody likes Congress, but people like their congress person. Our schools stink, but parents love their own kids' schools. People!)

Something else. Remember that analogy between the Canadian and the American healthcare systems? Yes, Canada does spend less than 8% of GDP on healthcare vs. our 14.5%. But we spend much more on our elderly population than the Canadians do. This kicks up the costs because 30% of healthcare dollars for an individual are spent in the final year of life.

We have 6 million regular drug abusers, 30,000 homicides yearly, 200,000 diagnosed cases of AIDS, crack babies, and alcohol abuse costing more lost work time and money than any other drug. Twenty percent of adults still smoke, and among young women, cigarette smoking is increasing.

With hundreds of thousands of Jane Fonda workout tapes sold and Jenny Craig outlets popping up all over the place, Americans still over-eat. Our consumption of fat, cholesterol, and sugar remains high. Most Americans get no or inadequate exercise. These are behavior-conscious acts that have precious little to do with greedy doctors, gouging drug companies, or an "indifferent government."

Another thing. Why, in a society of nearly 260 million Americans, are there only 500,000 doctors? We have twice that many lawyers. Well, it seems that the American Medical Association, with the support of overzealous state lawmakers, have artificially and intentionally limited the number of doctors produced by medical schools. For every med school applicant who gets in, many qualified applicants get turned down.

Even crazier, a lot of medical students who are accepted are from foreign countries. Med schools like them because, unlike American students, they pay full tuition-no grants or loans. Better yet, when they graduate, they go home-at least they're supposed to-posing no competition to the Yanks. Imagine what would happen if we dumped another 500,000 docs in on the population? Next thing, they'd advertise, drive down prices, and may end up driving cabs, just like some lawyers have had to do!

We also clip the vines of nurses and physician assistants, who, if laws allowed, could fix broken bones, prescribe drugs, conduct annual check-ups-and at a much lower cost. We talked about price controls, but it is hard to find an economist who agrees with us. The only one I can think of is Laura Tyson, and she works for us. How can price controls work? Tell people they can only earn so much, and they ration their services, lower quality, or both. Limit what drug companies can charge, and they will spend less on research and development rather than cut their profit margin. This could kill one of the few American industries that still leads in the international marketplace.

Besides, the government already plays a huge role in healthcare. Did you know that through Medicare, Medicaid, and other programs, the government already pays nearly 40% of all healthcare costs? Some even say that this heavy government involvement in healthcare has caused much of the rise in healthcare costs. What about the dreaded malpractice-fearing "defensive medicine"? It adds maybe 1% or 2% to the bill. Ditto for "skyrocketing drug prices"-3% at most. See, when people don't pay for things, demand soars. Last month somebody said, "When you're robbing Peter to pay Paul, you can always count on the support of Paul." At the time I didn't think it was funny. Yesterday I received a memo from a task force member. Turns out that last year healthcare costs rose only about 4%-just slightly higher than the inflation rate. Trends suggest that our healthcare costs are going down, not up.

In fact, many big companies and smaller companies have already, joined to pressure doctors, hospitals, and drug companies to reduce prices.

So there you have it. An aging,healthcare-consuming population with bad health habits, an artificially depressed supply, of doctors, and 40% of healthcare dollars paid by taxpayers.

Given this, what's the best possible healthcare plan? I'm afraid, Bill, we've pretty much got it.

One more thing-shred this memo!

-HRC