August 2, 1978

Carter Health Plan Correctly Cautious

Just about the time we work up a modicum of enthusiasm for a national health program, along comes Senator Teddy Kennedy to bring us back to earth.

This week he did it again.

President Jimmy Carter labored mightily and brought forth a mouse he termed a "set of principles" that by 1983 will provide womb to tomb health care for all Americans.

To implement "comprehensive health care coverage," Carter suggests that it:

1. Contain "aggressive cost controls" to avoid inflationary pressures;
2. Be "phased in gradually", with consideration given to the results of one phase before the next one takes effect;
3. Insure "freedom of choice" by patients of doctors and hospitals;
4. Be free to the "poor;"
5. Include a "significant role" for the private insurance industry.

Kennedy hit the floor running.  "Failure of leadership," he screamed.

The senator's dudgeon was aroused by the "piecemeal" approach.  He demanded a program that would not contain any "built-in, self-destruct buttons, to halt the program in its tracks if things go wrong!"

There - in one, Freudian slip - Kennedy reveals the fatal flaw of liberalism: Everything must be done at once in one great, untried package and continued indefinitely even if it goes wrong.

Carter has made some bad calls, but he is over the plate with this one.

If public housing, cross-town school bussing, urban renewal, community employment training and a lot of the other social planning failures had been tested first in a pilot project they might have been modified to do some good.  Those programs that are still around - social security and Medicare - would be more useful with tight fiscal restraint.

Public housing now is being torn down as fast as it was thrown up simply because people refuse to live tightly packed together.  Cleveland and our other big cities would be a lot healthier if school bussing plans had had built-in self-destruct buttons.

Kennedy is afraid, with justification, that a health coverage plan with inflation triggers could delay or kill expansion of medical care.  Just so.  That's the whole idea.

The hard fact is that an all-inclusive health care program envisioned by Kennedy can never fly.  There simply is not enough physical dollars available in the gross national product once we have fed, clothed, and sheltered ourselves - given the present level of public employment and social welfare.

Kennedy says a complete program of health care could be put in place for $25 billion.  Joseph Califano, secretary of Health, Education and Welfare, admits to $40 billion.  The General Services Administration, which has badly underestimated the costs of previous social welfare programs, says health care costs will be nearer $60 billion.

If these figures are hard to relate to personal experience, try and recall the flap earlier this year when $7 billion in extra social security taxes were laid on us.  And inflation will automatically increase social security taxes every year from now to bankruptcy in less than eight years.

It is utterly stupid to be talking of new socialist schemes when we can't even pay for the existing ones.  But, then, Senator Kennedy has made a career of stupidity.

As usual he gives us a lot of soft soap about saving what it will cost - by government regulation of doctor and hospital fees, and by eliminating private insurance.  Anyone who has lived through the last 40 years and still believes this may go soak his head.

The village idiot can figure out what Carter means when he says the national health program would be financed through several sources, "including government funding and contributions from employers and employees."

Many Americans will be expected to share "a moderate portion" of their direct healthcare costs, says the president gently, through "deductibles or other payments."  Of course, poor people won't be expected to participate in such "cost sharing."

The golden era of doing good with tax dollars filched from the pockets of working class Americans is over.  We will have to be very wise, very careful, and very honest to keep what we now have.

The only thing we can hope for, realistically, is to transfer Medicare to the federal income tax fund, reduce social security pensions about one-third, and set up an urgently needed catastrophe accident-illness program.

We have got to find a way to provide basic - in contrast to comprehensive - health care for the older poor.

We have got to insure a stable supplement to whatever retirement income we have built for ourselves.

We have got to have government help for those major misfortunes of life no individual can guard against.

These may seem modest goals to Kennedy, or even to Carter, but they are needed, attainable, and a first step.

"Better to light one small candle than curse the darkness."

Author: Lindsey Williams