YOU ARE HERE: LAT HomeCollections

Economics of Clinton Health Plan Debated : Reforms: Area doctors worry about a drop in the quality of care, while business owners fret that they'll be paying more.


President Clinton's plan to provide health care to all Americans was praised Wednesday by Ventura County medical workers as a necessary first step in health-care reform, but local employers worried that they will have to pay the plan's enormous costs.

The plan would provide health-care access to 37 million Americans not now insured and would attempt to control runaway costs.

"I'm saying it's about time," said Samuel Edwards, medical director at Ventura County Medical Center. "The main thing about (Clinton's plan) is that health-care reform is now under way, and I don't think we'll ever go back to where we were. . . . The toothpaste is out of the tube."

Dr. Paul C. Reisser, a family practitioner in Thousand Oaks, said he hopes that by accepting everyone for coverage, the federal health plan will improve overall care. "I'm sick of situations where insurance companies are turning people down because they had one runny nose, one chest pain."

Dr. Harry Menco, a Thousand Oaks oncologist, said many of the cancer patients he treats are uninsured or underinsured. "My patients are in serious need of having security," he said.

But medical professionals joined business leaders in questioning whether Clinton is right in projecting only a $350-billion price tag for his plan for 1994 through the year 2000.

"On top of the cost of the plan itself, we're looking at a considerable cost in loss of jobs for small businesses," said Pierre Tada, vice president of the Ventura County Economic Development Assn., with a membership of about 350 small businesses. "There are so many businesses that are just trying to hang on now. This could be the final blow."

Three years ago, George Mimaki, who owns West Flower Growers in Oxnard, gave his 80 employees the choice of health benefits or a pay raise. All chose the raise, and now Mimaki says he can't afford to provide health insurance unless he cuts his workers' pay dramatically.

"You can see how a health plan is a good thing," Mimaki said. "But right now it spells big trouble for small businesses."

Clinton said the plan would be financed largely through savings, including $238 billion from curbing growth in Medicare and Medicaid spending and increased competition between giant health organizations. He predicts an additional $105 million from a tax on cigarettes.

Some say Clinton's numbers don't add up.

"It has to be financially viable and that is not clear to me at this point," said Phillipp K. Wessels, director of the county's Health Care Agency. "If you generate an entitlement program, and you don't have a way to financially support it, do the benefits get reduced with people getting less?"

Jim Janousek, owner of Components for Automation in Simi Valley, said he doubts Clinton's proposal would cushion the health-care blow for small businesses. In its current form, the proposal would subsidize health insurance for businesses with fewer than 50 employees.

"Once the program goes through, it will be one of those things that will be cut back or disappear completely," Janousek said. "It's a carrot being held out in front of small-business owners so they won't object."

Janousek's company, which makes valves for boilers and blood analyzers, employs three full-time and two part-time workers. The company does not cover the part-time workers, and Janousek wonders how it could afford to do so.

Michael Cline, owner of Star Office Supply in Simi Valley, has the same concerns. His company has four full-time and three part-time employees.

"It's just going to increase the costs for my employees," he said. "When the government says it's a benefit, it may be a benefit for a year, or two, or even five, but as time goes on, because of the way the government's going to run it, it's going to cost me."

Physicians said they, too, will share the cost of the plan.

Reisser said the Clinton health plan may pit physicians against their patients.

"I did HMO care for (2 1/2 years)," he said. "I don't like it and I won't do it (again). In essence, it puts doctors and patients in a conflict-of-interest situation, because the more money spent on a patient, the less money the doctor gets."

Local physicians also worried that independent practitioners who provide personalized care will be squeezed out by big health-care organizations and that the quality of care will be sacrificed.

"I've always prided myself on giving individual care," said Oxnard-based obstetrician/gynecologist Ronna Jurow. "With these big groups you can't spend any time with your patients. What's going to happen to individuality?"

Hoping to find answers to some of their questions about the health care proposal, medical workers in the emergency room cafeteria at Ventura County Medical Center tuned in to Clinton's speech Wednesday evening.

Most said they thought the speech was inspiring in its aims but disappointing in its lack of details about how a new health care plan actually would work.

Los Angeles Times Articles