US Reform Bills "Losing Sight Of Cost Controls"

The current focus in the US health care reform debate on universal coverage has obscured another goal of the program, cost control, disappointing many consumer groups, business executives and labor leaders who joined the battle for health care legislation specifically for that reason.

Some feel the spreading unease could have mid-term political consequences for President Clinton and long-range implications for any economy which will spend about $1 trillion, or 14% of its Gross Domestic Product, on health care. The Congressional Budget Office says that share will grow to 20% in 2003 under current law. Cost-control advocates fear that as the administration seeks votes, some cost restraints in the current bills may be weakened and benefits added.

Representative Richard Gephardt's bill would control costs through fee limits on doctors and hospitals if market forces did not slow the growth of health spending to the rate of growth of the overall economy. Senator George Mitchell's bill contains no controls on health prices, costs or spending but seeks to slow spending growth through a new tax on health plans whose costs grow faster than a prescribed pace and by encouraging competition. Senator Robert Dole said his plan has no mandates or controls but would be financed by Medicare and medicaid cutbacks.