Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, April 21, 1993                   TAG: 9304210328
SECTION: EDITORIAL                    PAGE: A-11   EDITION: METRO 
SOURCE: CAL THOMAS
DATELINE:                                 LENGTH: Medium

DON'T GET SICK

Magaziner says the task force plan will guarantee - yes, guarantee - health care to all individuals, no matter how sick they are, whether they are employed or unemployed, whatever their economic status, from cradle to grave. (Actually, the president wants to make abortion part of the plan, so it might be said that his proposal will extend from womb to grave.)

This is a utopian dream that will cost a fortune, or reduce the quality and availability of care, or create lengthy waiting lists for some procedures - or all of the above.

I called my doctor to see what difference the emerging Clinton health plan might make in his ability to provide the same level of care he has been giving my family.

Dr. John Curry is a primary-care giver in family practice in Northern Virginia. He says government's heavy-handed behavior in the Medicare program for the elderly ought to be a warning of worse things to come.

Each new regulation, says Curry, is accompanied by threats of fines and jail terms for doctors who are found to have violated increasingly complicated rules. Many doctors, he says, have stopped accepting Medicare patients because the doctors don't get paid what their services are worth and there are too many hassles.

Time was, says Curry, when a doctor could bill Medicare a set amount for an office visit, but bureaucrats have created five separate categories of office visits and frequently second-guess doctors as to the proper category and fee.

The health maintenance organization, or HMO, is another preview of coming attractions, according to Curry. In exchange for a fixed fee, a patient can call the primary-care giver for the tiniest ailment.

Under the HMO contract, says Curry, "I expected to see only really sick folks and maybe do some annual physicals, but they make me carry a beeper and I not only get an average of six calls a night for the most minor problem, people want to come in and see the doctor for a cold. When they had to pay $20 out of their own pockets for an office visit, they would treat their own colds and I could see people who really needed to be seen."

Government-managed care will make it harder to reach the doctor. Physicians will increasingly rely on nurses and medical assistants to treat patients' ailments. Waiting lists will grow. "Where medical care used to be a relationship between a patient and the doctor," says Curry, "it will become a relationship with an amorphous organization, supervised by businessmen and overseen by the government."

When Big Brother is the supervising party of primary care, predicts Curry, it will be the frustrations and bureaucracy of Medicare multiplied by 10.

Before we rush to embrace Ira Magaziner's (and Hillary Rodham Clinton's) medical vision for the future, everyone should read a satirical but frightening article in the March 22 issue of Medical Economics magazine. Emergency physician Frank Venuti of Flats, N.Y., called it "If Medicare Ran Baseball." Venuti says games would be held in the snow. Some home runs wouldn't count. New rules would come out every other week. The games are broadcast on "The Government Fairness Network."

It's enough to make you sick, but you'd better not be. Chances are the doctor won't be available for some time - if ever. Los Angeles Times Syndicate