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Washington Diary: Another Dose Of Harry And Louise

By Margaret Carlson

Time cover (TIME, November 24) -- It's open season!" shouts one brochure. You bet it is--on us. Like lambs to the slaughter, we must make our "health-care elections" by Nov. 30, which means paying more money for less care, even as the cost of other necessities, like bread, milk and Big Macs, is holding steady. My insurer, Kaiser, has hiked premiums 18% since the Clinton health-care bill died a miserable death in 1994. And 8% fewer Americans have health insurance because their employers have decided it just costs too much. Boy, did we show that busybody Hillary a thing or two. It's true that there aren't any of those pesky government bureaucrats mucking around in your health care--instead it's bureaucrats at Aetna or Prudential whom you must convince that those heart palpitations call for a look-see by a cardiologist. The great fear that you wouldn't be able to see your own doctor under Clinton care has been replaced by the reality that you won't be able to see any doctor at all. At one HMO you can see a nurse-practitioner in a week, but it takes three months to schedule an appointment with a normal, run-of-the-mill doctor. A specialist? Forget it. Major surgery? Yes, if you really, really need it. But they'd rather you not spend the night.

For those who killed health-insurance reform, however, drive-by mastectomies are not efficient enough. The Health Insurance Association of America (which spent $10 million in 1993 on ads featuring hyperyuppies Harry and Louise, who spent their evenings worrying over the Health Security Act), along with an amalgam of industry groups, is marshalling its forces once again, as if some socialist, Swedish-type system were about to land on these shores. It's girding to defeat several pending bills that would correct some marketplace excesses. A provision in one bill would ensure that a woman could have direct access to an obstetrician (a specialist, after all) throughout her pregnancy. Another would allow emergency care anytime a "prudent layperson" would consider it appropriate. Another would remove bonuses for doctors who restrict care.

But the industry isn't going to take these fixes sitting down. "We need to start fighting like we're in a war," says HIA counsel Melody Harned. The Republican leadership, Harned wrote in a memo, asked the coalition to "write the definitive piece of paper trashing all these bills" and launch a grass-roots effort against them. But she warned that Republicans wanted a commitment (spell that money) from the coalition before they go out on a limb. "Get off your butts, get off your wallets," Harned quoted Senate majority leader Trent Lott as saying.

After the memo was obtained by the New York Times, Harned said she had no knowledge that Lott actually said those words. Still Lott is against legislation by body parts, not wanting Clinton to achieve by salami slice what he couldn't with the health-care bill. Lott named his meeting to fight the piecemeal bills "Clinton Care Returns: The Trojan Horse Strategy."

At this rate, soon we'll be offered a plan where the premium doesn't rise but you perform your own minor surgery at home. Novocain? Supply your own.





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