Republicans are calling President Bill Clinton’s formation of a commission to look into managed care an election ploy. They may be right. Neverthless, the federal government has an obligation to keep up with the changes in this rapidly growing industry.
The purpose of the commission, announced last week, is to recommend ways to protect consumers against changes in the health care industry. It will examine where the risks are to the quality of care as economic pressures exert greater force on the system. The commission is also a signal that the Clinton administration intends to take up health care reform again, if the president wins a second term.
Enrollment in health maintenance organizations has increased by 60 percent since 1991. More than 60 million people are now enrolled in HMOs and more soon will be. This increase partly explains a recent survey of 4,000 doctors that showed their incomes to be falling. More changes in the system are coming — more mergers between health plans and insurance companies, hospital- and doctor-created plans, and, everywhere, the effort to hold down costs will encounter demand by patients for the latest technological improvements in medicine.
Added to all of this, of course, are the millions of Americans who have no health insurance and enter the system through the most expensive route: the emergency room doors. Finding a place for them under managed care will be the largest challenge for the commission.