Some developments that merit further attention:
House Speaker Newt Gingrich may need all the friends he can muster, but his recent pandering to military veterans could send the wrong message. Speaking at a VFW convention in Salt Lake City, the Georgia Republican said he hopes to form a congressional commission to study ways of improving standards of care for veterans because they deserve better medical treatment. While those who risked their lives for the nation are worthy of respect and reward, Gingrich should avoid advocating expansion of the Department of Veterans Affairs hospital system. Veterans should have access to quality care, but a voucher system linking them to private-sector providers is a better way to spend taxpayers' money.
Those taking satisfaction with the high-profile criminal investigation of Columbia/HCA Healthcare Corp. should remember that the government often targets the big players in order to discourage smaller competitors from breaking the law. While Columbia's business practices are proving the company vulnerable, it's best for others not to throw stones. Recall the investigations and congressional hearings in 1992 of a number of prestigious not-for-profit hospitals. As Karen Pallarito pointed out last week (Sept. 1, p. 2), the hospitals were charged with doing some of the same stupid things that drew the government's attention to Columbia. Healthcare providers should focus on their own billing programs and financial arrangements, rather than Columbia's legal woes.
Medical savings accounts are a vivid example of making so much out of so little. During last year's raging debate over rules and limits on MSAs, conservatives had us convinced the individual accounts are a symbol of freedom, liberty and patient accountability. Critics, led by Sen. Edward Kennedy (D-Mass.), branded MSAs a tax dodge for the rich and healthy that could wreck Medicare and inflate the cost of private insurance. The congressional compromise included in the 1996 health insurance reform law was a modest MSA demonstration project that ends Dec. 31, 2000. But the public has mostly yawned, leaving enrollment far short of the legal limit. The fate of MSAs ultimately will be determined by the benefits provided and how the accounts are marketed to individuals. The political rhetoric has done little more than delay that process.