The Daily Tar Heel/ Wednesday, April 14, 1993
2
Group seeks to streamline U.S. health care
By Jason Richardson
Stale and National Editor
J . Pamela Bailey, president of the
Healthcare Leadership Council, said that
under a health-care system proposed by
"her group, all Americans could be cov
ered without any net increase in costs.
r .' “We think we’re spending enough
money now to take care of our health
care needs,” Bailey said in an interview
Tuesday. “We must retarget and spend
efficiently so that all Americans can get
the health care they need.”
Bailey’s organization is a group of
50 health-care industry CEOs formed
to establish a consensus on solutions to
the nation’s health-care crisis.
Bailey said the group was watching
First Lady Hillary Clinton’s task force
on health care carefully.
“We are pleased to see the emphasis
the president has placed on the issue,”
Bailey said, but she added that she would
reserve judgment until she saw the plan’s
final draft.
“The basic framework (of the Clinton
plan) is managed competition, the re
form of the health-care system that we
have supported for some time,” she
said. “It is unclear whether the final
plan will include the heavy hand of
regulation,” which would damage the
chances for real reform, Bailey said.
But Bailey said government did have
an important role to play in reforming
the marketplace for health care.
“Government can play a role in set
ting rules, especially in the insurance
market,” Bailey said, adding that prac
tices such as “job-lock,” under which
workers cannot leave bad jobs because
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they need health-care benefits, and the
firing of sick employees should be ended
by government.
“Government can also help Ameri
cans who don’t have coverage. Medic
aid needs to cover all of the poor,” she
said. Eventually, Medicaid could be
folded into the managed-competition
system, Bailey added.
“What we don’t need is for govern
ment to take over the health system,”
she said. “No government regulation
has ever been as merciless as the mar
ket.”
The Healthcare Leadership Counci 1’ s
managed-competition plan would have
some government involvement but
largely would rely on market solutions,
Bailey said.
“Managed competition is based on a
strong belief that quality needs to be
identified clearly and rewarded with
more business,” she said. “Competition
for patients should be on the basis of
cost, quality and patient satisfaction.”
Bailey said having health-care pro
viders compete for patients would en
sure that the providers who had the best
quality at the lowest cost stayed in busi
ness, while inefficient providers would
have to change to survive.
The managed-competition approach
would utilize private firms and “com
munity nonprofit purchasing coopera
tives” that would offer choices of health
care plans to individuals and small busi
nesses.
These individuals and firms would
read from a “Consumer Reports-like
publication” that would show the cost
and quality ratings of each health-care
Wilson
a member of the BCC Advisory Board.
The Wilson site, the last clear con
struction site on the main quad, is a
prime candidate for expansion of sci
ence departments.
Without referring specifically to the
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provider. The consumer then could
choose the provider and plan that best
suited his needs, Bailey said.
Because the results would be avail
able to the public, “doctors would have
every incentive not to overtreat or
undertreat,” she said.
Also, because most people using the
system would operate on a yearly pre
mium basis, rather than the current “pay
as-you-go” method, doctors would have
more incentive to practice preventive
medicine. Under the proposed system,
“doctors’ only task is to keep patients
well and to do it in the most cost
effective manner,” Bailey said.
Under a premium system, compa
nies or individuals would pay a lump
sum at the beginning of the year and
then pay a small fee each time they went
to the doctor. Although the fee would
only be around $5, this would discour
age overuse by patients, Bailey said.
Patients still could choose to pay a fee
for each service, but Bailey said that
would be one of the most expensive
options.
Under this plan, companies that paid
health-care benefits to their employees
would pay the premium directly to the
purchasing cooperative.
However, Bailey said her group did
not advocate a mandate for employers
to pay health-care benefits. “But the
reform system makes (health-care) plans
affordable,” she said. “Most companies
want to provide coverage, but they caij’t
afford it.”
For individuals and companies that
still could not afford to pay for employ
ees’ health care, Bailey’s organization
Wilson site, Feiss said the science divi
sions of the College of Arts and Sci
ences were in severe need of more in
structional and library space.
Venable Hall and Kenan Labs, both
science buildings, border the Wilson
site, and some department officials have
expressed an interest in building a sci
ences building next to Wilson Library.
The University administration has
had an alternative agenda throughout
the months of site negotiations, Amana
said, and advisory board members be
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recommends a subsidy, which would be
paid directly to the individual.
Bailey stressed that any plan should
provide for continued research and de
velopment in health-care issues. “Any
reform plan absolutely must preserve
the innovation that distinguishes this
health-care system from all the others in
the world.”
However, she said cutting costs also
was a major priority. “Incentives in a
reformed health-care system would (en
courage providers) to continue to seek
more cost-saving therapies.
Eliminating frivolous malpractice
lawsuits is another major issue addressed
by the plan, Bailey said. “We need to
reform the malpractice system to mini
mize defensive medicine,” she said.
Defensive medicine costs an esti
mated $36 billion per year, Bailey added.
The best way to reform malpractice
systems would “involve discussion with
trial lawyers and medical malpractice
experts,” Bailey said. “The end result
must be to cut costs.”
Involving pharmaceutical companies
in the plan would help keep drug costs
affordable, she said.
Bailey also said her group was against
a rationing plan, such as the one intro
duced in Oregon. “Asa nation, we don’t
need to be looking at rationing at this
point.”
The final result of the group’s plan
would be to provide affordable health
care for all Americans, while maintain
ing high standards of service, Bailey
said.
“We must offer a peace of mind that
Americans can afford.”
from page 1
lieve they “have not always been given
a fair shake.”
Mark Chilton, a Chapel Hill Town
Council member and UNC senior, told
the committee that Chapel Hill’s Re
search Conservation District laws might
prohibit construction on the Coker site.
Chilton said he believed the zoning
laws would bar any construction on the
Coker site by private citizens. “If any
body besides the University owned this
piece of property, it would be deemed
unbuildable,” he said.
Legislature considers
‘Truth in Sentencing’
By Andrea Jones
Assistant State and National Editor
N.C. Attorney General Mike Easley
and state legislators are pushing for a
Truth in Sentencing Act that they hope
will make citizens more aware of the
amount of time convicted criminals
spend behind bars.
Senate Bill 831 was brought before
a committee Tuesday. If it passes in
both houses of the General Assembly,
it will become effective this January.
N.C. Chief Deputy Attorney Gen
eral Andy Vanore said Easley thought
the bill was important because it let
both offenders and citizens know how
much timeconvicted felons were serv
ing. “Easley feels... people have the
right to know that when we’re sen
tencing a person to 10 years, that per
son isn’t going to serve anything like
10 years,” Vanore said. ‘That’s why
it'scalled the Truth in Sentencing Act.”
N.C. Sen. Dennis Winner, D-Bun
combe, the bill’s sponsor, said he
agreed with Easley. “The people ought
to know what is really likely to hap
pen. It just adds a little more truth in
the process," he said. The bill would
require the N.C. Department of Cor
rections “to quarterly report the aver
age length of sentencing that is served,”
Winner said. “In other words, if three
years is usually served for a 10-year
sentence, they would report that.”
He said the effects of the proposed
bill wouldbe felt in the courtroom. “At
sentencing, the judge is to inform the
people what the average time served
for sentencing currently is.”
According to the N.C. Sentencing
and Policy and Advisory Commis
sion, criminals were serving 40 per
cent of their sentences in 1987. Cur
rently, felons serve about 18 percent
of their sentences, and nonfelons serve
less than 10 percent of their time.
V anore said he thought the Truth in
Sentencing Act would alert the public
to the dilemma created by North
Carolina’s overflowing prisons. “Be
cause of the prison overcrowding situ
ation, nowadays when a person is sen
tenced to, say, 10 years for breaking
Campus Calendar
WEDNESDAY
5 p.m. UNC Vegetarian Club will offer free
vegetarian dinner in the park across from the Franklin
Street Post Office until 7 p.m.
International Center will hold an English Con
versation Partners Program Reception for all Ameri
can and international partners and their families in the
Toy Lounge on the fourth floor of Dey.
5:15 p.m. Asian Students Association will hold a
cultural workshop on Laotian Dancing in 206 Union.
5:30 p.m. Lutheran Campus Ministry will hold
a worship service followed by a fellowship meal at
and entering, that person ... eventu
ally serves about three years,” he said.
Stevens Clarke, a professor at
UNC’s Institute of Government, said
sentencing reform bills were nothing
new for legislators.
“There’s actually a bunch of bills,”
he said. “These bills were drafted for
the N.C. Sentencing and Policy Advi
sory Commission, which was set up
by the General Assembly to improve
... sentencing laws.”
Clarke, who drafted the sentencing
law that has been on the books since
1981, said new bills had attempted to
introduce laws that would have more
widespread effects than the proposed
Truth in Sentencing Act
“(They introduce) anew system of
sentencing, not only for felons, but
also for misdemeanors,” he said.
“These bills recommend ... a sen
tence based on the offense and the
offender's previous criminal record.
It’sdifferentfromprevious law in that
it’s more specific. Previous law does
include a presumptive sentence, but it
doesn’t tie the judge down as much.”
Robin Lubitz, executive director of
the N.C. Sentencing and Policy Advi
sory Commission, said the organiza
tion had drafted several bills that also
were being reviewed by committees.
“Thecommissionhas... introduced
a package of five bills,” Lubitz said.
“They’ re truth in sentencing bills also,
but they’re a little different. We're
proposing that the judge have a maxi
mum and minimum sentence(foreach
offender).”
He said Winner’s bill could be help
ful but added that quarterly averages
might be misleading in the face of
rapidly plummeting percentages of
time served. “Even though that’s what
they’re servingnow, that doesn’tmean
that’s what they will be serving by the
time they’re ready to get out.
“The bill is a step toward truth in
sentencing, and I think it’s a step in the
right direction, but it doesn’t go quite
as far as our bills do,” he said. “It’s a
step toward letting the public know
how much time criminals are serv
ing.”
6:15 p.m. at the Holy Trinity Lutheran Church on
Rosemary Street.
Newman Center will present a program by Rich
Henderson of Intervarsity after dinner.
Student Branch of the N.C. Association of Edu
cators will meet to discuss “Understanding Diver
sity” in 220 Peabody.
International Relief Committee will hold a sym
posium titled “How to End Atrocities in Bosnia” with
Dr. Letica, former adviser to the president of Croatia,
in 100 Hamilton.
VAC will hold an informational meeting on how to
volunteer with children in the Campus Y lounge.
UNC Pre-Law Club will hold elections in 206
Union.
7:30 p.m. Student Congress will meet in Room 2
of the Law School.
Carolina Critic will hold its general staff meeting
in Suite C of the Union.
UNC Hillel will welcome Professor Henry
Landsberger to discuss Jewish life in Germany in 112
Saunders.
SEAC will welcome the director of the Carnivore
Preservation Trust to speak on endangered species in
224 Union.
8 p.m. United We Stand UNC will meet in 203
Dey.
9 p.m. WXYC 893 FM will present Dance Music
on Wednesday Night Feature.
GEORGE
CARLIN
LIVE!
> ,
an %
April 22