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value 524
usual db 16.88
Det roi t
Local Doctors Respond
To Health Care Reform
RUTH LITTMANN STAFF WRITER
ew call it a blessing.
Some say it's a step
down the Orwellian road
to a system of health
care controlled by Big Broth-
er.
Medical professionals in De-
troit's Jewish community are
responding to the Clinton ad-
ministration's proposals for
health care reform with vary-
ing degrees of happiness and
outrage.
Dr. Harry Maisel, chairman
of Wayne State University
Medical School's department
of anatomy, favors the plan.
"I think it's excellent. Every-
body should have health cov-
erage," he said.
However, Dr. Maisel, who
also treats geriatric patients
on a private basis, says he
thinks health-care reforms
shouldn't go overboard.
"If the plan promises too
much, then it's not going to be
economically viable," he said.
"I think there should be some
rationing of health care. In Eu-
rope, for example, in order to
get a kidney transplant, cer-
tain strict criteria must be
met."
Dr. Maisel would like to see
the United States implement
a plan similar to the national-
ized system in Canada, where
the government pays for
health care with tax dollars.
Doctors Susan Hershberg
Adelman and Brian Kerman
oppose the idea.
"The system the Clinton ad-
ministration is proposing is es-
sentially, when fully
implemented, a one-payer sys-
tem like the system in Cana-
da," said Dr. Adelman, a
pediatric surgeon who repre-
sented the American Medical
Association on the White
House Health Professional Re-
view Group last spring. "Cana-
da's system is suffering from
rising costs that are rising at
the same rates as those in the
United States. The provinces
are definitely going broke."
Dr. Kerman, a podiatrist
who has a private practice in
Madison Heights and serves
on the staff of four hospitals,
says a one-payer system is lim-
ited.
"For example, if you live in
Windsor and you need a by-
pass, you have to go to London,
(Ontario)," he said. "People
from Canada come here to
practice and seek medical
care."
Dr. Kerman said much of
President Clinton's speech last
F
week was politically motivat-
ed.
"I think what we saw the
other night was Campaign
'96," he said. "Clinton can get,
by virtue of the sensitivity of
the issue, bipartisan support...
"And before (Congress) can
finalize anything, his presi-
dency is probably going to go
into a second term. He's dan-
gling the carrot in front of the
American public and he'll dan-
gle it for another three years."
At Sinai Hospital in Detroit,
Dr. Steven Rabinowe, chair-
man of the Department of
Medicine, expressed hope. He
said the plan, which guaran-
tees universal comprehensive
coverage, might encourage
people to exercise preventative
care — including the current-
ly uninsured who often utilize
expensive emergency room
services when their condition
becomes acute.
Canada's system
is suffering from
rising costs that are
rising at the same
rates as those in
the United States.
The provinces are
definitely going
broke.
Sinai President and CEO
Phil Schaengold said the Clin-
ton administration's plan, as
proposed, would benefit the
hospital by paying it for ser-
vices to the uninsured for
which it is currently not reim-
bursed.
But Mr. Schaengold and Dr.
Rabinowe question how the
United States will foot the bill
for reforms.
"The proposed savings that
would pay for this plan are not
based on valid assumptions,"
Mr. Schaengold said. "There's
a great deal of trust that some-
how we can make this system
so efficient that savings will
help pay for the increased ben-
efits. I don't believe those sav-
ings are there.
"It is identical to the situa-
tion with social security, where
you have an ever decreasing
number of people paying for
an ever increasing number of
individuals." ❑