Page 4-Tuesday, September 11, 1979-The Michigan Daily
Ninety Years of Editorial Freedom
Vol. LXXXX, No. 5 News Phone: 764-0552
Edited and managed by students at the University of Michigan
Soviet troops in uba:
Kennedy's health plan gives
power to insurance companie
Not another
W HAT STARTED' as a simple in-
quiry into the Soviet military
presence i Cuba has now blossomed
- thanks to the harping of cold
warriors and Senate opponents of the
SALT II treaty - into the latest in a
series of recent confrontations bet-
ween the Carter administration and
the Kremlin. And once again, as is
usually the case when exaggeration
and hawkish hysteria take the place of
logical assessment, the issue of troops
in Cuba is much ado about nothing.
Of course once the administration
confirmed the presence of 2,000 Soviet
combat troops in Cuba, the SALT op-
ponents - seeing their demogogic
harranguing losing support in the face
of a reasonable assessment of the pact
during the hearings - seized the issue
as the newest front from which to at-
tack the treaty.
And of course, the administration -
put on the defensive durftig the SALT
debate and challenging the charges of
' appeasement" - was forced to take a
hardline stance, that the "status quo"
was unacceptable and that the United
States would use "firm diplomacy" to
rectify the situation.
And of course the SALT treaty itself,
which just last month seemed likely to
pass, has now been invariably linked in
public and private debate to the issue
of the Soviet combat brigade in Cuba.
Fortunately, the level-headed leaders
of the Senate, notably Sen. Robert
Byrd (D-W. Va.), had the forthought to
postpone debate on the treaty to keep it
from falling prey to the Senate right-
wingers who still see superpower
relations through cold war lenses.
So the result has been that the
strategic arms pact, which makes a
significant contribution to reducing the
likelihoof of nuclear war, is being held
hostage by the same irrational few who
have tried unsuccessfully in the past to
link the treaty to Soviet trials of their
own citizens, to Soviet involvement in
Africa, and to the Kremlin's
emigration policies.
In that context, the discovery of
Soviet troops in Cuba .has been
axaggerated, distorted, taken out of
context, and for the most part widely
Fmisunderstood.
According to U.S. intelligence repor-
ts, the Soviets now in Cuba do not
possess air or sealift capabilities and
pose no threat to the security of this
country. In fact, the administration
has confirmed that the small Soviet
brigade is not even a menace to the
smallest of Latin American countries,
as if the Kremlin would be so short-
sighted as to actually ever consider
using Soviet troops to attack a country
in this hemisphere.
The outrage over the Soviet military
-
missile crisis
presence there is based on U.S. - Soviet
agreements reached after the Cuban
Missile hysteria of 1962, and on the so-
called Monroe doctrine of 1823. Butt
that 1962 agreement, never made
public, does not cover the presence of a
combat unit. And the Monroe Doctrine,
the last vestage of American im-
perialist mentality and the theory of
white man's burden, is a unilateral
doctrine that is as unrealistic as it is
ridiculous.
There is a dangerous and disturbing
pattern of hypocrisy in this country's
dealings with the Soviet Union. We
resist strongly Soviet attempts to gain
a foothold in Africa, while we hold it as
our right to attempt to extend our own
influence there to the point of covert
activities; that we protest indignantly
Soviet treatment of Jewish dissidents,
and become incensed when another
country comments publicly on affairs
which we consider domestic; That we
express public outrage over the
Ayatollah Khomeini's executions in
Iran, while pulling the switch on John
Spenklink in Florida.
The hypocrisy of American foreign.
policy has once again reared its
proverbial head with the issue of Soviet
troops in Cuba. The administration of-
ficially objects. They have to object,
since that is part of the game of
diplomacy. But there are also
American combat troops in various
places around the world which the
Soviets perceive as a threat to their
security and to which they object. Most
notably, there are currently 2,203 U.S.
military personnel in Cuba at the
Guantanamo Naval base, and we
reserve the sacred right to keep that
base there - against the wishes of
President Castro - while objecting to
an equal number of Soviet troops in
Cuba.
What makes the presence of Soviet
troops even more of an exaggerated
non-issue is the fact that the troops are
largely a symbolic show of force,
either to demonstrate Soviet solidarity
with the Castro government or to
discover any coup attempts - from
within Cuba or from outside - against
the Castro regime.
The troops there are only a symbolic
force. The administration hardline
response was symbolic, although now
the United States has painted itself into
a corner for the sake of SALT, and may
now not be in a position to accept
anything less than a complete .with-
drawal. And no doubt the Soviets, for
symbolism's sake, will have. to stand
firm.
And once again, symbolism, not
logic, is influencing and molding the
foreign policy of nations. And that is
truly the saddest chapter in the. con-
tinuing saga of U.S. - Soviet relations-
With the unveiling of his
"Health Care For All Americans
Plan," Senator Edward Kennedy
has joined a growing field of
politicians who are again placing
national health insurance near
the top of the political agenda.
The new Kennedy proposal is
being characterized as more
comprehensive in its coverage
and more liberal in its benefits
than the gradualist plan proposed
by the Carter Administration.
But critics contend that by
allowing for the participation of
private insurance companies as
"financial intermediaries" the
new Kennedy proposal is a
serious retreat from the concept
of national health insurance put
forward by himself and others in
the late 1960's and early 1970's.
AT LEAST four separate and
competing proposals for national
health insurance are now being
seriously pursued in Congress,
but only two - Kennedy's and
Carter's - are given a chance of
passage. These two proposals are
similar in major ways. Besides
providing a role for private in-
surance companies, both would
be financed primarily from em-
ployer-employee contributions.
Both contain provisions for
quality standards and cost con-
trols (which critics say are
inadequate), and neither would
directly affect the distribution of
medical resources or the kinds of
services offered.
The Administration plan would
phase is national health insuran-
ce over a period of several years.
The first phase would cover only
the aged, the poor, the unem-
ployed and those suffering from
catastrophic health expenses.
Other citizens would be included
later.
The Kennedy proposal which is
not yet in bill form, would include
all citizens and is more liberal in
its benefits. It has the endor-
sement of most of organized
labor, including the AFL-CIO, as
well as numerous civil rights and
church organizations.
THE EARLIER Kennedy
proposal omitting the private in-
surer has been re-introduced by
Rep. James Corman (D-C a), its
original co-sponsor. The bill
would involve the government
directly with health care
providers through a federal
health insurance corporation. In
addition, the bill would fund 50
per cent of the program out of the
progressive income tax. In the
new Kennedy version, the bulk of
financing would come from an
employer-employee payroll tax,
which authoritative economists
consider much more regressive
than the income tax.
The forth major proposal,
sponsored by Rep. Dellums (D-
C a) would create a national
health service. It would establish
a nationwide network of com-
munity-based health centers con-
trolled by health care consumers
and health workers. The program
would be financed by a separate
progressive health tax on per-'
sonal and corporate income. The
American Public Health
Association, representing the,
public health professions, has en-
dorsed the proposed Dellums
Health Services Act, but it is
given little chance of passage.
Kennedy's Health Care For All
Americans is designed to be
eminently passable. Organized.
labor is -likely to stick with it,
whatever its deficiencies. It not
only guarantees the future of
union health plans by
federalizing them (a major gain
in light of cutbacks in a number
of union health plans following
bitter contract disputes), it also.
provides a financial advantage
to unionized workers. Non-union
workers would be required to pay
35 per cent of the payroll tax that
would fund it. Unions, however,
would have the option of trying to
force the entire burden of that tax
on employers through collective
bargaining.
THE PROVISIONS of what one
Kennedy spokesman called "a
meaningful role for private in-
surance companies", could go a
long way toward neutralizing the
opposition of the powerful Blue
Cross and Blue Shield health in-
surance organizations, as well as
that of the American Hospital
Association (AHA) and the
American Medical Association
(AMA), which maintain close ties
to the "Blues."
It is precisely this private in-
surance provision in the new Ken-
nedy proposal that critics argue
is a damaging retreat from an
acceptable national health in-
surance plan. Corman argues
that allowing a proliferation of
private insurance plans - and
structuring separate programs
By Martin Brown
for the employed, the unetm-
ployed, he old, and the poor -
will result in a program "that is
not really universal health in-
surance, that creates a great
disparity in the ways in which dif-
ferent people are treated. You
will end up with a program that is
unmanageable."
Corman's Health Security Act,
formerly the Corman-Kennedy
bill, has forty-seven co-sponsors
in the House. "We are going to try
to move national health insuran-
ce as fas as we can in this direc-
tion," a spokesperson for Corman
said.
OPPONENTS OF THE current
Kennedy and Carter proposals
also contend that the par-
ticipation of private insurance
companies will obstruct cost con-
trol. Says Marilyn Elrod, a health
specialist for Rep. Dellums: "We
are totally against the Kennedy
and Carter proposals. Once you
let the insurance companies in,
you will never be able to control
costs."
Before Medicare passed, the
late Sen. Wayne Morse (D-OR)
warned against including Blue
Cross as financial intermediary.
"Blue Cross is essentially a
creature of the hospitals," he
argued. "It cannot possibly serve
as an agent of the government."
However, Blue Cross and the
AMA had engaged in intense lob-
bying to assure a role for Blue
Cross under Medicare and later
Medicaid.
THE RESULTS seem to con-
firm the fears of the critics like
Morse. After the implementation
of Medicare in 1967, the rate of in-
flation in medical care costs,
already high, doubled. Numerous
investigations have attributed
this super-inflation directly to the
poor financial supervision
provided -by Blue Cross, which
serves as the financial inter-
mediary for 6,876 out of 7,906 of
the hospitals participating in
Medicare.
According to Sylvia Law, of the
Health Law Project of the
University of Pennsylvania, "The
picture that emerges (of Blue
Cross) is one of total unaccoun-
tability. Hospitals are paid in ad-
vance for whatever they claim.
Books are audited, often years
later, by commercial auditors
(hired by Blue Cross) with no par-
ticular expertise in health ser-
vices and no capacity to judge
whether or not a cost is
reasonable... when particular
items are caught and questioned,
the hospital can engge in an ex-
tended dispute with the inter-
mediary, confident that the in-
termediary will not be ex-
cessively 'aggressive' in pursuing
the matter."
Profit-making insurance com-
panies would have equally strong
financial motives for permitting
inflated health care costs and the
proliferation of unnecessary and
expensive services 'to continue:
the larger the total flow of money
through private insurance com-
panies as financial inter-
mediaries, the larger is the
volume of profits they can realize.
THE NEW Kennedy proposal-
specifically eliminates some of
the most atrocious financial
abuses that have occurred under
Medicare, such as the ways in
which hospitals are allowed to ob-
tain reimbursement for capital
depreciation costs. And a Ken-.
nedy spokesperson told PNS that
by encouraging competition in the
health insurance industry and by
requiring prospective budgeting
(setting costs in advance of.
payment), the Kennedy plan
would provide effective cost con-
trol measures. Kennedy claims
that the program will actually
result in a cut in total national
spending on health care by $38.
billion a year b 1983.
But critics are skeptical of cost-
control mechanisms that fail to
break-up the cozy relationship
between health care providers
are private health insurance
organizations. Says Elrod, "We
have had a kind of prospective
budgeting under Medicare and.
that hasn't stopped the ac-
celerating ratesof health care in-
flation."
As it stands, the critics charge,
the Kennedy and Carter plans
would only pour more money into
a health care system plagued by
professional rigidity and
stagnation. The bills would do
nothing to correct the current-
severe maldistribution of health
care resources, or to ease the
national burden of health cost i
flation..
Martin Brown is the former
West Coast representative o
Science in the Public Interest
and author of The Socia!
Responsibility of the Scientist.
He wrote this piece for the
Pacific News Service.
SArica
Patricia A. Theiler
member of the
editorial colective:
of The Alchemist'
of Ann Arbor
September 10
Letters
Jews differ on South
To the Daily:
In his September 7th editopial
entitled "Black-Jewish Rift
Began Before Andy Young Af-
fair," senior editor Keith Rich-
burg ' asserts that Young's
resignation did not produce an
immediate polarization of these
two minorities, but rather that
animosities had been brewing for
quite some time. He attributes the
ideological separation to a lack of
consensus on a political issue,
namely relations with South
Africa.
According to Mr. Richburg,
blacks and Jews are no longer
able to maintain the once fruitful
relationship enjoyed during the
civil rights movement because
they differ too intensely in their
views toward the African nation:
Israel, and therefore American
Jews favoring the continution of
investment and arms sales,
blacks fervently opposing support
for the repressive white minority
government.
What the editor fails to realize
is that Begin's policies toward
South . Africa do not necessarily
mirror the views of all Israeli
citizens, nor do they represent a
consensus opinion among
American Jews. Certainly not all
Jews agree with Israel's actions,
in fact many deplore her blatant
Similarly, it is just as unfair to
assume all Israeli citizens and
American Jews uphold a policy
which has been a major source of
conflict in Israel. Allegiance does
not dictate agreement.
-Judith A.Freedel
September 9
Alchemist
To the Daily:
The fall supplements of the
Michigan Daily serve a valuable
purpose by informing new studen-
ts of the many services in Ann Ar-
bor. I was disappointed to notice
in the Thursday, September 6th
issue of the paper, however, the
absence of coverage of two ser-
vice organizations set up to meet
the needs of the community.
In the article comparing the
prices of local grocery stores in
the campus area, there was no
mention of the many food co-ops
in town. The co-ops provide whole
foods (additive and chemical
free) on a non-profit basis. There
are discounts available at all the
co-ops. (Members of the People's
Food Co-ops can earn a 20 per
cent discount on food if they work
one hour a week). The co-ops are
located on 4th Avenue near the
Farmer's Market and on Packard
near the State St. intersection.
tainment, and alternative
lifestyles.
Perhaps future Daily articles
will address the need of students
in town to be aware of the many
resources which provide choices
that fit their needs and interests.
II I I,..
lilt i/ YM
t~Cs
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