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 4. v¢