Two-Tier Health Care
All Americans can rejoice in the positive outcome of President Reagan’s hospitalization and the reassuring results of the examinations that he underwent.
Furthermore, the nation can take great pride in the quality and sophistication of its medical care, without equal in the world, that made possible both the effective treatment and the high-technology tests of the President.
The President, like other Americans who are 65 or older, was eligible for Medicare financing of his hospitalization, tests and surgery. He elected instead to use health-insurance coverage that he has under Blue Cross-Blue Shield and a California state retirement policy, and will pay from his own pocket any costs not covered by the insurance.
Medicare offers substantial protection for short-term acute care, including hospital costs, with the exception of a first-day deductible, and 80% of the physician fees if the doctor agrees to accept the Medicare fee as full compensation. For low-income elderly in California, Medi-Cal pays the premium for the physicians’ portion of the Medicare coverage and picks up deductible and co-payment billings.
Unfortunately, an increasing number of Americans, now estimated at 35 million to 37 million, including about 3 million in California, are without any health-insurance program, be it Medicaid (Medi-Cal in California), Medicare or private programs. For those covered by Medicaid, access to care is often limited because extremely low fees discourage broad participation by doctors. For the medically indigent adult, access to any kind of care, let alone care of the quality received by the President, is problematical.
Los Angeles County offers indigent and other patients all of the basic diagnostic and surgical procedures that the President received through all six of its facilities--County-USC Medical Center, Martin Luther King, Harbor-UCLA, Olive View, High Desert and Rancho Los Amigos--according to a county official. That is a remarkable performance, given the financial squeeze imposed by dwindling state funding.
Many other regions of the nation do not meet those standards, however. The trend toward two tiers of medical service--usually first-class for those with insurance, sometimes mediocre for those without--has encouraged many, including the President, to call for a fresh look at the way American health care is financed.
