=======================
                         JeffNEWS, July 12, 1994
                         =======================


Healthcare Reform Is Historic, Altruistic and 
Must Include Four Basics for Everybody
---------------------------------------------

By Robert D. Reinecke, MD
   Professsor of Ophthalmology and Director, Foerderer Eye Movement Center
   for Children, Wills Eye Hospital

   I preface all my remarks about healthcare reform by saying how excited I
am by it. It's one of the few times in history that the whole country has
been interested in an altruistic domestic question for an extended period
of time - for at least a year now. That alone has to help the morale and
ethics of the country.

   Now, is there a real crisis? I'm certain there is. I find it
unconscionable that when you get get sick, you should have to worry about
money. We must find some way that we can separate those two issues so that
becoming sick does not cause a second problem of finances. Today, it is a
very serious economic threat to many people when they or a family member
face a serious illness.

   Are a lot of people threatened?  Yes, and these include many people who
tend to fall through the cracks of the present system.

   In Pennsylvania, we have a very good supporting system so that the very
poor receive adequate care, though they still tend to over-use emergency
rooms. Certainly, the affluent have easy access to care.

   The borderline people include those who have to hold down two jobs, have
difficulty getting along economically, then one of the spouses loses a job,
and with it health insurance, so that family is severely threatened.

   That is a very real problem, and anyone who denies it is just not
thinking clearly, as far as I'm concerned. 

   Having stated the problem, what must the solution include?

   I would insist health insurance include at least four things. It must
be:

1. Universal. Some may question the actual numbers of uninsured Americans.
Is it 25 million, 30 million, or 37 million? What does it matter? Even one
person uninsured is too many. We have to be more inclusive and get
everybody into the system. All the other civilized countries have done so.
We must do so.

2. Transferable. The job lock is terrible for many people - being locked
into a job simply because you fear losing your medical insurance. You
should be able to transfer your insurance when you change jobs, with
perhaps a noninsurable period of time before you're eligible for insurance
with your new job. Of course, worse is when you're let out of a job and
don't have another. But there are many really good solutions to that
problem, and I am confident Congress will develop them.

3. Noncancellable. Many patients worry considerably that their insurance
will not cover a particular condition, especially those with long illness
histories. We have so many potential riders on our insurance now, this is a
legitimate concern. It should be eased.

4. Based on a community rating, not a particular group or class. There
should be a definite package that's deductible. No person should be
excluded because of a particular condition or circumstances. If you want
additional benefits, you will have to pay for them on top of a uniform base
for all.

   Despite all the variables, complexities and anxieties, it remains a
miracle of our times that society is considering these issues so openly and
our public being educated about them. It's really a history lesson in the
making.


------------------------------------------------------------------------------
Information provided by:  Editor, JeffNEWS
                          (215) 955-6204
------------------------------------------------------------------------------