American Health Care Could Look Like UHS

If you don't like University Health Service, you're going to hate the health care reform that will be introduced next month by a task force chaired by Hillary Rodham Clinton.

That, at least, is what doctors at UHS and experts in college health service so about the upcoming reforms.

On the face of it, university health services compare a small part of the nation's health care system. Of the $838 billion spent on health care last year, $1.4 billion was spent in student health services.

UHS is structured much like the new model in that it is a health maintenance organization. Clinton's plan is expected to set up a system where HMO's would compete for patients with some government restriction.

College health service, like the anticipant new American system offer pre-payment plan that over certain types of care and exclude others. And the health service also emphasize care by general practitioners and restrict access to specialists--characteristics certain to be part of the national reforms.

"I'm sure that if the whole country was managed the way UHS was managed we would only be paying a fraction of the health costs," says Dr. Kenneth Gold a UHS primary care physician.

Officials at the American College Health Association (ACHA) have lobbied the Clinton task force to consider health services as a model. "The model of college health services deserves close scrutiny by health over reformers," David P. Kraft, the ACHA president, said in a statement.

"College health services successfully respond to cries for accessible responsive quality services at an affordable cost. Indeed, the college health model fully integrates direct medical and psychological care with health education activites to promote healthier lifestyles." Kraft said.

UHS Director," Kraft S. Rosenthal '59 says the health services cooperative approach must be transferred to the new system.

"You can't run a national health care system with everyone thinking of me," says Rosenthal. "You've got to stop thinking about what is beat for me as a pharmacist, me as a nurse, me as a doctor. . ."

While doctors nationwide have expressed nervousness and trepidation that reformed may limit their choice and reduce their salaries, UHS physicians worry more that the Clinton plan could not go far enough.

"I'm very optimistic," says Dr. Firemon E. Hardenbergh, chief of ophthalmology at UHS. "I just hope the present administration isn't too timid.

"I'm in favor of party socialized medicine," says Dr. Sidney Wanzer, the director of the UHS satellite clinic at Harvard Law School. "I really like the Canadian model.

But doctors at UHS have some cause for concern about the new reforms. Chief of Medicine Dr. Charles Weingarten worries that the Clinton plan could make some parts of UHS taxable. And some doctors say many of their peers may lose some degree of autonomy under the upcoming plan.

"A lot of doctors go into health care because they think they will control themselves," says Dr. Robert Fasciano chief of the dental health service. "They don't control themselves anyone. The insurance companies look at a service and say we don't cover that. And patients think that means it's not needed.

Not everyone, though sees UHS as a useful model."

"My gut is it's not going to be a part of anybody's reforms," says Lee Professor of Health Policy Robert Blendon. "At a university health services, you have a population that is health and doesn't need may service. The world at large is bigger, less healthy with much different kinds of problems."