While many Americans have greeted President Clinton's national health care proposal with enthusiasm, two Harvard Medical School professors complain that the proposal would "obliterate private practice" and "complete the corporate transformation of American medicine."
The two professors, Associate Professor of Medicine Dr. David U. Himmelstein and and Assistant Professor of Medicine Dr. Steffie Woolhandler, voiced their criticisms in a letter that appeared in Sunday's New York Times.
Himmelstein and Woolhandler co-direct Harvard's Center for National Health Program Studies at Cambridge Hospital.
The letter blasted Clinton's plan for its emphasis on managed competition, which the two professors believe will encourage health maintenance organizations and large health insurance companies at the expense of small health care providers.
In a phone interview yesterday, Woolhandler said, "The Clinton plan will be one that essentially limits the choices of patients and the choices of physicians."
He said that neither patients nor doctors will have the choice of smallscale, non-HMO practices. "Managed competition will destroy the pieces of the American health system that do work," Woolhandler said.
Himmelstein said he feels that the large insurance companies stand to gain the most from Clinton's plan. "Basically the only health care In their letter, the physicians claim thatClinton's system will hurt private practitionersand specialists, depriving the public of thatoption and leaving approximately 275,000physicians in a "private practice sector devoid ofpatients." Himmelstein explained that they wrote to "pointout that...there would be a massive disruption forboth doctors and patients." "Our intentions were to let people know whatmanaged competition means. There are implicationsto the plan that the president hasn't made clear,"said Woolhandler. Himmelstein suspects that the large insurancecompanies will play a role in the development ofthe bill before it passes in Congress. "It's a lobbyist's dream," he said. But William M. Grigg, director of the newsdivision for the Public Health Service inWashington, D.C., defended Clinton's plan. Responding to the charge that it will deprivepeople of health care choice, Grigg said that mostpeople don't have a choice now. "Companies andunions presently tell people what plans to gowith," Grigg said. "This plan will provide aminimum of several different options.
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