1960

Bill and Hillary Clinton’s introduction of a national health plan moved me to call some doctors in the class to see what they think. Their verdict: the goal of universal coverage is good, but they are worried about the Clinton details.

Jerry Bart, a hematologist in Houston, thinks the Clinton idea of a “global budget” (a national lid on health spending) will inevitably lead to “the R-word—rationing.” He’s not necessarily against that, but doubts the American people are ready for it. A self- described conservative who supports the Dartmouth Review (I made a pitch for the Class of ’60 Scholarship Fund), Jerry nonetheless believes in universal coverage, having had to pay out of his own pocket when his uninsured son was badly injured.

Hal Harris, an ear-nose-throat specialist in Holyoke, Mass., is especially sympathetic to the Clintons’ criticisms of health insurance companies, which he says are “opulent in their excesses,” but thinks that the Clintons are “not leveling” on the cost of their pro- gram. “The big trouble with American health is the patients,” he says, meaning their lifestyles.

Saul Roskes, a pediatrician and kidney disease researcher in Baltimore, says he antic- ipates that, among other changes in the med- ical profession, doctor incomes will fall under the Clinton plan. Saul’s son Erik ’B6 is a res- ident in psychiatry.

Ira Salafsky, a pediatrician in Evanston, 111., says he favors parts of the Clinton plan, includ- ing universal guaranteed coverage and com- munity rating of insurance premiums, but is worried that “managed competition” is an untried concept and thinks that a Canadian- style single-payer system may be better if the payer is not the government.

Ken Seslowe, an orthopedic surgeon in Manhattan, favors universal coverage and thinks that the U.S. may end up with a Cana- dian-style plan and price controls, but is wor- ried about the government’s ability to man- age the program. Medicare, representing 15 percent of his patients, accounts for 7 5 per- cent of his administrative time and problems, he says.

Alan Shons, who just moved from Cleve- land to Tampa to start up a plastic surgery department at the University of South Flori- da, favors universal coverage, but doubts that creating a “new, multi-layered government bureaucracy” will make U.S. medicine more efficient. Alan’s daughter, Sue, graduated from Dartmouth in 1989 and ran the College’s volunteer programs for two years before mov- ing on to get her M.B.A.

"“fo w b— ~ . Jim Sniderman, a urologist in Dayton, Ohio, says that the Clinton program will force him out of solo practice and into some form of group practice, but “I went through big- ger changes when my hair fell out.” Jim says he is more worried that the Clinton plan relies on “voodoo economics” and will lead to “black market medicine,” where patients can get care outside government price controls.

Frank Vimelli, a plastic surgeon in Win- chester, Mass., thinks that tire Clinton plan is “the most workable, intelligent plan” he’s heard about, but he’s afraid that “powerful lob- bies” such as insurers and pharmaceutical companies, will block it in Congress.

As always, you’re invited to send in your opinions on this or any other subject.

Meantime, Martin Budd seems to be in great shape, practicing law, driving a Porsche around Hartford, and busy with extracurric- ular activities including the vice chairmanship of the Anti-Defamation League’s national budget committee, the presidency of the multi-cultural Charter Oak Cultural Center, and board membership of the Hartford Sem- inary. He’s also chairman of the Israel task force of the Hartford Jewish Federation, which sponsored a symposium I attended on the eve of the Mideast peace accord.

Other news: Michael Heitner and Michael Savage both were elected to the exec com- mittee of the Dartmouth Alumni Association of New York.

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