The Clinton plan aims to contain spiraling costs, so companies already in the habit of paying their workers’ medical bills should feel some relief Companies with generous benefits may also scale them back in line with the government’s more basic health package.
To control costs, the plan envisions a wider role for nurses, both as cheaper primary-care providers than doctors and as well-informed quality-control officers enforcing HMO–practice guidelines.
Despite government subsidies, small-business advocates say the cost of insuring workers would lead to major cutbacks. Doomsday predictions run as high as a million layoffs. Most experts say that number’s bloated, but small business will certainly feel the pinch.
Because of universal coverage, they seem like winners. But like the elderly, they would initially remain under the protection of Medicaid and Medicare–targets for the most strenuous cost-cutting. If financing falls short, the poor will feel it first.
Because of their expertise, medical specialists have traditionally been the most respected–and highest-paid-doctors in the country. The new plan’s emphasis on HMOs would sharply increase demand for the general practitioners who staff them. That means fewer slots for specialists.
