Word: dones
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Dates: during 1970-1979
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Domestic Policy Adviser Stuart Eizenstat, he says, is typical of the Administration mold: "A skilled version of an unimaginative breed." Georgians Hamilton Jordan and Jody Powell, says Fallows, cultivate the laid-back style of "cool guys getting the job done without trying too hard or taking it all too seriously." One of the few to win a favorable notice is National Security Adviser Zbigniew Brzezinski, "high-strung and vain," but also "the one among Carter's senior associates who tried every day to test the limits of his job and come up with new ideas...
...medicine instead of crisis care. They stress exercise, weight control, cutting out drinking and smoking. Says Dr. Hoyt D. Gardner, president-elect of the A.M.A.: "America medically suffers more from affluence?and consequent self-indulgence?than from poverty." But not many doctors are genuinely optimistic that much will be done...
...Some insurance practices operate directly to drive up costs. Many insurance companies will pay for lab tests only if they are done in a hospital on a supposedly sick patient. The result is to encourage hospitalization of untold thousands of people who could be diagnosed and/or treated at far less cost in a doctor's office. Says one Houston physician: "Say a man in his late 30s to early 40s complains of chest pains. I tell him he needs a thorough physical. In the office my fee would be $45, the tests $250, for a total...
Doctors, too, tend to order every test that a patient could conceivably need. In part, that is done to reassure patients or to protect themselves against malpractice suits. Says Dr. E. Kash Rose, senior radiologist at Queen of the Valley Hospital in Napa, Calif.: "One study showed that 80% of skull X rays were unnecessary for care and treatment of patients. Rib X rays are done purely for the mental relief of the patient rather than for medical reasons. The treatment is exactly the same" whether the X ray discloses a fracture...
What then can be done? The experience of other industrial nations offers little comfort; many of them are struggling with medical-cost problems too. In West Germany, where most medical bills are covered by insurance companies supported by tax funds, doctors charge so much that their incomes average $100,000, far higher even than in the U.S., and medical costs consumed 12.8% of G.N.P. last year. The government, reluctant to raise taxes further, is pressing doctors and hospitals to hold down charges...