(Archived document, may contain errors) 807 January 31,1991 PFDCEFIIONVS. REX TAKING A SECOND IDOK AT CANADIAN HEALTRCARE INTRODUCTION In the continuing debate over how to reform Americas ailing health care sys- tem, one solution often proposed especially in the press -is for the United States simply to adopt a g overnment-run system similar to that of Canada.
The Medicare conference agreement fails the two criticalrequirements of a responsible drug benefit program for the nation'sseniors. The original idea underlying this legislation wasnever just about adding drug coverage to Medicare. It wasabout doing so in a way that would not lead to huge additionalliabilities to future generations, and in a way that would reformthe program so that it could respond to the changing needs of theelderly and disabled. But the agreement will not leadto that.
Among die most prominent in an array of health cue reform measures now pending in Congress is S. 1227, the "HealthAmerica: Affordable Health Care for All Americans Act." The bill's prominence derives mainly from its sponsorship by George Mitchell, the Maine Democrat who is Senate Majority Leader. The 349-page bill also is the most recent and comprehensive version of what is called the "play or pay" approach to health care refoxm. In this, the federal govern- ment would require employers either to"play" by covering their employees (and employee dependents) with at least a specified minimum level of health insurance or to "paypt a payroll tax to fund an expanded Medicaid-type program to cover their workers and dependents. The only employer exempt from this system would be the federal governmem Buried in the bill is a provision that congressmen and their staffs, like other federal workers and refirees, would continue to enjoy a wide choice of privat