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U.S. HEALTH-CARE SYSTEM NEEDS AN ADJUSTMENT, NOT AN OVERHAUL

The political demise this year of President Clinton's health-care plan has led many lawmakers to question the political clout of AARP, the American Association of Retired Persons, and many AARP members to question whose interests AARP really rep- resents.

AARP was the biggest supporter of Clinton's approach to health care. The association lobbied strenuously in behalf of the plan without polling its members to learn if it had their consent.Many of the elderly are puzzled why AARP was behind a bill that its critics claimed would make some cuts in Medicare that would dramatically reduce the provision of quality health-care services to the aged.

Even more puzzling is AARP's support for a health-care reform measure whose primary purpose is to break the connection between doctor and patient so that government bureaucrats could step in and save taxpayers' money by denying the elderly expensive treatments.

The answer to this puzzle might be found in the incestuous relationships for which Washington is infamous. Americans are learning that many of the associations that they join are run by people who have a different agenda from that of the membership.

Association executives use their positions to make deals with congressional committees and regulators that advance their careers at the expense of the interests of the association's members.

In AARP's case, many of its members are attracted by insurance and travel discounts and cannot discern from the newsletter the nature of the political activities for which their dues are being used.

AARP's situation is further complicated by what many regard as a conflict of interest: According to newspaper reports, the president of AARP is married to Senate Democratic leader George Mitchell's health-care adviser.

In our current system, whatever its shortcomings and the meanness of insurance companies, doctors are our advocates. They have incentives to deliver to us the best care available - and even more of it than we need.

In any government-based system, this is not the case. The amount and quality of medical care is fixed by the budget and it then could be rationed by a variety of factors such as availability and age. No one can get any more than the government makes available.

The U.S. medical-care system is fundamentally sound. It needs only a few adjustments, not a thorough overhaul.

Some way needs to be found, if possible, to make medical insurance portable so that people are not financially exposed when they change or lose jobs.

The other problem in the system is the unemployed poor who currently receive their care free from hospital emergency rooms. An alternative would be government-run clinics for the indigent. In fashioning such a system, we should keep in mind the fate of the private charity hospitals that once ministered to the poor.

They were killed, in part, by medical liability suits. If we are not careful, the lawyers - Clinton's largest political constituency - will design a health reform that serves their interests.