> > THE FOLLOWING ITEM COMES FROM REP. McDERMOTT, *NOT* FROM THE > WHITE HOUSE. IT IS BEING PROVIDED TO LIST.HEALTHPLAN SUBSCRIBERS > PER RESULTS OF A SUBSCRIBER VOTE AS TO WHETHER IT SHOULD BE PRO- > VIDED AS AN EXCEPTION TO THE "WHITE HOUSE ORIGIN ONLY" CONTENT OF > LIST.HEALTHPLAN. > > -- STEVE FREEDKIN , LIST.HEALTHPLAN MANAGER > > TO REMOVE YOUR NAME FROM THE LIST.HEALTHPLAN SUBSCRIPTION LIST, SEND > ME A MESSAGE WITH THE SUBJECT: REMOVE LIST.HEALTHPLAN > > FOR COMPLETE LIST.HEALTHPLAN INSTRUCTIONS, SEND ME A MESSAGE WITH THE > SUBJECT: SEND WELCOME LTR LIST.HEALTHPLAN > > From: "P.RUBIN" The American Health Security News: A weekly report on health care reform and the single payer plan Vol.II No. 25 FOR IMMEDIATE RELEASE FOR MORE INFORMATION Monday Contact: Barry E. Piatt August 15, 1994 PHONE: 202-225-3106 GOOD NEWS/BAD NEWS: House Majority Leader Dick Gephardt (D-MO) released the text of his "leadership" health reform bill 8/11/94. The good news: the bill does, indeed, move in the right direction on a number of issues important to the single payer bloc. The bad news: it's not clear whether that movement is far enough, or occurs on enough issues. Here's a run-down of those issues the single payer bloc considers to be "bottom line" and their disposition in the Gephardt draft: * Universal coverage: The Gephardt bill would begin to phase in 100 percent universal coverage in 1997, and seeks to achieve it by 1999. Clearly, the Gephardt bill is far superior to the bill drafted in the Senate by Majority Leader George Mitchell (D-ME), which would allow more than 12 million Americans to remain permanently without health insurance. While the Gephardt bill's date for achieving universal coverage is later than the single payer bloc would like to see, the phase-in start-up date is a reasonable one and Gephardt deserves support for sticking to the 100 percent universal coverage goal. With both President Clinton and Sen. Mitchell appearing to back away from that goal, Gephardt's bill becomes the best bet for achieving it among the "managed competition" bills. Whether members of the single payer bloc will accept a date significantly later than they believe necessary to achieve universal coverage remains to be determined. * State single payer option: The Gephardt bill does provide a real and workable state single payer option. This is a major improvement over the state option included in the House Ways and Means Committee bill. That option was not workable and, thus, was not real. Single payer backers will support this provision. * Benefits: Out-of-pocket spending caps set by the House Ways and Means Committee bill were far too high: $8,000 annually for individuals/$16,500 annually for families. The Gephardt bill lowers the cap to a more manageable level of $3,000 annually for individuals/$6,000 annually for families. (1994 dollars, indexed to growth of Gross Domestic Product). That's still significantly higher than the single payer bill, under which no out-of-pocket spending is required beyond the payroll tax/premium. * Medicare Part C: The best that can be said about this provision is that there was some movement. The single payer bloc wants Medicare Part C open to all so that no American is forced into managed care. The House Ways and Means Committee bill limited Medicare Part C enrollment to employees of firms with 50 or fewer workers. The Gephardt bill improved that by expanding enrollment to include employees of firms with 100 or fewer workers. While recognizing the improvement, single payer backers continue to favor unrestricted enrollment in Medicare Part C. * Insurance reform: The Gephardt bill still allows experience rating and the premium-pricing discrimination which inevitably results. That's a problem. The Gephardt bill does attempt to end price discrimination against small businesses by requiring the "association" market to sell to small businesses at the same price if offers to "associations." -- more -- American Health Security News 8/12/94 Page -2- ONLY THE STRONG SURVIVE: Nearly two years after the McDermott single payer plan was dismissed by the White House and the media as "not politically feasible" a curious fact about it remains: when health reform legislation is considered on the House floor, only the McDermott plan will have reached the floor by surviving the congressional committee process, being reported to the full House in the same form it was reported by a House committee. It also is interesting to note that only the single payer plan has generated genuine grassroots support and passion in its favor. NOT WORTHY OF THE NAME: A new, last minute, so-called "health reform" bill -- backed mostly by folks who really don't want comprehensive health reform -- was unveiled 8/11/94 by Reps. Roy Rowland (D-GA) and Michael Bilirakis (R-FL). The bill's major strength: it makes Members who sponsor it look as if they are for health reform (it is called a "health reform" bill, after all). The bill's major weakness: it does very little or nothing to actually reform the nation's health care system. The Rowland-Bilirakis bill is most notable for what it fails or even attempts to do: * It does not attempt to deliver universal health insurance coverage. It aims, instead, for an anemic 90 percent coverage by 2004, which would leave 24-30 million Americans without health insurance permanently. * It does not attempt to control health care costs. * It does not attempt to make private health insurance more affordable. * It does nothing to ensure that most Americans can continue to choose their own doctors or hospitals. In fact, it would accelerate the trend toward employers forcing employees into managed care situations where the employees' right to choose their own doctors or hospitals is restricted unless the employee is willing to pay extra or seek special authorization. * It preserves experience rating (which allows premium price discrimination) and institutionalizes age-based discrimination. The bill allows insurance companies to charge some age groups as much as four times what they charge others for health insurance. That spread is extreme, and means that insurance would become increasingly unaffordable for people as they age, even at a relatively young age. HEALTH CARE OLYMPICS: The new NBC-TV network program, "TV Nation", tested the health care systems of three nations in a program which aired 8/9/94. In a segment written by Natalie Jason and reported by Bob Costas and Ahmad Rashad, the program tracked individuals with a hairline lower limb fracture (Canada), a bad ankle sprain (United States), and a broken leg (Cuba) as they sought diagnosis and treatment through their health care delivery systems. Canada -- which has a single payer system -- rated highest, with a combination of rapid treatment and low cost. Cuba placed second, scoring points for rapid treatment and comprehensive care, but losing points due to economic isolation which created quality of care problems. The U.S. finished third, for requiring the patient to go through an "insurance company obstacle course" to obtain treatment, and charging big medical fees. The cost differences for the treatments rendered were especially interesting: * In Canada: $15 for crutches. No other cost. * In the United States: Total charge: $450.70. Costs include charges of $80 for an emergency room service visit; $137 for a foot x-ray; $44 for an ace bandage; $118 for x-ray of the ankle; $16.90 for dye used in the x-ray process; $46 for crutches. * In Cuba: no cost. -- END --