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FOIA Number:
2006-0885-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Health Care Task Force
Series/Staff Member:
Prunty
Subseries:
OA/ID Number:
3925
FolderlD:
Folder Title:
Misc.: Interest Groups - General [2]
Staek:
Row:
Section:
Shelf:
Position:
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�Subject; Health Care Interest Group Watch
Alliance for Managed Competition
American Academy of Family Physicians
American Academy of Pediatrics
American Academy of Physician Assistants
American Association of Physicians and Surgeons
American Association of Retired Persons
American Chiropractic Association
American Council for Health Care Reform
American Dental Association
AFL-CIO
American Federation of State, County, and Municipal Employees
American Health Care Association
American Hospital Association
American Medical Association
American Pharmaceutical Association
American Protestant Health Association
American Nurses Association
American Psychiatric Association
American Psychological Association
Association of Private Pensions and Welfare Plans
Blue Cross and Blue Shield Association
The Building and Construction Trades Department
The Business Roundtable
Campaign for Quality Health Care
Campaign for Women's Health
Catholic Health Association of the United States
Catholics for a Free Choice
Children's Defense Fund
Citizen Action
Citizens Against Rationing Health
Coalition for Equal Access to Medicines
The Coalition for Family Privacy
The Coalition for Managed Competition
Coalition for Oral Health
Consortium of Citizens With Disabilities
Consumer's Union
The Council for Affordable Health Insurance
Families U.S.A.
The Farmers Union
Federation of American Health System
Generic Pharmaceutical Industry Association
Group Health Association of America
Health Care Choice Project
�Health Care for All
Health Industry Manufacturers Association
Health Insurance Association of America
Health Care Leadership Council
The Health Project
Independent Insurance Agents of America
Industrial Biotechnology Association
International Brotherhood of Teamsters
Long-Term Care Campaign
Mental Health Liaison Group
Minority Contractors Association
National Association for Home Care
National Association of Children's Hospitals & Related Institutions
National Association of Counties
National Association of Manufacturers
National Association of Private Enterprise
National Association of Retail Druggists
National Association of Social Workers
National Association of Women Business Owners
National Committee to Preserve Social Security
National Conference of State Legislators
National Congress of American Indians
National Council of Churches of Christ in the U.S.
National Council of La Raza
National Council of Senior Citizens
National Governors Association
National Health Care Coalition
National Hospice Organization
National Medical Association
National Medical Liability Reform Coalition
National Retail Federation
National Restaurant Association
National Small Business United
National Urban League
Pharmaceutical Manufacturers Association
Public Citizen's Congress Watch
Religious Coalition for Abortion Rights
Roman Catholic Archbishops
Rx Partners
Service Employees International Union
Small Business Legislative Council
United Auto Workers
U.S. Chamber of Commerce
U.S. Conference of Mayors
Universal Health Care Action Network
Washington Business Group on Health
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�Subject: Health Care Interest Group Watch
Alliance for Managed Competition
Represents: Aetna, CIGNA, MetLife, The Prudential, Travelers. (Collectively provide health care
coverage to more than 60 million Americans.)
Goal: Managed competition.
Concerns: Wage and price controls.
American Academy of Family Physicians
Represents: National association of family doctors with chapters in all 50 states. (More than
74,000 members.)
Strategy: Do not have a PAC. Building a grassroots network. Sophisticated press office. Good
reputation in Congress.
Goal: Universal coverage through employer-based system within a global budget. The Academy
is one of the two large medical specialty organizations to come forward with a reform plan that
endorses a global budget as part of cost containment. Cost containment through the use of a
global budget determined by a national health board. Specific strategies to move toward a
generalist-oriented health care system, including reforming medical school admission criteria and
curriculum, changing Medicare support of graduate medical education, and reforming physician
fee schedules.
Concerns: Worried about mismatch between infrastructure and expanded coverage. Concerned
that will be disproportionately affected under a wage freeze because of current disparities between
generalists and specialists. Concerned that short term cost containment will diminish immediate
investment in primary care training.
Other The AAFP does not specifically endorse managed competition, but would allow for it and
encourage managed care. Working on ideas for "managed cooperation" in rural areas.
American Academy of Pediatrics
Represents: Pediatricians nationwide whose goal is advocacy for children and youth. (45,000
members.)
Strategy: Not strong lobbying force, but because of "white hat"public reputation opinion
important. Active coalition participant.
Concern: Nervous about global budgets (concerned that, absent guarantees, children's access will
be diminished first).
Goal: In last Congress, endorsed Matsui bill (pay or play for women and kids) that included allpayer rates for pediatric and obstetric services. Their priority is universal access for children; any
coverage phase-in should begin with children and pregnant women. Benefits package should be
child sensitive, recognizing the particular needs of all children including children with special
health care needs. Must be one-tier system-"Medicaid doesn't work". Should address future
demand for primary care physicians through: flexible loan policies, expansion of the NHSC;
incentives to increase number of minority primary care physicians; and development of pediatric
RBRVS to guarantee adequate reimbursement. Cost-containment proposals must include
emphasis on preventive care and income-adjusted cost-sharing.
American Academy of Physician Assistants
�Represents: 22,000 practicing physician assistants and 3600 students enrolled in the country's 55
accredited physician assistants programs. Academy chapters located in all 50 states. Members
provide medical treatment for 150 million patient visits per year.
Strategy: Sway in rural settings where Physician Assistants are more often utilized.
Goal: Increased utilization of physicians assistants and other non-physicians. Want health care
reform to provide incentives for increased use of physicians assistants (PAs): recognize PAs and
other non-physicians as authorized providers under new system, encouraging states to enact more
flexible laws and regulations for PAs, transfer Medicare GME dollars from resident training to
support the training of non-physicians, provide appropriate reimbursement for PAs in all settings.
Also support basic benefit package, universal access, cost controls should focus on prevention
of inappropriate cost shifting, elimination of excess bureaucracy, malpractice reform.
Concerns:
Licensure, empowerment, reimbursement issues
American AgsQcifltion Physicians anfl Syrgggng
Represents: The Association is a national, not-for-profit physician and osteopath membership
corporation. (Represents 35,000 members)
Goal: Preserve private medicine. Medical savings accounts. Proposals include establishing
medical savings accounts, insurance reforms, reducing regulations and mandated benefits, and
development of private alternatives to Medicare. Believe health care cost escalation due to: taxsubsidized prepaid insurance; regulations; and legal overhead.
Concern: Managing system will lead to rationing.
Other. Group has little influence.
American Association of Retired Persons
Represents: 34 million Americans over age 50. Has chapters in all 50 states.
Strategy: Has financial strength, huge membership base, influential in media and on hill
(although damaged somewhat by their strong backing of catastrophic). Lack of unifying
principles of membership undermines their effectiveness.
Goal: Blended approach of single payer, employer based and tax incentives. Remain open. Four
goals for reform: universal access to affordable quality health care and long-term care, systemwide cost containment, prescription drugs, and fair and affordable financing. Benefits package
should include preventive, primary, acute, transitional and long term care. Cost containment
through global budget.
Other Open to Administration plan, as long as comprehensive.
Concerns: Long term care and prescription drugs, seniors bearing financial burden without added
benefits.
American Chiropractic Association
Represents: 22,000 chiropractors and students at the accredited chiropractic colleges. The
Nation's 45,000 chiropractors serve over 19 million patients annually and are licensed as primary
care in fifty states.
Goal: The purpose of the ACA is to seek to advance and protect the patient's access to
chiropractic services and promote the drug-free, non-surgical care doctors of chiropractic provide
a healing art.
Strategy: Fairly effective grassroots network. Important in certain states (e.g. Iowa, New
Hampshire)
Goal: Chiropractic services included in the basic core benefits package. Encourage use of
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�chiropractors as primary care providers, and gatekeepers under managed care plans.
ftmeiKpn Council for Healft Cflif R^fpnn
Represents: Drawn from the general public-consumers. A grass roots consumer association to
protect and inform consumers.
Strategy: Grass roots at the Federal level
Goal: The council supports eliminating administrative red tape, changing insurance reform,
reforming malpractice issues, and providing quality of care to all Amencans.
American Dental Association
Represents: The American Dental Association (ADA) represents a total of 139,620 dentists, with
73% of U.S. dentists members of the ADA.
Strategy: Grass roots, active, strong advocacy.
Goal: The primary criteria for the ADA is universal access and inclusion of dental benefits in the
core package. Theirfinancialpackage is employer based, provides coverage for indigents, small
employer relief through HIPCS and risk reinsurance pools, and co-payments. The ADA is for
the protection of all working people from financial ruin as a result of illness, education services
and access to preventive dental services for children. The ADA believes dental services are not
a cost problem. If there is not a problem, don't change us.
Concern: Inclusion of dental services in the benefits package
AFLzOQ
Represents: 88 unions, 14 million members. Unions representing individuals employed in
manufacturing, the public sector, service and building and construction.
Strategy: Strong effective grassroots network; influential with Congress; large campaign
contributors.
Goal: Support establishment of purchasing cooperatives. Support universal access through
regional purchasing and delivery system with enforceable budget. Community rating for all.
Consumer choice among plans. Quality assurance system including development of practice
guidelines, health outcomes, research and technology assessment. Finance retiree health care by
unified purchasing and delivery system. Medicare eligibility to 60. Finance system through broad
and equitable mechanisms.
Concerns: No employers can opt out of HIPCs; no taxation of employer-provided benefits.
American Federation of State. County, and Municipal Employees
Represents: More than 1.3 million public employees and health care workers throughout the
U.S. Employees of state, county, and municipal governments, school districts, public and
private hospitals, universities and non-profit agencies who work in a cross section of jobs
ranging from blue collar to clerical, professional and paraprofessional. White collar
employees account for one-third of the membership. The largest and most influential AFLCIO union
Goal: Single payer but are willing to work with us and AFL-CIO. Very concerned that
public sector not be used to create "critical mass" for HIPCs.
American Health Care Association
Represents: 51 affiliated associations and 11,000 non-proprietary and proprietary long term
care providers that care for one million nursing facility and long term care residents
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�nationwide. Primarily proprietaiy nursing homes.
Strategy: Powerful lobby at federal and state level, particularly in certain states.
Goal: AHCA has developed "Quality Care for Life", a long term care financing reform plan
which includes nursing home care, consumer choice, quality incentives, and cost containment
through public and private resources. Long term care needs also include respite care, adult
day care, home and community-based care.
Concerns: Concerned about their members ability to provide care in the new system. Long
term care in benefit package.
American Hospital As$Qfiqtipn
Represents: (5,300 hospitals) Umbrella organization for hospitals of all sizes and ownership
types nationwide. It is the largest hospital trade association in the country.
Strategy: Individual hospitals are major employers and therefore have substantial influence in
districts.
Goal: Coverage through a core benefit package in a pay-or-play system. Delivery reform
through community care networks similar to managed care. Concerned that managed
competition will drive hospitals to be the lowest price vendor and threaten their mission
orientation. Do not support a global budget but might support a "bottom up" budget through
capitation of payments. Advocate antitrust reforms to permit easier coordination/collaboration
between hospitals.
Concerns: Universal access. Cost controls which shift costs
Other As of 7/1 have made not commitment to The Health Project and will not unless it is
clearly a bipartisan initiative and with support from all sectors, particularly substantial
business community backing.
American Medical Association
Represents: Approximately 300,000 physician members. Federation of 50 state medical
associations and the District of Columbia, county, metropolitan societies and over 80 national
medical specialty societies
Strategy: Influential with Congress; large campaign contributors; able to generate significant
press coverage; major grassroots network.
Goal: Universal access to care through an employer mandate and Medicaid reform, insurance
market reforms, particularly community rating, and elimination of preexisting condition
restrictions. Want the right for organized medicine to negotiate with federal agencies and
regulatory programs and at the local level with managed competition entities. Want
professional liability reform; freedom of patients to choose their physician and system of
health care delivery; quality assurance through practice parameters and outcomes research;
administrative cost reduction; establishment at the federal level of a minimum benefits
package (with repeal of state mandates); and decreased regulation.
Concerns: Cost and Price controls. Restricted physician choice. Loss of professional autonomy
American Pharmaceutical Association
Represents: APhA represents more than 195,000 pharmacy practitioners, scientists, and
pharmacy students. The interests of professional pharmacists in academic settings, in
pharmacies, and in institutional settings such as hospitals and nursing homes.
Strategy: The third of the three most influential pharmacy groups on Capitol Hill -- (the
National Association of Retail Druggists and the National Association of Chain Drug Stores
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�are the other two).
Goal: Strong supporter that prescription drug coverage be included in the basic health care
package. Similarly supportive of a Medicare Rx drug benefit. Wants Rx drug coverage to
pay for the professional patient counseling done by pharmacists. Believe that such utilization
review services are extremely cost effective.
American Protestant Health Association
Represents: 200 Protestant church-related health care institutions.
Strategy: Community hospitals can be influential in local district.
Goal: Seek fundamental reform of health care system making universal coverage at reasonable
coat a reality. Develop incentives, built upon capitated payments for population groups, to
change corporate and individual behavior. Move from disease treatment to health
improvement. Community based servant leadership is key to universal and affordable
coverage.
American Nurses Association
Represents: 2.1 million registered nurses through its S3 constituent state and territorial
associations and its more than 200,000 members.
Strategy: Effective lobbyist on nursing issues, strong grass roots efforts at both the Federal
and state levels, and ability to mobilize quickly, forefront on political and legislative issues.
Goal: The ANA supports health care system that assures access, quality and services at
affordable cost. The financing mechanisms must be employer based with minimal copayments. The benefit package must provide prevention, health screening, extended and long
term care, and mental health benefits. Nurses want to be "empowered." Believe they need to
be protected in managed competition system.
American Psychiatric Association
Represents: (38,000 members) National medical specialty society specializing in the
diagnosis and treatment of mental illness (including substance abuse). Comprise over 70
percent of the nation's psychiatrists.
Strategy: Active PAC. Focused on mental health issues.
Goal: Support nondiscrimination between mental health and other health benefits for patients.
Focused on eliminating what they feel are artificial limits (e.g. 20 visits, etc.) on services.
Guaranteed benefits package must include appropriate mental health benefits (inpatient care,
outpatient treatment, and partial hospitalization and ambulatory care). Also support coverage
of psychopharmacological treatments under drug benefit. Want to ensure that innovative state
efforts to expand mental health coverage can continue.
Concerns: Concerned about consumer protections, reimbursement of providers, and oppressive
utilization review. Nervous about state and federal efforts to reimburse non-physician mental
health providers.
American Pgychqlogical AgsQcifttipn
Represents: APA represents more than 74,000 members nationally and around the world;
40,000 students, foreign, and high school teacher affiliates; divisions in nearly 50 areas of
psychology; and affiliations with state and Canadian psychological associations.
Strategy: Grassroots network.
Goals: The priorities of the APA include mental health benefits, universal coverage, cost
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�containment, rehabilitation services. Quality assurance provisions necessary for persons with
disabilities. Want to be treated as functional equivalents to psychiatrists.
Association of Private Pensions and Welfare Plans
Represents: Companies and individuals concerned about federal legislation and regulations
affecting all aspects of private sector employee benefits. APPWP members include employers
of all sizes-principally Fortune 500 major companies-as well as insurance carriers and
employee benefits consulting firms.
Goal: In December, the APPWP adopted a new stance, becoming the first employer
organization to support an employer mandate and a limitation of the employee tax exclusion
for employer-paid health coverage. Employer mandate coupled with tax credits and subsidies
for low-income individuals and employers with large numbers of low-income workers; also
individual mandate to accept or acquire health care coverage. Limitation of employee tax
exclusion for employer-paid health coverage to the cost of the basic benefits package.
Integration of managed care systems in all health care systems, both public and private, to
curtail the practice of cost-shifting. Support health care expenditure targets for all health
system payers.
Blue Cn>s? and Blue Shield Asgpfiflfon
Represents: 71 Independent Blue Cross and Blue Shield Plans. Coordinating organization for
BC/BS Plans throughout the nation. Collectively, the Plans provide health benefits protection
for nearly 70 million people, and serve an additional 34 million people through the Medicare
program where Plans administer 70 percent of all the program's claims.
Strategy: Viewed as moderate voice among insurers; widely consulted.
Goal: Do not believe HIPCs are necessary, just larger pools. Because of their history, they
believe they will be at a competitive disadvantage in a managed competition system and will
be looking for some assurance of risk adjustments and standardized benefits. Support
insurance reform (rating/pre-existing condition bans), increased managed care, and
administrative simplification. Would move the market to community care networks with
obligations that the percentage of people in AHPs increase each year. Would require
employers to continually increase percentage of employees in AHP each year in order to keep
their deduction.
The Building and Construction Trades Department
Represents: (5 million members) 15 affiliated international unions in the construction industry.
Goal: Same position as AFL-CIO generally. Believe Taft-Hartley plans should continue to
perform administrative functions.
The Business Roundtable
Represents: (200 Chief Executive Officers) Association of business executives of Fortune 500
companies in all fields
Goal: Pure managed competition. Creation of group purchasing arrangements for small
groups and individuals. Large employer opt-out. Standard benefit package, income-based
subsidies for individuals, limits on tax free portion of health benefits for employees, outcomes
research and medical malpractice reform. Pre-emption of state laws that mandate specific
benefits and restrict managed care.
Other Scope of influence is significant, but frequently overestimated.
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�Campaign fpr CMity
O?
Coalition: (nationwide) consumer groups and malpractice victims.
Goal: Oppose anti-consumer restrictions on the rights of malpractice victims. Say, "The
problem is not that there are too many malpractice lawsuits. The problem is too much
malpractice." Say, "An alarm bell went off when Hillary Clinton made a promise to the
AMA to 'solve your malpractice problems' in return for doctors support for national health
care.
Strategy: Organizing consumer, labor, senior citizen and other groups in more than 20 states
to stop the administration from "treating our legal rights like bargaining chips in a high-stakes
political poker game."
Campaign for Women's Health
Represents: 8 million members nationwide representing women's groups, unions, and health
care organizations and including Older Women's League, Planned Parenthood Federation of
America, YMCA of the USA, NARAL, and Black Women's Agenda.
Strategy: Active grass roots, hot issue in Congress, and political clout.
Goal: Universal access and a comprehensive benefits package that meets the needs of women,
including maintenance and promotion including primary and preventive services and primary
and preventive reproductive health care; long term care—respite, spend down, effective
immediately, home care; health care delivery in a variety of settings; health care delivered by
a variety of providers; community based programs; financing and accountability.
Catholic Health Association of the United States
Represents: (1200 health care facilities) Nation's largest organization representing not-forprofit, single-sponsor, health care institutions.
Strategy: Community hospitals can be influential in local district.
Goal: Unified and comprehensive health care system. Through "Integrated Delivery
Networks, all persons are provided a comprehensive benefits package. Networks are owned
and operated by a variety of entities including former insurance companies, hospitals, and
physicians. Networks compete for customers on basis of quality and service and receive riskadjusted capitated payments from independent "State Health Organization." National Health
Board sets overall budget. Employer-basedfinancingsupplemented by public funds.
Catholics for a Free Choice
Concern: Say bishops were attempting to unfairly influence the decision of individual women
on the basis of economics.
Other: Claim most American Catholics support government funding of abortion services. (Cite
a '92 CBS/N Y. TIMES poll showing that 62% of Catholics support federal funding of
abortions for poor women.)
Children's Defense Fund
Represents: Organization's interested in Children's issues. Fund research for children. (SO
states)
Strategy: Respected in media, effective lobbying group on children's issues, strong grass roots
Goal: The priorities of the CDF are as follows. Child health benefits, including mental health
universal access; access to medical care; comprehensive coverage-primary and preventive
services; phase infirst,pregnant women and children; affordable premium based of family
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�income with no cost sharing; continuity of coverage-portable; ensure availability of services,
invest in public health; Medicaid, poor peoples program; transition into a new system takes a
number of years to put in place, put children first.
Concerns: Children benefits, primary and preventive services.
Citizen Action
Represents: S million consumers. In 32 states, membership comprised of working class,
middle class, employed in white collar and service industries, activists, cross generation lines
and half are below the age of 45.
Strategy: Some strong state affiliates, broad based canvassing efforts, ability to mobilize,
although not as powerful or influential nationally as numbers might indicate.
Goal: Supports single-payer approach because of its ability to meet principles of affordability,
universality, comprehensiveness, choice and public accountability.
Concerns: Views managed competition as approach which will shift costs to their own
families while limiting their choice of providers. Fear of being forced into a substandard
plan. Middle class families think they will have fewer choices than low income persons.
Gtizens Against Rationing Health
Coalition: Five conservative and GOP groups (American Conservative Union, Citizens for a
Sound Economy, American Legislative Exchange Council, The United Seniors Council, and
Citizens United). Headed by Don Devine, former OPM director under Reagan and currently
an American Conservative Union board member, and former Representative Beau Boulter
(R-TX), Vice President of the United Seniors Association.
Strategy: Will release a detailed health care reform package and launch an intensive lobbying
and grassroots effort, as well as plan a national media advertising campaign. Says they will
generate 15 million pieces of mail from citizens to the White House, buy TV and radio spots,
hold rallies and recruit thousands of citizen lobbyists.
Finances: Will carry a $10 million campaign against Clinton's plan.
Goal: Will try to build support for an alternative: medical savings accounts. Wants to change
the tax code to allow individual deductions of up to $4,800 for health insurance premiums;
add new deductions for the uninsured -- including refundable tax credits for the poor and for
those with pre-existing conditions;" and create medical IRAs. Medicare/Medicaid recipients
would have the option of converting their coverage into a medical savings account or private
insurance plan.
Coalition for Equal Access to Medicines
Coalition: NY Times call an "unusual union" of poor people, minority groups and public
health advocates. Organizing members of the coalition include officers from the following
groups, all of which are members: National Rainbow Coalition, American Legislative
Exchange Council, National Depressive and Manic Depressive Association, National Medical
Association, National Black Caucus of State Legislators, Institute for the Puerto
Rican/Hispanic Elderly, National Multiple Sclerosis Society, National Black Nurses
Association, People's Medical Society, Lupus Foundation of America, Caiifomia
Hispanic-American Medical Association, National Urban League, Allergy and Asthma
Network, National Kidney Cancer Association and the National Council on the Aging.
Strategy: The coalition will lobby against Medicaid formularies which have already been
approved by both the House and Senate and are likely to be included in the deficit-reduction
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�bill that emerges from conference committee.
Finances: Created and financed by the prescription drug industry.
Goal: Wants to ensure that Medicaid formularies do not deny access to medicine "crucial" to
the health of their members.
Other The coalition has "enlisted" black clergy in its campaign. The drug industry fiercely
opposes formularies: They say state officials will select drugs on the basis of cost, not quality
and fear that Medicaid formularies will set a precedent for similar restrictions under any
national health insurance plan that Congress might enact.
The Coalition for Familv Privacy
Concern: Claim registries would pose a "major threat to family privacy." Charge that the bill
would impose a federal vaccination mandate that would supplant parentsrightsto make
vaccine decisions for their children.
The Coalition for Managed Competition
Coalition: Consists of the big five insurers (Prudential, Cigna, Aetna, Metropolitan Life, and
Travelers).
Concern: Say that many traditional indemnity insurers have looked to insure only the
healthiest customers.
Strategy: Massive ad campaign.
Coalition for Qrql Hyalft
Goal: Wants basic dental care in the reform plan.
Consortium of Citizens With Disabilities
Represents: Coalition comprised of over 75 consumer, service provider, and professional
organizations which advocate on behalf of persons with disabilities and their families. Over
42 national organizations are members of CCD's Health Task Force including many disease
organizations. The Consortium represents more than 43 million Americans with disabilities
include individuals with physical and mental impairments, conditions, or disorders, severe
acute or chronic illness which limit or impede their ability to function.
Strategy: Significant grassroots potential
Goal: Acute care benefit should be comprehensive and include long-term care services.
Significant concerns regarding the responsiveness of managed care to people with disabilities.
Reform must ensure non-discrimination and fully participation by people with disabilities,
appropriateness of available services (particularly for younger disabled individuals) and equal
access to health services.
Concerns: Non-discrimination of benefits. Special needs of population.
Consumer's Union
Represents: 5 million members. Membership includes magazine subscribers in all 50 states.
Advocacy offices in Washington D.C, Austin, TX and San Francisco, CA.
Strategy: Readership among middle and upper middle class. Viewed as authority on value for
the dollar. No real grassroots operation or cohesive grassroots constituency.
Goal: To meet needs of consumers, reform plan must provide universal quality health care
regardless of age, income, employment or health status; contain costs with a national budget
and administrative simplification; fairfinancing;public accountability and maintain consumer
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�choice.
Coacems: Concerned that managed competition will not work to control costs and could lead
to a multi-tier health system with restricted consumer choice and large out-of-pocket
expenses. Reform plan should allow states sufficient flexibility to experiment with singlepayer approach if they so desire.
The Council for Affoniable Health Insurance
Coalition: A group of 30 small indemnity insurers.
Concern: Paints a bleak picture of the future if most consumers have to buy their insurance
through health alliances.
ramiiie? y ^ ,
Represents: American families-Families USA is a liberal health care consumer group working
for affordable, high-quality health care and long term care.
Strategy: Combines sophisticated grassroots activism with media savvy. Reports well
reported in Media and on Capitol Hill (effectively promotes agenda while maintaining nonpartisan, quasi-academic stance). Active coalition builder.
Goals: universal coverage; basic benefits comparable to those of most Americans; quality
standards; cost-containment; long term care.
The Farmers Union
Represents: (250,000 farm families) Rural farmers in 26 states, a general purpose national
farm organization.
Strategy: Grass roots at Federal, state and local level, mobilizes quickly, and influential in key
agriculture states
Goals: The Farmers Union supports state flexibility so the states can adopt a single payor
system. Supports universal coverage. They support a plan that meets the needs of rural
America-access, choice and quality. The group recognizes that they share the President's
objectives and will set aside their ideology to support the President so long as their objectives
are not abandoned.
Federation of American Health Svstem
Represents: 1400 Investor owned hospitals and several managed care companies
Strategy: Major campaign contributors. Very effective lobbying organization.
Goals: Managed competition. Proposal would provide universal access to coverage through
income-related subsidies; cap tax-free portion of employers and employees health premiums;
create Accountable Health Plans which cannot exclude based on pre-existing condition and
must community rate; and establish National Health Board to set standard benefits package
and facilitate health outcomes data.
Concerns: Very wary of cost and budget controls.
Generic Pharmaceutical Industry Association
Represents: Composed of the leading U.S. manufacturers of generic prescription drugs, was
established in 1981 to foster knowledge of the safety, efficacy, equivalency and quality of
generic drugs and to promote their increased acceptance and use.
Strategy: Influence at both the national and state levels, but do not come close to matching
that of the name brand manufacturers.
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�Goals: The Association supports the following principles for health care reform, universal
access and expansion of Medicare to include outpatient drug benefits. To control costs, true
competition should be returned to the pharmaceutical marketplace through the establishment
of a single reimbursement price for multi-source drugs and establishment of a national open
formulary for multi-source products. They argue that they are not contributing to drug price
inflation. The generic industry is already cost-competitive and should not be burdened with
rebates similar to those imposed on the high priced innovator products. Their primary request
is to insure that they be treated differently than the name brand manufacturers. Theoretically,
they should support price controls, because they would not lose as substantially as the
commercial manufacturers, but they have yet to take this position. Reform Medicaid law to
eliminate mandatory rebate provision, which they argue unfairly hits them because they do
not have profit margins.
Group Health Association of America
Represents: 323 member HMOs, enrolling more than 27 million people. Largest trade
association for organized prepaid health care systems.
Strategy: Legislative representation at the federal and state level, legal counsel, education
programs, and research, and wide distribution of publications.
Goals: Managed competition. Basic benefits package must be comprehensive, with reasonable
cost sharing. "Managed care" should be defined in statute and should include an HMO
component, selective contracting with providers, quality assurance and utilization review
programs, and financial incentives for enrollees to use the plan's providers and procedures.
Exclusive HIPCs for small employers. Tie tax deductibility of health benefits to lowest
priced plan. Risk adjustment for premiums. Concerned about capacity of plans to absorb
large new populations.
Concerns: Long term care, prescription drug benefit
Health Care Choice Project
Goal: Advocates market-based health care reform.
Health Care for All
Coalition: 87 civilrights,unions and abortionrightssupporters.
Goal: Push for inclusion of abortion services as part of the basic benefit package.
Health Industry Manufacturer Association
Represents: 300 Associations. Manufacturers of medical devices, diagnostics, and health care
information systems.
Strategy: Influential. Major industry group employing a significant number of individuals.
Goals: Market-based approach. Believe malpractice/ tort reform should apply to them through
policies restricting product liability. They generally feel wary of budgeting mechanisms and
resource evaluation/planning, fearful that diagnostic services and medical equipment and
devices may be restricted. They were very concerned with Oregon's waiver plan.
Concerns: Budget, caps, technology assessment activities
Health Insurance Association of America
Represents: (270 Members) Trade association for nation's commercial health insurance
companies.
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�Strategy: Gradison is well respected on the Hill, but has lost the 5 big insurers recently.
Goals: Support general managed competition framework. After regularly opposing any kind
of comprehensive reform, now in a negotiating position. On access, would require employers
to offer, but not pay for, a plan, and offer a payroll deduction so that employees can purchase
the coverage. On cost containment, would require uniform rate setting for providers, but
managed care should be primary vehicle for achieving sustained systemwide cost savings.
Insurance reform, including no pre-existing condition limits. On HIPCs, HIAA likes existing
association type schemes. Believes HIPCs should be tried but should compete against other
pooling arrangements. Want federal preemption of state anti-managed care laws. Support a
tax cap. Opposed to global budgets. No monopoly power for HEPCs-allow employer optout; Extent of community rating mandated; caps on premiums; allow supplemental insurance.
Pushing choice, not just in doctors and hospitals, but in insurance plans as well.
Concern: Argue that the number of competing health plans would dwindle after the first year
or two of Clinton-style managed competition because no new organizations could afford the
costs of entering the market."
Other Industry's reform plan would limit government's role to requiring an end to
discrimination in coverage; mandate employers to provide minimum benefits, and subsidize
coverage costs for small employers and the unemployed.
Strategy: Has a month long, $4 million ad campaign underway with TV ads on CNN and
print ads in 10 newspapers. Ads package highlights maintaining the private insurance market
and promoting a wide choice of insurance plans and doctors. Running a half-hour
infomercial. The ad ran 5/16 in New York City, Los Angeles, New Orleans, Indianapolis and
Wichita (5/13). Emphasize support for doctor choice. More than 40,000 people have called
their hotline. Use 800 calls to demonstrate grass root support. Spending $1.5M to organize a
grassroots campaign to include nationwide meetings and distribution of a film about health
reform.
Health Cane Leadership Council
Coalition: Paul Tsongas will be spokesperson. Is a Washington group composed of 50 of the
largest insurance companies, pharmaceutical manufacturers, medical clinics and hospitals.
Goal: Against price controls in the Clinton health plan. Favors managed competition.
Strategy: Tsongas will meet with editorial boards nationwide to make the HLC case. Efforts
include proselytizing among employees, and having industry executives visit local editorial
boards and Rotary Clubs.
Other Aides say Tsongas will receive a "moderate to large" retainer.
The Health Project
Coalition: Includes more than a dozen organizations, including health associations, advocacy
groups and unions. Senator Rockefeller urged the creation. Members include: AARP,
AFL-CIO, AHA, AAFP, ANA, Families USA, the National Association of Social Workers
and two unions.
Goal: Will coordinate a nationwide campaign to promote the outlines of President Clinton's
health care reform package.
Finances: It has an initial budget of $150,000.
Independent Insurance Agents of America
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�Represents: 280,00 insurance agents and their employees. Largest national trade association
of independent insurance agents, who are located in virtually every town and city in the
country.
Strategy: Large PAC campaign contributions, very influential at the state legislative level.
Visible in local communities.
Goals: Support cost containment measures including administrative simplification, managed
care and utilization review. Tax incentives for self-employed individuals and small businesses
to provide health care coverage. Insurance reform including elimination of risk exclusions,
and guaranteed portability. Reinsurance mechanisms for insurers. Pre-emption of state
mandated health benefits. Medical malpractice reform.
Industrial Biotyyhnolpgy Agswiafan
Represents: More than 1 SO companies (small and entrepreneurial firms) that are responsible
for more than 85 percent of the sales, revenues and research and development expenditures in
the biotechnology industry. Three out of four biotech companies have fewer than 50
employees, and 990 out of 100 have fewer than 300 employees. Mostfirmsare less than ten
years old.
Strategy: The 1 of 2 associations for the biotech community. Their influence is growing, but
still young. Plans are to merge with the Association for Biotechnology Companies this
summer will add even more. Not much on advocacy, but could rally with therightissue.
Goals: The primary criteria for the IBA is strong drug benefit package (including medication,
prevention, immunization), outpatient drugs, cost containment for overall health care costs,
and HIPCS. IBA says regulating drug prices won't be enough. Any regulation will not only
constrict but may eliminate biotech industry. Under a managed competition system could
succeed at keeping the price of drugs fairly low, except for new drugs or current drugs for
which there is no therapeutic alternatives, and then the IBA would be hurt in this effort.
Willing to negotiate plan, to limit future price increases in exchange for therightto continue
to set introductory prices.
Concerns: Price controls on new drugs, expansion of the current medicaid rebate program,
therapeutic substitution, and global budgeting.
International Brotherhood of Teamsters
Represents: 1.4 million workers and 400,000 retired workers. Very diverse union representing
people in private industry and state and local government including trucking, brewery, food
processing, clerical work and health care.
Strategy: Large union with significant political clout, increased since Ron Carey became
President.
Goals: Single payer supporters who have seen major labor-management disputes arise due to
rising health care costs. They are supportive of systemic reform and will likely accept an
employer-mandate construct, but could be concerned about any tax-cap provision that limits
their ability to negotiate for a rich benefits package, or that results in reduced benefits for
their members.
Long-Tenn Care Qunpaign
Represents: 138 national organizations representing 60 million people. Large coalition
representing a diverse range of interests including religious denominations, business, labor
unions, racial and ethnic groups, youth, people with disabilities, elderly, veterans, nurses and
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�consumer groups.
Strategy: Huge grass roots network. Ability to pull large crowds. Media savvy.
Goals: Non-ideological on approach as long as long-term care is included as benefit.
Dedicated to enacting comprehensive long-term care benefit which provides full range of
services but particularly home and community-based care. Eligibility based on determination
of disability rather than age or ability to pay.
Mynfol Health Liaison Qiyup
Represents: Coalition of more than 33 national organizations across the United States that
share concern for mental health issues including National Mental Health Association, National
Alliance for the Mentally 111, Amencan Psychiatric Association. Grassroots, Consumers,
Family Advocacy, and Providers Organizations in 50 states.
Strategy: Coordinated message provides relative influence.
Goals: The Mental Health Liaison Group seeks to promote a plan that supports mental health
services, including both acute and rehabilitative services, in a system which provides access
for all Americans.
Concerns: Discrimination in benefit package against mental illness
Minority Contractors Association
Represents: Construction builders with small contracting businesses across the United States.
Strategy: Much influence in black community.
Goals: Play or pay. Contain a high percentage of very small and financially vulnerable
businesses. Organization opposes employer mandates and feel that those businesses who do
not pay for insurance don't pay for it because they can't afford it. Stand to benefit from
insurance reforms such as community rating, insurance pools, as well as cost controls.
Employer mandates especially if imposed without subsidies for at risk enterprises.
National Association for Home Care
Represents: The purpose of NAHC is committed to assuring the availability of humane, costeffective, high-quality home care services to all individuals who require them.
Goals: Supportive of change in system, advocate of a national plan. Home care is the best
way to reduce costs and increase health care. Home care and hospice services in both acute
and long-term care settings. Acute care basic benefit package—home care and hospice
services. Access based on need and not age. Provider participation. Safeguards for quality
assurance and cost containment. Financing must be progressive and broadly based. Benefits.
National Association of Children's Hospitals & Related Institutions
Represents: 131 member hospitals. Represents free-standing, acute care children's hospitals,
pediatric departments of major medical centers, and specialty children's hospitals devoted to
rehabilitative and chronic care for children. Children's hospitals represent 1% of the nation's
hospitals, and care for more than 12% of all hospitalized children and 24% of hospitalized
children with chronic and congenital conditions.
Strategy: Influential in children's health community
Goals: Managed competition. A national health care plan needs to meet the needs of children
through the following principles. Health care reform is accountable for children's health care
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�needs. Employer-financed health care insurance. Minimum benefits package for children.
Availability of pediatric trained care. Cost containment. Recognition of the special funding
requirements for providers who serve a disproportionate share of low- income children.
Administrative simplification.
Concerns: Benefit plan and cost containment strategy without tailoring to children's special
needs.
National Aggpcifltipn pf Cgynfag
Represents: Over two-thirds of the 3044 county governments in the United States belong to
NACo, ranging in size from Los Angeles County (pop. 8 million) to Loving County, Texas
(pop. 100). The county governments themselves are the actual members, and county
membership allows its elected and appointed officials to participate in NACo. 13,000 elected
county officials; 2 million county employees
Strategy: NACo is the only national representative of counties in the U.S. and its member
counties will be critical to the implementation and success of a health care reform package.
Goals: NACo supports the general managed competition framework of managed care systems,
with an emphasis on preventive and primary care; federal government should work with states
and counties to develop purchasing cooperatives; federal government should develop rates and
benefit package that includes coverage for mental health, substance abuse and long term care;
financing should come from a national tax; federal government should reduce administration,
costs through simplification. NACo opposes capping federal health care entitlement
programs.
National Association of Manufacturers
Represents: More than 12,000 member companies and subsidiaries. Industries of all sizes
located in every state. Many mature industries with older workers. NAM member companies
employ 85 percent of all workers in manufacturing and produce more than 80 percent of the
nation's manufactured goods.
Strategy: Influential with both Congress and the media.
Goals: Managed competition. Conducted survey of members in 1992 which found that NAM
members are more receptive to reform approaches they previously opposed, provided these
approaches are part of a comprehensive health care reform package. Reform must include:
universal coverage, medical liability tort reform, administrative and quality initiatives,
mechanisms to measure and disseminate health care outcomes, cost containment measures to
address corporate cost increases and cost-shifting, integration of Medicare, maintain selfinsurance option, and broad-based financing mechanisms.
Concerns: Concerned about further tax on top of energy tax in economic package.
National Association of Private Enterprise
Represents: NAPE has over 50,000 members nationwide. NAPE's members are primarily
unincorporated mom-and-pop businesses with fewer than 10 employees.
Strategy: NAPE has attempted to take a more low key approach to legislative issues, than its
largerrivalslike the NFIB. It has recently raised its profile in Washington and around the
country by holding "speak out" town meetings with local and congressional politicians on
various small business issues. NAPE has avoided taking any public position on health reform
until they know more details.
Goals: NAPE supports strong cost containment measures, including global budgeting and
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�malpractice reform. They support the 100 percent deduction and any additional tax incentives
for small businesses. Generally, they do not support mandates, but they are taking a wait and
see attitude to see what financial support might be provided. NAPE would like to continue to
provide health insurance benefits for its membership. Since most of their members have
insurance coverage, they are concerned that market reform might actually raise the cost of
health insurance coverage for its members.
Concerns: NAPE's hot buttons are cost containment and maintaining their ability to provide
health insurance to its members.
National Association of Retail Druggists
Represents: 40,000 independent retail pharmacies, including more than 60,000 pharmacies and
employing more than 112,000 community pharmacists who dispense over two billion
prescriptions annually. Represent the economic interests of drug store owners (either
individual owners or corporate).
Strategy: Strong grassroots, generally effective lobbying.
Goals: Concepts fundamental to any reform of health care. Pharmacy Services and
prescription drugs must be cost-effective methods of providing quality health care and serves
as a cost containment tool for reducing overall health care expenditures; outpatient pharmacy
services benefit; streamline administration in third-party prescription drug programs; free
access and choice in pharmacy services; eliminate pharmaceutical manufacturers'
discriminatory pricing practices; pharmaceutical products included in core benefit package;
cost containment; pharmacy services benefits; health education benefits
Concerns: Discriminatory pricing. Drug manufacturers practices.
National Association of Social Workers
Represents: 145,000 professional social workers. 55 chapters in the U.S. 80,000 clinical
social workers provide over half of the mental health counseling in the U.S.
Strategy: Strong grassroots, mobilize quickly, protect consumers, in all states.
Goals: Strong single payer to middle range (anything else will lead to two tier system and
poor people will lose out). Provide flexibility to states. Health care financed through
dedicated federal tax on personal income and an employer-paid payroll tax. Single
comprehensive set of health care benefits. Mental health benefits must be included in plan.
Concerns: Comprehensive parity for mental health benefits with physical health issues. Don't
believe co-pay should be different for mental health.
National Association of Women Business Ownere
Represents: NAWBO is the only national organization representing the interests of all women
entrepreneurs in all types of businesses. NAWBO'sfirstchapters were formed in 1978; today
the organization has 50 chapters and is affiliated with the World Association of Women
Business Owners in 23 countries.
National Committee to Preserve Social Security
Represents: Six million members and supporters. Grassroots senior citizens' advocacy and
education association. It is the nation's second-largest senior lobbying group and is dedicated
to protecting the entitlements which older Americans rely on.
Strategy: Working to overcome poor image created by tactics used to encourage membership
andfinancialcontributions by vulnerable seniors. While not particularly respected on the
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�Hill, they are feared for their PR apparatus and their ability to generate tremendous volumes
of mail.
Goals: Flexible. The National Committee supports the goals of the health care reform to
cover all Americans for acute and long-term care. Their main priorities are the inclusion of
long-term care and prescription drugs in the benefits package. Other issues of interest include
coordination with Medicare, cost containment, broad based financing, maintaining quality care
and preventive services.
Concerns: Being asked to help finance health reform without expanding their benefits.
National Confeiyncy pf gtate Legiglpfri?
Represents: Legislatures of 50 states, territories & possessions. 7400 individual state
legislators and staff.
Strategy: NCSL has a well organized bipartisan membership; it is very influential in state
legislation and reform policy; its lobbying arm represents interests of state legislatures before
Congress and Administration.
Goals: Managed competition/HIPC model. Supports universal coverage; encouragement of
purchasing cooperatives; establishment of minimum benefit package with emphasis on
preventive and primary care; national health care budget; state regulation of allocation of
technology; administrative simplification; malpractice reform
Other Very supportive of plan with two exceptions:
(1) NCSL stopped short of endorsing "managed care" because of concerns by rural
legislators and inner city legislators about the possibility (impossibility?) of managed
care working in undeserved areas; and
(2) NCSL feels that the federal government should develop an expedited waiver
process by which states can receive waivers (for 3 - 4 years) of requirements under
Medicaid, Medicare, ERISA and other federal laws to implement state enacted
programs that expand access to health care.
National Congress of American Indians
Represents: 144 member American Indian tribes and Alaska Native governments. Nation's
largest and oldest national inter-tribal organization representing tribes in 33 states.
Goals: Improve access to health care for Native Americans (over 50% not serviced by the
three Indian health care service systems) while maintaining consumer choice. Possible
limitations of managed care to service very poor and rural areas necessitates the coordination
between Indian Health Service and local health networks. Subsidies for small employers.
Improve availability of primary care providers. Benefits should include long-term care and
health promotion and disease prevention.
Concerns: Preserving tribal government/local community health care provision options
included in 638 programs (want less IHS domination) (culturally sensitive and relevant
health care).
National Council of Churches of Christ in the U.S.
Represents: 45 million Christians in the US. 32 member church bodies, including Protestant,
Orthodox and Anglican churches. Of the 141,000 congregations across the country, the
membership includes 6 historic black churches, Quaker meeting houses, Korean-Americans,
and Orthodox churches. Member of the Interreligious Health Care Access Campaign.
Strategy: Found in practically every community, strong grassroots network, they link in the
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�nation's ecumenical network-working relationships with Roman Catholic Church, Evangelical,
Pentecostal communities, Jewish and Muslim groups, foundations and other nonprofit groups.
Goals: Single payer, shifted positions to look at a variety of approaches. Criteria for support
on any health care program includes universal access and a comprehensive package of
benefits. Publicly-financed through income and corporate taxes; quality of care;
comprehensive benefits package including preventive care, health promotion, education;
primary and acute care; extended care and rehabilitative services at home and in institutions;
mental health; cost savings; simple financing; patient choice; state flexibility.
National Council of La Raza
Represents: Umbrella organization for 1 SO affiliated Hispanic Community-based
organizations. Largest constituency-based national Hispanic organization which improves life
opportunities for Hispanic Americans through applied research, policy analysis and advocacy,
capacity building assistance for community organizations, public information and special
projects. Their programs reach over 2 million Hispanics annually.
Strategy: Strongest in CA, AZ, TX, IL, respected on data collected
Goals: Favored single payer. Health care reform must address demographic and
socioeconomic conditions of Hispanic Americans. Should reduce structural elements and
policies that create barriers to access to both the private and public insurance systems for
Hispanic Americans. Universal access is key but special outreach efforts are necessary to
ensure real access for this population which often shies away from contact with official
offices.
Concerns: One size fits all plan insensitive cultural and socioeconomic differences.
Concerned about lack of research into Hispanic health issues.
National Cpimpl of Senipr Otizgng
Represents: Over 5 million Older Americans. 5,000 affiliated clubs and State Councils
nationwide. Mostly retired union members.
Strategy: Very organized grass roots organization, influence and ability to mobilize quickly.
Goals: Single payer, but flexible. The NCSC supports the following items for health care
reform; prescription drug benefit; long term care benefit; retiree benefit; cost sharing; quality
assurance; cost containment; health planning; patients rights; program Administration;
payment mechanism; no opt out of HIPCS; system leading to 2 Tier system.
National Governors Association
Represents: Governors of the SO states, American Samoa, Guam, Northern Mariana Islands,
Puerto Rico and the Virgin Islands.
Strategy: NGA represents the Nation's Governors collectively and in a bipartisan manner
before Congress and the Administration.
Goals: managed competition/HIPC model. NGA supports state-organized purchasing
cooperatives; core benefits package; federal minimum tort reform standards; limitations on
tax-deductibility of health insurance; single claim form/electronic billing; established goals for
growth of national health care expenditures; annual report to the states by the federal
government.
National Health Cai? Coalitipn
Coalition: A San Fernando Valley-based group of senior citizens comprised of 800-900
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�people. The coalition was developed two years ago.
Goal: Supports a single-payer system.
Other Expect a single-payer system would cost more money, but it's a price group is willing
to pay to see that everyone in the country can get health care.
National Hosnice Organization
Represents: 1400 provider members, 2,000 professional members with the mission to advocate
for the needs of the terminally ill and promote the philosophy of hospice care.
Goals: Home care benefits. Benefits package. Incentives for provider networks to contract
with existing community-based health care providers.
Natipngl Medical A??ocifition
Represents: More than 16,000 physicians. Physicians in all SO states, Puerto Rico and Virgin
Islands, most of whom are minority and of those most are African American.
Strategy: May be influential with Congressional Black Congress.
Goals: Single payer but flexible. Universal access, including subsidization of coverage for the
low-income. Comprehensive package with emphasis on prevention; freedom of choice
between provider and patient; government assurance of quality medical care with
representative minority participation; and compliance with Title VI of Civil Rights Act.
Address shortage of minority physicians. Build incentives for minorities to enter medical
profession.
National Medical Liability Refonn Coalition
Coalition: 60 Organizations (includes AMA)
Other Met with the malpractice subgroup of the task force.
National Retail Federjtfipn
Represents: 1.3 million retail establishments. The nation's largest trade group encompassing
the entire spectrum of retailing including department, chain, discount, specialty at independent
stores and associations. Their membership employs nearly 20 million people and had
registered sales in excess of $1.8 trillion in 1990. The large retailers (Sears, Penny's) drive
the organization.
Goals: Support managed competition. Oppose:
1) mandated coverage of part-time and
seasonal employees; 2) restricted employee freedom to select where they purchase health care
coverage (i.e. through employer, spouse's employer, or private insurance); 3) required stated
percentage contribution from employers (prefer to allow the free market to set employer
contribution levels.
National Restaurant Association
Represents: 710,000 foodservice operations. Nine million foodservice employees with a large
number of entry-level and part-time employees. Founding member of the Health Care Equity
Action League (HEAL), designed to find market-based solution to healthcare crisis.
Strategy: Large organization. Influential and conservative.
Goals: Managed competition. HIPCs no larger than necessary to spread risk equitably.
Continuation of self-insurance for large employers. Insurance reforms including community
rating with risk adjustment factors, elimination of pre-existing condition clauses once
coverage initially established. Standard benefit package. Limits on employees tax exclusion
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�for health benefits. Federal clearinghouse on technology assessments. No global budgets.
No employer mandates - very concerned about part-time workers.
Concerns: Employer mandate, particularly coverage of part-time employers
National Small Business United
Represents: 65,000 small business owners. NSBU represents small business owners in many
service and industrial sectors. NSBU places a major emphasis on small business advocacy,
taking a bi-partisan approach to working with Congress and other elected officials.
Strategy: Limited influence on Congress. Good with media.
Goals: Individual mandates; individual responsibility as the cornerstone of any health care
reform effort. In the past, they have been the more liberal, progressive group (more open to
discussing employer mandates as long as cost containment and individual responsibility are
addressed). Within the last year, however, they have become more adamantly opposed to an
employer mandate. NSBU's membership includes several models for small employer
purchasing cooperatives. They support therightfor small business to organize their own
HIPCs and to manage their own health care activities. Streamlining of delivery system
necessary, not just refinancing and containing costs. Contain costs with emphasis on
universal coverage and through provider/payor interactions at community level not federally
imposed restrictions. Including workers' compensation with health care reform could be
valuable to small business owners and employees, but there are concerns about how it will be
implemented. Oppose payroll taxes financing prefer broad-based taxes, including
consumption. They have expressed support for an increased income tax to help finance
coverage.
National Urban Leagu?
Represents: Constituent organization with 113 affiliates. Grassroots affiliates in urban areas
as a civilrightsand advocacy basis mainly focused on African-Americans.
Strategy: Solid, credible organization annually produces report on the State of Black America.
Goals: The Urban League supports the goals of health care reform to provide universal
coverage. Their priorities are ensuring that the most vulnerable, minorities and the poor.are
not further disadvantaged by a new system.
Concerns: Medicaid benefits tax, which has disproportionate impact on poor; increasing age
for Medicare eligibility, which causes African-American (who die younger) to contribute to a
system they are less likely to collect from; and new system which may hurt health care
providers who are from and care about their community or will put health care workers, who
are not culturally sensitive into communities.
Pharmaceutical Mjuiufacturei? Agsowtign
Represents: More than 100firmsthat produce drugs in the U.S., including Mercke, Searle,
Bristol-Myers Squibb, Pfizer, Inc. Is a nonprofit scientific and professional organization.
Strategy: Ability to mobilize quickly, powerful lobbyist, advocates for the drug manufacturing
industry, effective grass roots, significantfinancialresources and substantial clout in
Congress.
Goals: Noncommittal, but anti- government involvement. The PMA Board supports a
managed competition approach to comprehensive healthcare reform including the following:
inclusion of prescription drugs; prescription drug benefit to Medicare beneficiaries; Medicare
prescription drug coverage to at least 100% of poverty level. In principle, managed
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�competition is bad for them because of the formulas, but they could get drug benefits. The
industry has come around towards our plan. Supports global budgeting, fee for service option,
and antitrust relief. Opposes everything in cost control package both in the short and long
term. Wants voluntary price controls.
Public Citizen's Congress Watch
Goal: Back the Caiifomia standard.
Other The 75 Caiifomia law caps pain and suffering awards at $250,000, imposes a two-year
statute of limitation for bringing a suit, prohibits "lump-sum" payments for damages over
$100,000 and sets a sliding scale for atty. fees.
Religious Coalition for Abortion Rights
Goal: Support government funding of abortions.
Roman Cflthplif Arehbiphppg
Other The bishops are torn between mounting a blanket opposition to such a proposal,
bargaining for a version that at least minimizes their moral concerns or withdrawing from the
public debate. Concerned with whether or not catholic hospitals (approximately 10 percent of
all hospitals) would be forced to offer abortions.
Rs Parftiei?
Coalition: drug companies (organized by GD. Searle & Co., includes Searle and Upjohn Co.,
Bristol-Myers Squibb Co., Hoffman-La Roche Inc., Eli Lilly and Co., Wamer-Labert Co., and
Glaxo Holdings PLC).
Strategy: Hired Washington, DC, public relations firm Powell Tate. The group will
reportedly launch a grass-roots campaign through editorial page articles, direct approaches to
select journalists, and efforts to get drug company executives on non-traditional forums such
as talk radio and television shows. Concern: "Drugs provide relief, not just profit." Argue
drug prices "are quite reasonable," noting: while the cost of a coronary bypass operation
averages $40,000, drug therapy treatment for the same problem costs $1,000; only 3 out of 10
new drugs pay for their R&D costs; and average drug spending is $210/American compared
with $225/person in other industrialized countries.
Other Some of the industry's most prestigious and powerful members such as Merck, Pfizer,
American Home Products and Johnson & Johnson have declined to join the group, partly
reflecting conflicts among drug makers over initiatives put forth by the Clinton administration.
In the past, the industry has relied on PMA to argue its case to government officials and the
press. However, many of the PMA's members have been upset of late that the PMA has been
unable to keep the industry image from being tarnished. PMA downplayed the coalition's
independent campaign.
Service Employees International Union
Represents: More than one million members in U.S., Canada, and Puerto Rico. Public
employees make up one-half of membership. With more than 400,000 members working in
hospitals, nursing homes, and HMOs, largest union of health care workers.
Strategy: Large, fairly influential. Largest union is in Caiifomia.
Goals: Same as AFL-CIO (Support universal access through regional purchasing and delivery
system with enforceable budget. Community rating for all. Consumer choice among plans.
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�Quality assurance system including development of practice guidelines, health outcomes
research and technology assessment)
Small Business Legislative Council
Represents: Coalition of 100 small business trade associations. Council organizations
represent at least 1.6 million small businesses in diverse economic sectors (manufacturing,
retailing, distributing, professional and technical services,construction, transportation and
agriculture).
Strategy: Newsletter widely distributed. Well liked by key congressional members.
Goals: Their health care reform proposal does not include an employer mandate, but have
signaled their willingness to discuss if the cost issue is adequately addressed and small
businesses are not unduly burdened. They developed a reform proposal about two years ago.
Establishment of global spending goals and rate structures that reflect local circumstances.
Recently released statement supportive of price controls. Encourage creation of voluntary
small business "buying groups." Limits on employee tax exclusion for employer-paid health
coverage. Reform of small group case market should recognize importance of association
insurance plans (including MEWA's) as a means of providing coverage and relevance of
workers compensation as a large component of the health care debate.
Concerns: Cost control, employer mandate.
Vnifcd AytP Wgritei?
Represents: 1.4 million. Active and retired workers throughout the U.S. Automobile,
Aerospace & Agricultural implement and parts industry.
Strategy: One of the largest and most powerful unions. Particularly influential in industrial
midwest.
Goals: Single payer union, but willing to work with us. Very concerned about retirees health
care coverage.
U.S. Chamber of Commerce
Represents: 215,000 businesses and organizations. The U.S. Chamber of Commerce is the
largest organization of businesses. Over 90 percent of Chamber members have less than 100
employees.
Strategy: Strong Grassroots network, influential with Congress
Goals: Managed Competition. The Chamber's "Guidelines for Health Care Reform" support:
employer "contributions" only if there is an appropriate subsidy for low-wage workers and
their employers; comprehensive managed competition strategies, covering both private and
public programs; national core benefits package, stressing individual cost sharing; regional
purchasing groups for small businesses and individuals, with flexibility to allow business
coalitions to serve this function and insurance market reform; and cost containment to limit
cost increases to the growth of GNP. Limit tax deductibility of premiums for employees (but
not for employers). HIPC participation limited to firms of no more than 100 employees.
Mandate without subsidy; Undercutting self-insurance option; Destructive regulation of
premiums; Scale, timing, and tax-look at in context of whole economic package.
U.S. Conference of Mavore
Represents: Mayors of cities with a population of 30,000 or more. There are over 1,000 of
such cities in the country.
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�Strategy: USCM is a nonpartisan organization that calls national attention to the problems and
potentials of urban America. USCM represents the nation's cities before Congress and the
Administration.
Goals: USCM supports designing a basic benefits package that includes preventive services;
developing an information base that will allow consumers to choose among plans; reforming
the tort system for malpractice suits; developing standardized claims forms and electronic
billing systems; and the training and placement of culturally competent health professionals in
areas of local need. Health services now rendered at local health departments must continue
with a new system.
Universal Health Care Action Network
Goal: Will advance the single-payer cause once the Clinton plan is introduced.
Washington Business Group on Health
Represents: 180 Fortune 500 members
Strategy: Influential on health policy matters in Congress. Well known to trade press as well
as Washington-based media.
Goals: Managed competition. Very comprehensive benefit package. Allow HIPC opt out for
the self-insured. Believe managed care and managed competition have great potential to
manage costs. Unlike many business groups, very supportive of mental health benefits
(President Mary Jane England, not surprisingly, is a psychiatrist). Considered one of more
progressive large business groups.
MBB 3/25
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Health Care Task Force Records
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="https://catalog.archives.gov/id/10443060" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
<p>This collection contains records on President Clinton’s efforts to overhaul the health care system in the United States. In 1993 he appointed First Lady Hillary Rodham Clinton to be the head of the Health Care Task Force (HCTF). She traveled across the country holding hearings, conferred with Senators and Representatives, and sought advice from sources outside the government in an attempt to repair the health care system in the United States. However, the administration’s health care plan, introduced to Congress as the Health Security Act, failed to pass in 1994.</p>
<p>Due to the vast amount of records from the Health Care Task Force the collection has been divided into segments. Segments will be made available as they are digitized.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+1"><strong>Segment One</strong></a><br /> This collection consists of Ira Magaziner’s Health Care Task Force files including: correspondence, reports, news clippings, press releases, and publications. Ira Magaziner a Senior Advisor to President Clinton for Policy Development was heavily involved in health care reform. Magaziner assisted the Task Force by coordinating health care policy development through numerous working groups. Magaziner and the First Lady were the President’s primary advisors on health care. The Health Care Task Force eventually produced the administration’s health care plan, introduced to Congress as the Health Security Act. This bill failed to pass in 1994.<br /> Contains 1065 files from 109 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+2"><strong>Segment Two</strong></a><br /> This segment consists of records describing the efforts of First Lady Hillary Rodham Clinton to get health care reform through Congress. This collection consists of correspondence, newspaper and magazine articles, memos, papers, and reports. A significant feature of the records are letters from constituents describing their feelings about health care reform and disastrous financial situations they found themselves in as the result of inadequate or inappropriate health insurance coverage. The collection also contains records created by Robert Boorstin, Roger Goldblatt, Steven Edelstein, Christine Heenan, Lynn Margherio, Simone Rueschemeyer, Meeghan Prunty, Marjorie Tarmey, and others.<br /> Contains 697 files from 47 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+3"><strong>Segment Three</strong></a><br /> The majority of the records in this collection consist of reports, polls, and surveys concerning nearly all aspects of health care; many letters from the public, medical professionals and organizations, and legislators to the Task Force concerning its mission; as well as the telephone message logs of the Task Force.<br /> Contains 592 files from 44 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+4"><strong>Segment Four</strong></a><br /> This collection consists of records describing the efforts of the Clinton Administration to pass the Health Security Act, which would have reformed the health care system of the United States. This collection contains memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, newspaper articles, and faxes. The collection contains lists of experts from the field of medicine willing to testify to the viability of the Health Security Act. Much of the remaining material duplicates records from the previous segments.<br /> Contains 590 files from 52 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+5">Segment Five</a></strong><br /> This collection of the Health Care Task Force records consists of materials from the files of Robert Boorstin, Alice Dunscomb, Richard Veloz and Walter Zelman. The files contain memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, statements, surveys, newspaper articles, and faxes. Much of the material in this segment duplicates records from the previous segments.<br /> Contains 435 files from 47 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+6">Segment Six</a></strong><br /> This collection consists of the files of the Health Care Task Force, focusing on material from Jack Lew and Lynn Margherio. Lew’s records reflect a preoccupation with figures, statistics, and calculations of all sorts. Graphs and charts abound on the effect reform of the health care system would have on the federal budget. Margherio, a Senior Policy Analyst on the Domestic Policy Council, has documents such as: memoranda, notes, summaries, and articles on individuals (largely doctors) deemed to be experts on the Health Security Act of 1993 qualified to travel across the country and speak to groups in glowing terms about the groundbreaking initiative put forward by President Clinton in his first year in the White House. <br /> Contains 804 files from 40 boxes.</p>
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Identifier
An unambiguous reference to the resource within a given context
2006-0885-F
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Original Format
The type of object, such as painting, sculpture, paper, photo, and additional data
Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Miscellaneous: Interest Groups – General [2]
Creator
An entity primarily responsible for making the resource
Task Force on National Health Care
White House Health Care Task Force
Meeghan Prunty
Identifier
An unambiguous reference to the resource within a given context
2006-0885-F Segment 2
Is Part Of
A related resource in which the described resource is physically or logically included.
Box 32
<a href="http://clintonlibrary.gov/assets/Documents/Finding-Aids/2006/2006-0885-F-2.pdf" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/12093092" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
Medium
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Preservation-Reproduction-Reference
Date Created
Date of creation of the resource.
2/6/2015
Source
A related resource from which the described resource is derived
42-t-12093092-20060885F-Seg2-032-010-2015
12093092