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��PRESIDENT CLINTON PARTICIPATES IN CONFERENCE CALL WITH
CAREGIVERS ON LONG-TERM CARE AND THE HEALTH SECURITY ACT
Wednesday, March 2, 1994
President Clinton will participate in a conference call today with eight Americans from
around the country who are delivering long-term care in their homes to elderly parents,
spouses and disabled children. The President will talk with these caregivers, listen to their
personal stories of the barriers and financial burdens they have faced under the present
system, and outline the expanded long-term care benefits proposed under the Health Security
Act.
Brief biographical descriptions of the participants on the call follow and a fact sheet
on long-term care benefits under the Health Security Act is attached. A press release from the
American Association of Retired Persons (AARP), citing a recent study by Lewin-VHI on the
employment effects of the long-term component of the Health Security Act, is also attached.
EVE LEFKOWITZ
Langhorne, Pennsylvania
Eve Lefkowitz, a visiting nurse, provides care for both of her parents. Her mother,
Murial Hochberg, has lung cancer and requires assistance with bathing, dressing and
walking. Her father has mental disabilities. Because Eve believed that putting her
parents in a nursing home would destroy them, she moved them from New York to
her home in Pennsylvania. Her mother receives home health care five days a week
and her father attends adult day care. The cost of home care--$900 per week-is
depleting their savings. Despite Eve's desire to keep her parents at home, she will be
unable to afford care much longer. She works instead of staying home to care for
her parents, so that she may keep her group health insurance for her two small
children and self-employed husband.
BETH AND JAMES CRAMPTON
Omaha, Nebraska
Beth Crampton is a 23-year-old recent college graduate. Along with her 70-year-old
father, James, she takes care of her mother, Mary Lou, who is 66 and has
Alzheimer's disease. Beth and James are sole caregivers, save for some volunteers,
from the local chapter of the Alzheimer's Association. But respite is infrequent
because Mary Lou's behavior can sometimes be a problem, requiring skilled help, not
volunteers. Beth had delayed her entry into graduate school so that she could stay
home and care for her mother. Soon, she will continue her education and worries
about what will happen to both her parents when she leaves.
^Jpt^U^
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-more-
�Conference Call on Long-Term Care
Page 2
GOLDIA KENDALL
Jonesboro, Arkansas
Mrs. Kendall is 85 years old and has worked all her life as a cook and nurse. Her
husband, Elsworth Kendall is an 89-year-old retired factory worker and carpenter.
Five years ago, Mr. Kendall had a stroke which left him paralyzed from the waist
down. He also has Alzheimer's disease. Mrs. Kendall provides almost all of his daily
care. Medicare covers one hour of care a day, five days a week, to help with bathing
and dressing. Their income is too high to receive Medicaid. Mrs. Kendall placed her
husband in a nursing home five years ago but felt he was deteriorating and was not
receiving adequate care. She brought him home and vowed to keep him there. She
leaves him alone to run errands, but is extremely nervous about doing so.
GENE HAYES
Fresno, California
Gene Hayes, a victim of Parkinson's disease, cares for his 69-year-old wife who
suffered a heart attack in 1988 and has been comatose ever since. He also cares for
his 93-year-old father who has had multiple strokes and is in a wheelchair. His wife,
Velora, must be monitored around the clock as rotation and aspiration is necessary
every three hours. Gene has spent his savings, receives no public assistance and is
determined to keep his family at home for as long as possible. Gene pays out-ofpocket for unskilled help, however this expenditure leaves him $500 in debt every
month. Gene has his own health problems and will not be able to continue this care
indefinitely without some skilled help.
MARY HAMMER
Blacksburg, Virginia
Mary Hammer, 79, lives alone in her home as a result of community services.
Nineteen years ago she was in a car accident (hit by a drunk driver) and her left leg
was amputated. She subsequently suffered two strokes, leaving the right side of her
body partially paralyzed. She needs assistance with bathing, dressing, and other
activities. Mrs. Hammer receives personal care and companion services through the
local department of social services. Without this help, she would be unable to
remain safely in her own home and would need to live in a nursing home. Her
case illustrates that if good systems are in place, people can stay at home.
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�Conference Call on Long-Term Care
Page 3
DONNA L Y T T L E
South Ozone Park, New York
Donna Lyttle cares for her mother, Lillian, who suffers from Alzheimer's Disease.
Ms. Lyttle, who works at Harlem Hospital, has lived with and cared for her mother
since her father died last year. Her mother attends a day care program two days
per week which Ms. Lyttle pays for out-of-pocket. Ms. Lyttle also pays out-ofpocket for unskilled home care as skilled care is too expensive. These bills total
$500 per week. Ms. Lyttle has put her personal life completely on hold. She is an
example of an adult child whose life-focus is caring for her mother, both financially
and emotionally.
VERA T E S K E
Wheaton, Kansas
Vera Teske, 66, cares for her 70-year-old husband, Melvin, who suffers from
Alzheimer's Disease. They live on a family farm near Topeka, Kansas. Vera must
help with eating, dressing and bathing every day. Finding skilled outside help in
their rural area is extremely difficult. Vera and Melvin have five grown children
and thirteen grandchildren who help with Melvin's care when they can. The Teskes
are an example of a rural family who would purchase home and community
services if the skilled care was available in their community.
MARGE GARRISON
Houston, Texas
Marge, 55, and her husband. Bill, have a 22-year-old daughter, Jennie, who is
mentally retarded and autistic. Jennie's needs made it impossible for Marge, a
former school teacher, to continue working. Jennie's condition is challenging. She
must have basic things done for her and must be fully supervised. She attends
public school, but must leave the system in May. Marge has a bad back (largely
from lifting Jennie) and very high blood pressure, and Bill has suffered a heart
attack. The Garrisons have two other children who want to assist with Jennie's care
in order to keep her at home. Marge fears that unless they get some home and
community-based care, this will not be possible.
-30-30-30-
�LONG-TERM CARE AND THE HEALTH SECURITY ACT
March 2, 1994
Expands Home and Community-Based Care
The Health Security Act will establish a new home and community based care
program, enabling more than 2 million older Americans and 1 million Americans with
disabilities who need long term care to live at home, independently, in their
communities, or with family caregivers -- which most prefer. Services will be tailored
to meet individual needs and could include such services as in-home care, personal
assistance, respite for family caregivers, adult day services, rehabilitation, assistive
devices, and services in assisted living facilities.
Protects Nursing Home Residents
The Health Security Act will improve the quality of life for nursing home residents.
States will have to let nursing home residents keep more of their personal assets and
still qualify for Medicaid. The personal needs allowance for all Medicaid residents
would be increased to a minimum of $50 a month.
Makes Private Long-Term Care Insurance More Affordable
The act will improve the quality of private long-term care insurance by establishing
tough national standards that prevent insurance companies from denying people
coverage or choosing only the best risks. New tax incentives, similar to those available
for health insurance, will help make private long-term care insurance more affordable.
Encourages People with Disabilities to Work
Individuals with disabilities who work will be eligible to obtain tax credits for 50
percent of the costs of personal expenses needed to work, up to $15,000 maximum per
year. This will provide more opportunity for people with disabilities to be further
integrated into the workforce.
Supports Family Caregivers
The President's approach will help family members care for relatives with disabilities
with the long-awaited support they deserve, giving families a break when they need it
most.
-30-30-30-
�i
2002
AARP
Bnn/fttij lifttimes of txptntnce and leadership rn serve alljfi-ncntcions.
FOR RELEASE: March 1, 1994
CONTACT: John Rother
202-434-3701
Attached is an estimate of the employment effects of the home and community-based
component of the Administration's Health Security Act. This estimate was developed by
Lewin-VHI, the leading independent health econometrics firm in the country that has
developed an economic model of the impact of various health reform proposals.
As you can sec, their estimate is that this part of the Administration's bill would, if
enacted, generate over one million new jobs when fully implemented.
John Rother, Director
Legislation and Public Policy Division
-30-
Amcriciii .•Us..u-ur-.ou or'RctircJ Persons 601 £ Street. N'.'.V. Wishir.gton. D.C. 20049
I^voln 'A Kura,css Pres-.xcrtt
'.2021 434-2277
Horjcc R Occcj Ext:\itivt Dtrccror
�February 2. 1994
MEMORANDUM
To:
Van Ellet
From:
Dave Kenneii
Lisa Alecxih
SuDiect.
JoD Gam as a Resuu of Heaith Security Aa LTC Provisions
This memo orovides an estimate ot the numoer of jobs that are likely to be created by
the new nome and commumty-basea service program proposed under the Health Security Act
(HSA). The estimate presented here is only for the new home and community-based program
ana dees not include the job effects of other portions of the Act.
The new program for persons with significant disabilities provides a substantial increase
m expenditures for home and community-based services. In calendar year 2002. the first
calendar year the program is fully phased-m, total new expenditures for home and communityGasea services are expected to De neany $40 billion (in 2002 Ss).
This estimate is based on the assumption that all states match their full federal
allocations, and includes new out-of-pocket expenditures for cost-sharing by participants.
Other Key assumptions are summarized in the attached table. We estimated the additional
jobs m four components: 1) case management expenditures: 2) net new expenditures
associated with visits: 3) net new expenditures for residential facility care: and 4) overhead
other than case management, such as benefits, rent, and management salanes.
We estimate that in calendar year 2002. the number of new full-time equivalent
personnel (PTEs) required to deliver care under the fully phased-in program would be
approximately 950.000. This estimate includes new care providers, as well as case managers
required. It is expected that many of the care providers would actually be part-time workers. If
we assume that one-quarter of the required new FTEs work part-time (25 hours per week), the
numoer of new |0bs increases to approximately 1,050.000. These estimates are consistent
with the assumptions concerning the number of eligible persons, units of service, pnees for
services, and case management used to develop the cost estimates for the new program.
Please call if you have any questions.
�-2KEY ASSUMPTIONS USED IN ESTIMATING THE JOS IMPACT
FOR THE HOME AND COMMUNITY-BASED SERVICES PROGRAM
UNDER THE HEALTH SECURITY ACT. CY 2002
C o m p o n e n t s of Estimate
Assumotions
Case M a n a g e m e n t Assumptions
Numoer of Reaoients
Caseload oer Case Manager
Salary (1993 Ss)
without overneaa
with overneaa
Numoer of F^Es
Net N e w Expenditures Associated with visits
Direct Excenaitures 11993 Ssr
^ o u r ^ Rate (1993 Ssi
Home Health Aide
Homemaxer
LPN
Overan Average
'•IS '.! nome neaitn a;ce: 45 o hcrnemaKer: and i 0 o LPN)
Numoer o? " E s
Net New Expenditures Associated with Residential Care
Direct Exoenditures (1993 Ss)
Annuai Excenditures/Recicient 11993 Ssi
Numoer ot New Reccienu
Ratio ot flecipients to WorKers
Average Houny Rata (1993 Ss)
Numoer of M bs
O v e r h e a d Other than Case Management (all in 1993 S s )
Benefits ;sociai security taxes, worxers comp. 4 health ms.. etc.)
Rent ana Cther Excerses
Supervisor Salary Excenaitures
Average Salary
Numoer of ^ cs
9
,,
2.3 million
50
$27,000
S58.900
57.000
$8.6 Diliion
$720
S6.20
$12.10
$7.20
o
665.000
$1 9 billion
$27,500
160.000
0.95
$6.30
170.000
Si0.5 billion
$2.5 billion
$5.3 billion
$22 billion
$50,000
50.000
2
3
a
1
Direct new excenaitures for visits does not include indirect costs (such as agency overhead.
:ase management, etc.). Direct new excenaitures are eaual to one-half of the net new
expenditures under Tie program, excluding case management - i.e.. (Total Expenditures Under
Program - Current Expenditures (either Medicaid or direct trom recipients) • Case
Management(/2.0. This assumes that overhead on direct care worxer salaries is eaual to direct
salary payments. Overhead is descnoed m footnote 4 below. Direct new expenditures for visrts
are equal to total direct new expenditures less residential care expenditures.
Based on approximately 7 percent of new recipients under the program receiving residential
care.
The numoer of worxers per recipient is based on the following assumptions: 1) each recipient
requires 24 hour care, resulting m 4 21 FTEs per recipient: ana 2) at any given time there would
be one worker for every four reaoients.
Cvemeao s ccrc-sea cf : i 24 percent for benefits (such as social security taxes. Workers
Ccrrp . ream rsnerits. e:: •. 2: 55 percent 'cr '9 t ana c:~er expenses: ana 3) 2' cercent fcr
agency sucervisor saianes .assuming i 7 employees per sucen-nscr at an ave age annual salary
of $50.0C0 for suce.rvisors m 1993).
n
r
Note:
£aiarv levels are casea cn cata rrom i-icso^.ai Cc~censa!;cn Se-v.ce. 'Heme Care i i j.-.- ar.a 8ene' 's
fleoon: 1991-92." Jem H. ZarKa Associates, inc.: Oawana. NJ, 199V
�THE WHITE H O U S E
WAS
H IN GTO N
December 2, 1993
VISIT TO THE EL PUEBLO HEALTH SERVICES CLINIC TO
DISCUSS RURAL HEALTH CARE ISSUES
DATE:
LOCATION:
TIME:
FROM:
L
Decembers, 1993
El Pueblo Health Services Clinic, Bernalillo, NM
3:00 pm MST
Julia Moffett
PURPOSE
This event gives you the opportunity to tour a rural health care facility, to hear from a doctor
on the front lines of rural health care, to have a discussion with both patients and providers
regarding their problems and concerns and to further educate them about how the Health
Security Act of 1993 addresses rural health care problems.
The patients and providers who have come togther for this event are, for the most part, not
experts in rural health care. They come to this discussion with their own problems and
circumstances-security, access, shortage of doctors and facilities, inability to get specialty
treatment-which are representative of many of the typical health care problems experienced
in rural areas. The doctors and other rural health care administrators in the audience bring
many more personal stories with them in addition to a more macro-understanding of the
problems these areas are facing.
IL
BACKGROUND
Message
This event is essentially a regional event due to its time and subject matter. However, no
regional health care event which will resonate more than one which focuses on rural health
care issues. The Health Security Act of 1993 does a lot to address the needs of rural
communities: By providing universal coverage, the plan creates affordable insurance even i f
you farm, own a small business or work in a small business; the plan encourages more
doctors and nurses to serve rural America; the plan guarantees access to the services rural
Americans need with funding for additional transportation services as an example; the singleclaim form will dramatically reduce red tape, both for doctors and consumers; choice will be
improved; and networks of rural doctors and leading medical centers will improve the quality
of rural medical care.
�The El Pueblo Health Services Clinic. Bernalillo and the state of rural health care services
The El Pueblo Health Services Clinic has been in operation for 17 years. The staff includes
Dr. Alan Firestone and Dr. Carmen Rodriguez, 1 full-time medical assistant, 1 office manager,
1 full-time billing clerk, and 1 full-time insurance billing person. This staff has grown from 1
front desk receptionist when the clinic opened. Additionally, the administrative space at the
clinic has grown by 500%. The clinic sees 35-45 patients per day. Approximately 15-20% of
the patients are Medicaid recipients, 30-35% are uninsured. Atypical for rural areas, this
clinic serves a small Native American and Migrant population.
Bernalillo is in Sandoval County, one of 30 of the 33 New Mexico counties considered
underserved by federal standards. Although it is a low to middle-income, rural area,
agriculture is not as predominant as it is in many other counties. It is, however, plagued with
many of the problems indicative to New Mexico as a whole: more than 25% of the New
Mexico population is uninsured, more than one-third of the uninsured are children, nearly
40% of them are under 100% of the federal poverty level, one-third of them are employees of
businesses with under 25 employees, and nearly two-thirds are not working. New Mexico
ranks 47th in the country for lack of access to primary care--21% of the New Mexico
population does not have access to primary care.
Dr. Alan Firestone
Bom in Youngstown, Ohio, Dr. Firestone came to Bernalillo as a National Health Service
Corps member after earning his medical degree from UCLA. After spending 11 years in the
Corps, the federal government attempted to reduce the size of the Corps and Dr. Firestone
was told to shut down his clinic. Instead, Dr. Firestone chose to leave the Corps but to keep
the El Pueblo Health Services Clinic open.
m.
PARTICIPANTS
Tour
The President
Dr. Alan Firestone, Director, El Pueblo Health Services Clinic
Discussion
There are twelve people whom you will have the primary discussion with. In addition to Dr.
Firestone, they are patients from the area as well as other rural health care providers. Their
biographies are attached.
The larger audience of 50 people is comprised of additional patients and providers ranging
from Bernalillo to Albuquerque to other surrounding rural towns and counties. You may wish
to include these people if you choose to expand the discussion as they are all involved with
rural health care in some fashion. A list of these people is attached.
YES
The VIPS attending the event will be seated in a special section of the audience and are not
�expecting to participate in the primary conversation. You may choose to ask them to say a
few words if you open the discussion up to the larger group. They are:
Mayor Ernie Aguilar and Mrs. Mary Kay Aguilar
Senator Jeff Bingaman and Mrs. Anne Bingaman
Senator Pete Domenici
Governor Bruce King and Mrs. Alice King
Congressman Bill Richardson and Mrs. Barbara Richardson
Congressman Steven Schiff
Congressman Joe Skeen
* Chris and Donna Key and Jimmy Kidd have been invited.
IV.
PRESS PLAN
The press will be prepositioned during the clinic tour both inside and outside. The discussion
outside is open press. Several local television stations may go live during the outside
discussion.
V.
SEQUENCE OF EVENTS
You will arrive at the El Pueblo Health Services Clinic and will be met by Dr. Alan
Firestone.
You and Dr. Firestone will proceed into the clinic for a brief tour of the facility.
(The elected officials traveling with you will proceed directly to the tent.)
You will first walk through the waiting room to greet patients on your way to
Examination Room #1.
In Examination Room #1, you will meet Dr. Carmen Rodriguez and the patient she is
examining.
You will then proceed to the Children's Examination Room as well as Examination
Room #2. You may have an opportunity to greet patients in both areas.
You then proceed to Dr. Firestone's office to hold while the press positions for the
discussion outside.
Once the press is positioned, you and Dr. Firestone proceed to the tent area. You will
be greeted by Mayor Ernie Aguilar and his wife, Mary Kay.
Once in the tent, you may greet the 12 participants in the discussion.
Dr. Firestone will then introduce you.
�*
You will then make brief opening remarks.
*
Dr. Firestone will then briefly introduce each of the twelve participants and they will
tell you a little about their history and experiences with rural health care.
*
You may follow up with the participants with individual questions or further
information about the plan.
*
You may also choose to open the discussion up to the wider audience or to initiate a
Q & A period.
*
When the conversation is through, you should make brief closing remarks.
*
Dr. Firestone will then thank everyone for joining you today.
*
You may meet and greet with the audience upon departure.
VL
REMARKS
Cards are enclosed which include brief opening and closing remarks as well as an outline to
use when leading the discussion on rural health care and how the Health Security Act of 1993
addresses rural health care issues.
�PROFILES OF DISCUSSION PARTICIPANTS
Harriett Pacheco Brandstetter
Ms. Brandstetter is the Executive Director of La Clinica de Familia, a privately and federally
funded community/migrant health center. She has 27 years of community health experience.
Her clinic is part of a 17 year old clinic system which includes four medical clinics and one
dental clinic. Her patients primarily consist of the underserved populations of New Mexicans
and Central American border residents. Her clinics are operating at full capacity with long,
active waiting lists.
Christina Campos
Ms. Campos is a trained community encourager for Guadalupe County. Her role is to
activate the community to design a healthcare system which is affordable and acceptable to
the citizens of this county. The community is a single-provider town of 2,100 residents.
There are other part-time providers in the County of 4,200 citizens, but not enough to meet
the healthcare needs of the County. Ms. Campos also serves as the financial officer of a
small hospital in Santa Rosa, and is able to articulate the problems of this ranching
community from many different perspectives.
Blanche Ekdahl
Ms. Ekdahl is 86 years old and lives in a trailer park in Abiquiu. She has severe arthritis and
walks with a cane. Her doctor has told her she must have surgery to replace her knee and he
has scheduled it to occur in the next few months. Since Abiquiu is a tiny, remote village far
from nursing care, Ms. Ekdahl will be forced to move to either Los Alamos or Sante Fe
where she will have access to consistent care.
Dr. Alan Mark Firestone
Bom in Youngstown, Ohio, Dr. Firestone came to Bernalillo as a National Health Service
Corps member after receiving his medical degree from UCLA. After spending 11 years in the
Corps, measures were taken to decrease the Corps numbers and he was told to close down his
clinic. Instead, Dr. Firestone chose to leave the Corps but to keep the El Pueblo Health
Services Clinic open. It is currently in its 17th year of operation.
1
Celestin ' W Gachunin
Cel Gachupin, the former Governor of the Zia Pueblo (40 miles north of Albuquerque), had a
son, Robert, who came down with asthma at age 2, and Cel became asthmatic at the same
time. Robert was in and out of the hospital and shifted back and forth to specialists many
times. Robert's life nearly ended at the Zia Pueblo ranch several times. He would stop
breathing and Cel would have to pound him on the back to start breathing again, then drive to
where they could call an ambulance. Ond day, when Robert was 8, Cel took him fishing and
Robert said it was the best day of his life. That night, Robert woke up in the middle of the
�night, as he often did, and called for his mother to bring him a nebulizer. As his mother and
father were holding him in their arms, he went limp. They had to call an ambulance from
Placitas, about 30 miles away, which proved to be too long a wait before Robert died.
Karen Lewis
Ms. Lewis is a patient of the El Pueblo Health Services Clinic. Though currently uninsured,
she was insured until her premiums doubled following surgery six years ago. She, like so
many rural residents, has to drive a long distance for care. Additionally, her grown children
face many health care problems, with her son and daughter-in-law most recently being told to
quit one of their jobs in order for the couple to qualify for children's health care assistance for
their young child.
Forrest William Mason
Mr. Mason has had diabetes for 40 years and has high-blood pressure. He was bom in
Estancia 75 years ago. He is a success story in that his care is currently very good (his
doctor, Linda Stogner is in the audience) but, without it, his situation would be disastrous.
He lives 54 miles from Albuquerque. In the past, Mr. Mason has had a gall-bladder attack
and had to travel to Albuquerque for treatment.
Lynn Mathes
Ms. Mathes is a patient at the El Pueblo Health Services Clinic. She is an uninsured, single
mother with three grown children. Her employment history has consisted of many short-lived
rural jobs which typically have no infrastructure, no insurance and no security. Following an
accident at the stable where she was working, Ms. Mathes has incurred tremendous bills
which remain unpaid and has been unable to hold a permanent job. She currently finds
herself bartering jewelry for the therapy care her injury requires. Due to her limited budget,
she can only afford to pay each of her doctors $5 per month.
Neddv Qgaldez
Mr. Ogaldez is a patient at the El Pueblo Health Services Clinic. He has been uninsured, but
has recently obtained a job at a paint and body shop which may offer insurance at some
point. Previously, he has been out of work with an infection he contracted from working with
cattle. He has two children and piles of unpaid medical bills.
|
Miranda Sapien
Mrs. and Mr. Sapien live 2 miles west of the doctor. Her mother was living with them for 12
years. She had Parkinsons disease and was totally blind. The closest home care that they
knew about was in Albuquerque. In order to get someone to their home, they would have to
pay their transportation plus $7 an hour-which has taken a toll on their limited budget. Once
their mother became bed-ridden. Dr. Firestone would make housecalls, but when he could not
or when they felt as if they were burdening him by calling, their mother went without care.
�Angela Sosa
Ms. Sosa will talk about the story of her mother who died of a brain tumor at 62 years old.
At 62, she was ineligible for Medicare. Ms. Sosa mother's case was one of many in which
people have little documentable income from their various rural jobs and, therefore, do not
qualify for Medicaid. Ms. Sosa belives her mother's condition could have been exacerbated
by her lack of access to doctors and her mother's difficulty in understanding the complexity of
the system.
3
Jack Vick. M.D.
Dr. Vick is a resident physician at the Department of Family and Community Medicine at the
University of New Mexico University Hospital. He intends to pursue a rural health care
practice upon completion of his residency. In the past, he served as the sole provider for a
small rural hospital and clinic when the only physician abondoned the center.
AUDIENCE MEMBERS
(This list includes audience members with direct relationships to rural health care issues only)
Francisco Crespin, Jr., M.D., New Mexico Department of Health District Health Officer
John Ekdahl, son of patient in discussion
Genevieve Gachupin, wife of person in discussion
Pamela Galbraith, Administrator, Medical Services, University Hospital, UNM
George Stephen Goldstein, Director, New Mexico Health Care Initiative
Petal Gordon, patient
Joaquin and Lala Gurule, patients
Kay Elene Handleigh, nurse who wimesses lack of quality rural health care services
Ben and Les Harrison-Inglis, patients
Arthur Kaufman, M.D., Chairman, Department of Family and Community Medicine, UNM
James Kolb, Administrator, Catron County Medical Clinic
Patricia Lavine and Dale Patrick Lavine (son), patients. University Hospital, UNM
Murray Lewis, husband of patient in discussion
Wanda Lizar, mother of patient in discussion
Nora and Brian Lucero, patients
Eugenic Lujan, County Extension Agent, Guadalupe County, organized county to provide care
Alice Luna, patient
Bill Sapien, husband of patient in discussion
Charles Steams, patient
Jessica Sosa Stewart, sister of patient in discussion
Linda Stogner, M.D., Director of Hope Medical Center; former National Health Service Corps
Priscilla Taylor, patient
Vincentita and Miquel Toledo, patients
Chris Urbina, M.D., Department of Family and Community Medicine, UNM
�President William Jefferson Clinton
Talking Points for Brunch with Older American Groups
Washington, DC
February 17, 1994
The people here today are from twelve groups, representing more than 60 million
Americans. And we're going to need the help of every one of your members to make
health reform a reality.
One of my key tests for health reform is: does it protect older Americans? My
proposal does. It preserves and strengthens Medicare. It gives you new prescription
drug coverage and options for long term care. And it protects your choice of doctor.
The other approaches to health reform in the Congress threaten Medicare, taking
money from it to pay for other people's health care.
Now Congress comes back next week and will take up the balanced budget
amendment — which in my view is a gimmick that will slash Medicare. Make no
mistake: right now in Congress there are people who want to use Medicare as a bank
to pay for other things. If the balanced budget amendment passes, or if any-of-the
other health care proposals pass, Medicare will be at risk.
We've shown that you can reduce the deficit without hurting older Americans. Some
out there believe the only way to reduce the deficit and reform health care is to hurt
older Americans. I know we can do better.
I am here today to tell you we will not let this happen. I am here today to talk to these
leaders about how we can fight to protect older Americans.
When others try to balance the budget on the backs of older Americans, when others
try to reform health care solely on the backs of older Americans, we must say no. We
must protect Medicare, and I want to join with older Americans all across the country
in this fight.
�President William Jefferson Clinton
Radio Address to the Nation
May 21,1994
Good morning. Today I would like to talk to you about the progress we are
making together on two of the most important goals of our Administration: improving
the economy and guaranteeing health care to all Americans.
Although we are still in the dawn of our recovery, we have already begun to turn
the economy around and to set the stage for long-term, sustainable economic growth.
The deficit is down. Long-term interest rates are down. Inflation and
unemployment are all down. Growth, the stock market, and consumer confidence are all
up. And in the first fourteen months of our Administration, two and one half million jobs
were created ~ ninety percent in the private sector — and more than the previous four
years combined.
What's most important to me is that inside each of these statistics is good news
about real people. About an entrepreneur hanging out his shingle. About a worker
getting a raise. About a parent buying toys for the baby. Economic security was our first
major battle - and all the signs say we are winning.
And on our quest to guarantee health security to all Americans, we have made
history this week. After 60 years of fits and starts, of road blocks and dead ends, we are
finally making real progress towards comprehensive health care reform. This week, for
the first time ever, the relevant committees in both houses of Congress have begun to
review and modify our proposal to guarantee all Americans private insurance.
Their action follows more than a year and a half of debate and discussion on this
issue: in town hall meetings, in doctor's offices, and around kitchen tables. There have
been twists and turns along the way ~ there are no doubt more ahead — but we are
steadily moving closer to our goal: passage of major health care reform legislation this
year.
And as with the economy, the victory of passing health reform this year will be a
victory for American families.
As I have travelled around the country I have heard first hand from some of the
more than 1 million people who have written to Hillary and I describing their problems
with the current health care system. These letters are all a little bit different - they come
from different parts of the country, from people in different circumstances with different
backgrounds. The letters are different, but the message is always the same: do
something, and do it soon.
�Some people say we should wait awhile and study this issue further. To those
who think we should wait, I say: come to the White House; read some of these letters.
Read the one from the mother who was forced to sell her home and go on welfare to
provide medical benefits for her sick son. Tell it to the nurse who had to leave the
bedside of a cancer patient to attend a meeting on a new insurance form. Tell it to the
little boy who was afraid to tell his parents he felt sick because he knew they couldn't
afford a visit to the doctor. Tell them we should wait. As I said in my State of the Union
address: you tell them, because I can't.
But the action the Congress has taken in recent weeks proves that their call for
urgency has been heard. The committees in Congress are well on the way to passing a
bill that will make the health care nightmares detailed in these letters a thing of the past.
Yes, there will be obstacles ahead, but we will surmount them. There will be roadblocks,
but we will overcome them. What is different this time? This time there's no turning
back: the American people have raised their voices and said "Do it carefully, do it right.
But this time, finish the job."
As Senator Wofford told his colleagues at the opening of their historic committee
hearing yesterday, "We know it won't be easy. But history won't forgive us if we fail to
seize this opportunity to find the highest common ground, not the lowest common
denominator." I am confident that members of Congress will do just that — rise above
partisan differences to pass a comprehensive reform bill that will guarantee all Americans
private insurance.
In 1935, the Congress passed Social Security, and from that day forward older
Americans knew they could face retirement and old age with dignity and . In 1965 they
passed Medicare, guaranteeing that people over 65 would never again be bankrupted by
medical bills they couldn't pay.
We are closer than ever before to making 1994 the year Congress made history
once again by guaranteeing all Americans private health insurance that can never be taken
away. Let's work together now to finish the job. We can get this done this year, and we
will get this done this year.. With your help, I know we can do it.
Thank you for listening.
�President William Jefferson Clinton
Radio Address to the Nation
Dallas, Texas
March 2 6, 1994
Good morning.
This morning, I'm speaking t o you from Texas, courtesy o f
s t a t i o n KRLD i n Dallas, and from the S c o t t i s h R i t e H o s p i t a l For
Children — one of t h e f i n e s t p e d i a t r i c medical centers i n
America. Places l i k e S c o t t i s h R i t e don't ask severely disabled
c h i l d r e n , or s e r i o u s l y i l l c h i l d r e n , "can you pay?", they ask
"where does i t h u r t , and how can we help?"
On Wednesday a t the White House a Catholic nun spoke about
h e a l t h care i n a way seldom heard i n Washington. She pushed a l l
the p o l i t i c s and complex arguments aside and said h e a l t h care i s
about basic human values: i t ' s about honoring t h e i n t r i n s i c value
of every human being.
S i s t e r Bernice C o r e i l ( c o r e - r e l l ) , should know. She's a
member of t h e S i s t e r s of Charity, a r e l i g i o u s order which runs
the l a r g e s t n o n - p r o f i t h o s p i t a l system i n America.
She knows, as we a l l do, t h a t i f we don't do something now,
the f u t u r e o f h e a l t h care i n America w i l l include less choice,
lower q u a l i t y care, and bigger b i l l s . Instead of h e a l t h care
being a v a i l a b l e t o a l l Americans, h e a l t h care w i l l become a
luxury, and t h a t i s wrong.
I b e l i e v e we can do b e t t e r , by b u i l d i n g on what works i n the
c u r r e n t system and using the workplace t o guarantee p r i v a t e
insurance f o r every American. This i s t h e idea most people
support — and i t i s t h e foundation of our plan.
Just a few davs ago, t h e f i r s t of the manv committees
considering h e a l t h care reform i n Congress approved a plan l i k e
ours, covering everv American. I n s p i t e of a l l t h e s p e c i a l
i n t e r e s t s and t h e TV ads, t h a t committee made an important
statement. A f t e r 60 years of s p e c i a l i n t e r e s t g r i d l o c k , the
American people are being heard loud and c l e a r . They want us t o
take care of t h e i r important business every day — l i k e h e a l t h
care reform — and t h a t i s what we are going t o do.
Our approach t o h e a l t h care reform i s s t r a i g h t f o r w a r d . We
guarantee p r i v a t e insurance f o r everv American t h a t can never be
taken awav. And, we are very c a r e f u l t o base our approach on the
best o f American values.
Guaranteed p r i v a t e insurance — making sure everyone has
good h e a l t h care, not only those who can pay whatever i t costs
—
�i s the t i c k e t to opportunity.
When our plan passes and your
health care can never be taken away, that means you w i l l be able
to change jobs, move, or s t a r t a small business, without worrying
that your health or your families health w i l l be threatened.
Second, the freedom to make our own choices in l i f e i s an
American tradition, and w i l l always be part of American medicine.
We guarantee you the right to choose your own doctor and your own
insurance plan. We t r u s t you with the freedom to choose your own
doctor, rather than leave that choice to your employer or your
insurance company.
Third, health care reform and our plan i s about fairness.
We're going to correct the abuses in the insurance business. No
more fine p r i n t . No more denying people insurance because they
are sick. No more lifetime l i m i t s that cut off your coverage
when you need i t most. No more higher rates for the elderly, or
for small employers. None of those things are f a i r — and every
American deserves to be treated f a i r l y .
Fourth, health care reform i s about keeping f a i t h with those
who came before us. We preserve and protect Medicare, without
reservation or exception. Older Americans must be able to choose
their doctor and keep t h e i r Medicare. We also want to cover
prescription drugs under Medicare, and provide the elderly,
chronically i l l children, or disabled Americans the chance to get
long-term care in their home or their community i f they need i t .
F i n a l l y , health care i s about responsibility, and rewarding
those who work. Under our approach you w i l l get your insurance
through work. Most jobs already have health care. Why shouldn't
they a l l ? Eight out of ten Americans without insurance belong to
working families. We should always reward work in America. And
the right to health care should be part of that reward.
Opportunity. Freedom. Fairness. Honoring those who came
before us. and those who take r e s p o n s i b i l i t y now.
These are the
values that have helped build America, and that are at the heart
of our health care proposal.
This weekend marks the a r r i v a l of Passover and Palm Sunday.
I t ' s a special week of r e f l e c t i o n for everyone of the Jewish and
Christian f a i t h s . A time when we step back from the concerns of
daily l i f e and think more deeply about our r e l i g i o u s traditions
and the values they teach us.
S i t t i n g in t h i s Hospital for Children — which does
miraculous work — I am reminded that providing health care and
the peace of mind that comes with i t i s also the p r a c t i c a l
expression of our best ideals.
�These wonderful doctors and nurses and volunteers a t
Scottish Rite Hospital For Children take i n every c h i l d . No
family has been charged for treatment here. They l i v e our best
values.
But they would be the f i r s t to t e l l you that more than nine
million American children have no health insurance. And most
don't have a hospital l i k e t h i s . That i s n ' t right.
Health care reform i s about doing what's right. About
having compassion and about bestowing dignity on each of us as
God's children.
These are eternal values. They are the source of the moral
authority that has made America great, and they are the lessons
each of us i n our own way can take from Passover and Easter.
With these values to guide us, I know we w i l l succeed.
Thank you for listening.
�
Dublin Core
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Title
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Health Care Task Force Records
Creator
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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
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William J. Clinton Presidential Library & Museum
Identifier
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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
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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
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President Clinton – Speeches/Addresses
Creator
An entity primarily responsible for making the resource
Task Force on National Health Care
White House Health Care Task Force
Simone Rueschemeyer
Identifier
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2006-0885-F Segment 2
Is Part Of
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Box 36
<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/12092987" 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
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William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
Medium
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Preservation-Reproduction-Reference
Date Created
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2/6/2015
Source
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42-t-12092987-20060885F-Seg2-036-006-2015
12092987