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2006-0885-F
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This is not a textual record. This is used as an
administrative marker by the William J. Clinton
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Collection/Record Group:
Clinton Presidential Records
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Health Care Task Force
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�Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
AND TYPE
001. memo
SUBJECT/TITLE
DATE
DNC [Democratic National Committee] Speaker's Bureau to Health
Care Constituents; re: Health Security Express! (2 pages)
07/14/1994
RESTRICTION
Personal Misfile
COLLECTION:
Clinton Presidential Records
Health Care Task Force
Walter Zelman
OA/Box Number:
3797
FOLDER TITLE:
Miscellaneous [Folder 1]
2006-0885-F
ip2839
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�ADMINISTRATIVE ROLES FOR IRS IN HEALTH REFORM
Depending on the preferences of policymakers, the Internal Revenue Service could either
have an extensive or limited role in the administration of health reform. If decision makers
choose to utilize the IRS, the Service could be responsible for any or all of the following
functions:
•
Collection of premiums for the basic benefit plan.
•
Determination of eligibility, dissemination, and enforcement of subsidies to lowincome persons.
•
Determination of eligibility, dissemination, and enforcement of subsidies to firms
with high concentrations of low-wage workers.
•
Recapturing excessive employer subsidies through an excise tax on individuals.
A. Collection of premiums for the basic benefit plan.
If the IRS was responsible for collecting and enforcing the payment of premiums, it could
work in tandem with the Health Alliances who would provide information on benefit plans and
prices to individuals and their employers. Under the mandate, the state-based Health Alliances
would be responsible for maintaining detailed enrollment records for each policyholder. In
addition, if the IRS had responsibility for collecting the premiums, the funds would flow in the
following manner:
Employers and Employees: The firm would send employer and employee contributions for
the mandated health insurance benefits to the Treasury Department through the Federal Tax
Deposit (FTD) system. Payments to the FTD would generally follow the current withholding
schedule for individual and employment taxes. The employer would report quarterly to the IRS
on Form 941 the total amount of employer and employee contributions for health insurance. On
a quarterly basis, the employer would also provide the Health Alliance with more detailed
information on the amount of contributions made on behalf of each employee. The Health
Alliance would submit statements to the Inter-Alliance Cooperative Trust Fund for payments.
Self-employed and non-workers: Taxpayers would include health insurance contributions
in their estimated tax payments. Alternatively, they could have an option to have contributions
withheld from selected non-wage sources of income (e.g., pensions or interest payments). They
would also be responsible for notifying the Health Alliance of such payments.
End-of-Year Reconciliation: At the end of each year, the employer would report on W-2's
to the employee and the IRS the total health insurance contributions made during the year on the
employee's behalf. Non-workers (and the IRS) would also receive an information report (a
1099) from any payer who withheld health insurance contributions.
The Health Alliances would also have reporting requirements. They would provide 1099HA's to employers, all covered individuals, and the IRS. These forms would notify the
�V
-2-
recipient of (1) the premium liability during the previous year; (2) the amounts paid; and (3) any
additional outstanding liabilities.
Individuals and employers would be responsible for paying outstanding amounts as part of
their final tax returns. To encourage the timely payment of premiums,finalpayments in excess
of 10 or 20 percent of liabilities would be subject to interest and penalties. Individuals who do
not have income tax liabilities would not have to file a return if withheld or estimated health
insurance payments equaled final liabilities.
Trust Fund: The Treasury Department would be responsible for transferring premium
revenues to the Inter-Alliance Cooperative Trust Fund. The Trust Fund would also be receiving
revenues from other Federal Sources, as well as paying out revenues to the Health Alliances.
Enforcement: The IRS does not have the necessary information to verify payments until tax
returns and information returns are processed and matched. Under the current computer system,
processing and matching is generally not completed for eighteen months after thefilingof a
return. However, the computer system is being modernized, and IRS personnel report that this
lag should be shortened significantly over time. In the short-term, it is unlikely that the IRS
would be able to match all documents completely. Over time, the IRS could develop techniques
for matching which would target resources to those returns most likely to be in noncompliance.
If an error is detected in the payment of the premiums, the IRS would correspond with the
taxpayer. Late payments would be subject to penalties and interest charges. The IRS would
initiate further actions (audits, for example) if payments were not forthcoming. A cautionary
note, however: the IRS generally does not pursue further actions except when the amounts owed
are sizable (such as in the case of medium and large employers).
B. Determination of eligibility, dissemination, and enforcement of subsidies to low-income
persons.
The IRS could provide health insurance subsidies to low-income persons, regardless of
whether or not the Service also collected premiums.
IRS as Collector: Individuals could pay the full premium to the IRS during the year and
receive a rebate for the subsidy amount at the end of the year when theyfilea tax return. Or,
based on anticipated annual income, individuals could choose to reduce premium payments
during the year.
IRS as Agent for Delivery of Subsidies: Individuals would be required to pay the full
premium amount to the appropriate state agency (such as the Health Alliance). At the end of
the year, they couldfilewith the IRS for a refundable credit equal to the difference between the
amount paid and the amount owed. In addition, employees could be given the option of
claiming the subsidy in advance by reducing their Federal tax withholding by the estimated
amount of the subsidy. Individuals without tax liabilities could receive a transferable credit
certificate from a state or Federal agency, which could be provided to the state agency in lieu
�-3of cash.
Income Measure: To ease the administrative burden for individuals and the IRS, only items
reported on the tax return should be included in the measure of family income. Income could
be measured on annual basis only. Most non-taxable forms of income, such as needs-based cash
assistance, would not be included in the eligibility criteria. Hence, a welfare recipient, with no
other sources of income, would pay nothing for health insurance coverage.
Family Unit: Again, to ease the administrative burden, it would be preferable to use
existing tax provisions to define the family unit.
Timing: It is difficult to provide needs-based assistance in a timely fashion through the tax
system, while minimizing compliance costs. Low-income persons may have cash-flow problems,
and thus it would be desirable to provide them with the subsidy on a weekly or monthly basis.
On the other hand, the tax system would not normally obtain information about the eligibility
of the recipient for up to a year after the receipt of an advance subsidy.
To balance both of these concerns, it might be desirable to assign responsibility to a State
agency to assist low-income persons in determining whether they would be entitled to a reduction
in their premium payments based on anticipated annual incomes.
Verification and Enforcement: IRS would use the same verification and enforcement
procedures described in the collection section above. The experiences of the 1980's with the
EITC offer important lessons. Unless the eligibility rules for the health insurance subsidy are
simple and verifiable, compliance problems are likely. With health insurance premiums varying
for each Health Alliance, it will be difficult for the IRS to verify subsidy amounts for each
recipient. The overpayments are also likely to be for relatively small amounts, and the IRS
would generally notfindit cost-effective to actively pursue these overpayments.
Determination of eligibility, dissemination, and enforcement of subsidies to employers.
Again, the IRS would be able to provide the subsidies to employers, even if it did not collect
premiums.
IRS as Collector: Based on the anticipated annual wages of workers,firmswould adjust
premium payments during the year. Employers would report to the IRS on a quarterly basis two
amounts: the amount of the health insurance liabilities for the quarter and the amount actually
paid. On their tax returns, employers wouldfilea separate schedule, containing information on
the wages of workers for whom a premium reduction was claimed.
IRS as Agent for Delivery of Subsidies: Even if the IRS did not collect premiums, it could
still deliver the subsidies to businesses. Businesses might be required to pay the full premium
amount to the appropriate agency (such as the Health Alliance). At the end of the year,
businesses could file a separate schedule with the IRS for a refundable credit equal to the
difference between the amount paid and the amount owed. In addition,firmscould be given the
�-4option of claiming the subsidy in advance by reducing payments of withholding taxes by the
estimated amount of the subsidy.
Verification and Enforcement: To verify and enforce eligibility criteria for a wage-based
subsidy,firmsmay have to provide the IRS with much more detailed information about their
health insurance contributions.
There has also been discussion about varying the subsidy by other characteristics of firms.
For the IRS, it would be relatively simple to monitor afirm'seligibility based on information
the agency already collects. For this reason, varying the subsidy with profits would be an
efficient use of the agency's resources. If other characteristics were chosen as a proxy of a
firm's need for a subsidy, the IRS might need to collect additional information, such as average
payroll or number of employees.
Regardless of the administering agency, subsidies to businesses will increase the filing
burden forfirmsand the IRS. Compared to other possible agencies, the IRS has an ongoing and
continuing relationship with employers. Even in the case of tax-exempt organizations, these
employers pay withholding taxes for their employees.
D. Recapture the employer contribution paid to workers in high-income families.
A possible financing source under discussion would impose an excise tax on low-wage
employees with significant sources of other income (e.g., spouse's earnings, interest, pension
payments) whose employers received a subsidy for health insurance premiums. The excise tax
rate could be set at 100 percent of the employer subsidy amount, or it could vary with family
income, reflecting differences in ability-to-pay. Affectedfilerscould pay this excise with their
individual income tax return, and they could adjust their health insurance withholding or
estimated payments during the year to reflect this anticipated liability. Payment of the tax would
be included in a line on the tax return, entitled "Additional Taxes." To ease the administrative
burden of both the IRS and employees, only those with individual income tax liabilities could
be subject to this tax.
Verification and Enforcement: Employers would have to report on the employee's W-2 the
amount of the premium and the amount actually paid. This information would be required for
all employees.
�FT OW OF FUNDS
Health
Alliance
Treasury
Inter Alliance
Trust Fund
�REPORTING REOUIREMNTS
Employer
Health
Alliance
IRS
I
Employee
�SUBSIDIES
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�June 3, 199 4
LEWIN-VHI ESTIMATE OF FEDERAL HEALTH CARE REFORM SAVINGS
FROM AUTOMOBILE INSURANCE COORDINATION
At the request of the State Farm Insurance
Companies, Lewin-VHI, Inc. (a well-known Washington,
D.C.-based health p o l i c y firm) has estimated the federal,
budgetary savings from coordinating the medical
^component of- automobile insurance w i t h the h e a l t h care
system. As documented i n the attached r e p o r t , Lewin-VHI
estimates t h a t such coordination, as proposed by State
Farm, would save the federal government $16.73 b i l l i o n
over f i v e years (1996-2000). I n a d d i t i o n , s t a t e and
l o c a l governments would save 55.02 b i l l i o n ( p r i m a r i l y
through reduced Medicaid payments) and employers would
save $14.28 b i l l i o n , over the same f i v e years. (These
Vsavings may vary t o some degree depending on the
p_
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3 P e C
J^t ^^^^
r S 0 fh e a l t h c a r e
reforra
')
Ctt-d* L ^ ^ ^ t a t e Farm's proposal f o r automobile insurance
c o o r d i n a t i o n would produce the estimated savings by
e l i m i n a t i n g d u p l i c a t e payments by h e a l t h care plans
( p u b l i c and p r i v a t e ) and by automobile insurance
c a r r i e r s f o r the same medical expenditures. The
proposal would accomplish t h i s by r e q u i r i n g t h a t
automobile accident-related i n j u r i e s be t r e a t e d through
the h e a l t h care plan of the i n j u r e d i n d i v i d u a l and t h a t
automobile insurers d i r e c t l y , reimburse h e a l t h care plans
f o r such treatment t o the f u l l extent o f l i a b i l i t y under
automobile insurance p o l i c i e s . I t also would r e q u i r e
the states t o implement a d m i n i s t r a t i v e and dispute
r e s o l u t i o n procedures t o f a c i l i t a t e the reimbursement
process.
The Lewin-VHI report suggests t h a t the State Farm
proposal could b e n e f i t not only the h e a l t h care system,
. but also the automobile insurance system, by preventing
cost s h i f t i n g and applying general h e a l t h care
cost-containment mechanisms t o automobile insurance
coverages. This could help eliminate w a s t e f u l and
u n j u s t i f i e d expenditures on medical treatments covered
by automobile insurance.
The State Farm proposal i s set f o r t h i n d r a f t
s t a t u t o r y language (Appendix A of the Lewin-VHI r e p o r t ) ,
which could be incorporated i n t o v i r t u a l l y any f e d e r a l
h e a l t h care reform l e g i s l a t i o n . The proposal does not
depend on other s p e c i f i c s of health care reform.
State Farm strongly urges Congress t o include
these automobile insurance coordination p r o v i s i o n s ,
which would s i g n i f i c a n t l y b e n e f i t the American p u b l i c ,
i n whatever h e a l t h care reform l e g i s l a t i o n may be
enacted t h i s year.
©
Printed on recycled paper
�DRAFT:
June 27, 1994
AUTOMOBILE INSURANCE-AMENDMENT
TO SENATE FINANCE COMMITTEE
HEALTH CARE REFORM MARK
T.
P r o v i s i o n o f Automobile Insurance M e d i c a l S e r v i c e s
Through H e a l t h Plans
A.
Treatment Through H e a l t h • P l a n s : I n d i v i d u a l s ,
e n r o l l e d i n a h e a l t h p l a n would r e c e i v e m e d i c a l s e r v i c e s
covered by automobile insurance e x c l u s i v e l y t h r o u g h t h e
h e a l t h p l a n i n which t h e y a r e e n r o l l e d , t o t h e f u l l
e x t e n t t h a t t h e h e a l t h p l a n p r o v i d e s f o r such s e r v i c e s .
B.
Uniform Cost Containment:
Medical s e r v i c e s
covered by automobile insurance t h a t a r e p r o v i d e d
t h r o u g h h e a l t h p l a n s would be s u b j e c t t o t h e same c o s t
and q u a l i t y c o n t r o l s as o t h e r services" p r o v i d e d by
health plans.
C.
A p p l i c a t i o n o f A n t i - F r a u d and Abuse
P r o v i s i o n s : Any p r o v i s i o n s p r e s c r i b e d t o p r e v e n t h e a l t h
care f r a u d and abuse would would a p p l y t o h e a l t h care
covered by automobile i n s u r a n c e .
II.
Payment f o r Automobile Insurance M e d i c a l S e r v i c e s
A.
D i r e c t Payment t o H e a l t h Plans:
Automobile
i n s u r e r s would d i r e c t l y reimburse h e a l t h p l a n s f o r
treatment o f i n j u r i e s sustained i n automobile accidents,
t o t h e e x t e n t t h a t such t r e a t m e n t was m e d i c a l l y
necessary and a p p r o p r i a t e and t o t h e f u l l e x t e n t o f
l i a b i l i t y under t h e a p p l i c a b l e automobile i n s u r a n c e
contract.
B.
No D u p l i c a t e Payments: Automobile i n s u r a n c e
•payments f o r medical s e r v i c e s p r o v i d e d t h r o u g h h e a l t h
p l a n s would be made s o l e l y t o t h e h e a l t h p l a n s (except
t o reimburse i n d i v i d u a l s f o r copayments.and d e d u c t i b l e s
p a i d o r payable t o h e a l t h p l a n s ) . There would be no
l i a b i l i t y f o r payment t o any person o t h e r t h a n t o a
h e a l t h p l a n by an automobile i n s u r e r (or any person
i n s u r e d by an automobile i n s u r e r ) f o r m e d i c a l s e r v i c e s
covered-by automobile insurance t h a t a r e w i t h i n t h e
scope o f h e a l t h p l a n b e n e f i t s .
�- 2 -
C.
Payment f o r Care Outside H e a l t h Plans: R i g h t s
t o automobile insurance payments f o r medical care
-providedr"othex~-than-"through"' t h e - " h e a l t h plan" o f "the
i n d i v i d u a l d e c e i v i n g such care would not be i m p a i r e d , t o
the e x t e n t t h a t such care' i s b o t h u n a v a i l a b l e t h r o u g h
the h e a l t h p l a n and m e d i c a l l y necessary and a p p r o p r i a t e
(e.g., l o n g - t e r m c a r e ) .
D.
Use o f Fee Schedules:
Automobile i n s u r a n c e
payments f o r h e a l t h care s e r v i c e s would be made i n
accordance w i t h any fee schedules e s t a b l i s h e d f o r heath
care s e r v i c e s g e n e r a l l y "(except i f o t h e r w i s e , a g r e e d by
an automobile i n s u r e r and a h e a l t h p l a n ) . The s t a t e s
would develop o r approve fee schedules f o r any
a u t o m o b i l e a c c i d e n t - r e l a t e d medical s e r v i c e s n o t covered
by a g e n e r a l h e a l t h care s e r v i c e s fee schedule.
III.
Administration
A.
Payment F a c i l i t a t i o n :
S t a t e s would be
r e q u i r e d t o develop and implement e f f i c i e n t systems f o r
r e c o v e r y o f payment f o r automobile a c c i d e n t - r e l a t e d
m e d i c a l s e r v i c e s from, automobile i n s u r e r s , i n c l u d i n g
computer data systems and mechanisms f o r r a p i d
r e s o l u t i o n o f l i a b i l i t y issues o r d i s p u t e s .
Bi
S a n c t i o n s : P e n a l t i e s would be imposed f o r
f a i l u r e t o comply w i t h t h e s t a t e a d m i n i s t r a t i v e
requirements.' f o r implementing automobile i n s u r a n c e
coordination.
C.
Consistency w i t h Other H e a l t h Care Reforms:
The. requirements f o r automobile i n s u r a n c e c o o r d i n a t i o n
would be implemented i n accordance w i t h t h e o t h e r
r e f o r m s p r e s c r i b e d by t h e A c t .
�r
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AUTOMOBILE MEDICAL INSURANCE COORDINATION
AS PART OF HEALTH CARE REFORM
Coordinating the medical component of automobile insurance with the health care
system would produce savings for both the health care and the automobile insurance systems.
It also would respect consumer choices of particular health care plans and generally create a
more "user-friendly" system for consumers.
Savings to the Health Care System. Automobile insurance coordination would produce
savings for the health care system by requiring automobile insurers to reimburse health care
plans directl' for such plans' expenditures on medical services covered by automobile
insurance. This would eliminate duplicate health plan and automobile insurance payments for .
such expenditures, which currently amount to approximately $5 billion per year about
40 percent of the total of $12.5 billion of health care costs annually paid by automobile
insurers. At a time when millions of Americans have no health insurance coverage at pH.
there is no iustification for allowing such duplicate payments to continue.
Savings to the Autnmnhlle Insurance System Automobile insurance coordination
would also produce savings for the automobile insnnmce system bv extending to automabile _
insurance medical coverages any cost containment mechanisms applied by health plans.
Requiring direct reimbursement from automobile insurers to health plans would ensure that
any cost management measures implemented by health plans, inchidjng fee schedules ana
treatment guidelines, would translate into similarly managed costs tor automobile insurers. ~
Benefits for Consumers. Automobile insurance coordination would benefit consumers
both through the savings it would produce for the health and automobile insurance systems
and by simplifying the delivery of and payment for medical care for automobile accidentrelated injuries.
Under a coordinated system, individuals would receive care for automobile accidentrelated injuries, whenever possible, through the same health plan or provider group they have
chosen for treatment of other types of injuries and illnesses. This would respect the fact that
most consumers would prefer to establish a relationship with a doctor or group of doctors
rather than changing doctors depending on the circumstances givingriseto the medical
treatment being sought. Coordination also would guarantee that consumers retain their right to
recover from automobile insurers any deductibles and coinsurance they have paid or owe to
their health plans or providers for treatment of auto accident-related injuries. By making this
right a matter of federal law, coordination would facilitate consumers' ability to recover such
deductibles and copayments.
Automobile insurance coordination would not interfere with consumers'rightsto
recover both non-medical damages attributable to automobile accident injuries, including
recoveries for pain and suffering and lost wages, and any expenditures on medical care that is
necessary or appropriate but is not covered by the injured individual's regular health plan.
Automobile insurance coordination also would not alter the currentrisk-basedsystem
for auto insurance coverages. It would therefore retain existing incentives for drivers to
minimize therisksthey pose, and for automobile insurers to advocate safer vehicles, safer
highways, and more prudent driving behavior.
Overall, automobile insurance coordination would produce a more rational system with
increased efficiencies to make health care coverage and automobile insurance more affordable
for all Americans.
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BENEFITS OF AUTOMOBILE INSURANCE COORDINATION
Health Can System •SawwyT
0
Automobile insurance coordination will produce substantial savings for the health
care system, including health care programs financed by the federal government.
According to a report recendy released by Lewin VK, Inc., properly designed
automobile insurance coordination would save the federal government
$16.73 billion over five years (1996-2000). In addition, state and local
t governments would save $5.02 billion (primarily through reduced Medicaid
payments) and employers would save S14.28 billion, over the same-five years.
0
Automobile insurance coordination would produce the estimated savings by
eliminating duplicate payments by health care plans - public and private - and
automobile insurers for the same medical expenditures. It would accomplish this
by requiring automobile insurers to reimburse health care plans directly for their
expenditures on medical care covered by automobile insurance.
0
The federal government savings from automobile insurance coordination would
result primarily from new proceduralraaadatesfor direct payment by automobile
- insurers to Medicare and other federal government programs for automobile
accident-related medical services. Currently, such programs' right to collect from
automobile insurers isfrequentlyineffective, because of the difficulty of
identifying the responsible automobile insurer, the delays involved, and the
difficulties and costs of disputeresolutionand reimbursement collection.
Automobile insurance coordination would correct these problems by requiring, as a
matter of federal law, that states implement efficient administrative
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and dispute resolution procedures to facilitate automobile insurers' reimbursements
to health plans. These procedures would go well beyond any collection
improvements that are possible under current law.
0
The health care system savingsfromeliminating duplicate payments by health
plans and automobile insurers would be particularly significant in states with
traditional fault-based automobile accident liability systems. In such states, it is
difficult (in some cases, not permitted) for health plans to obtain reimbursement
from automobile insurers for expenditures on automobile accident-related care,
and many health plans therefore never even attempt such recovery. Automobile
i
insurance coordination would require such reimbursement, making automobile
i
insurers directly liable to healtli plans for the costs of services necessary or
appropriate to treat automobile accident-related injuries and illnesses.
Eliminating duplicate payments through automobile insurance coordination is
sound public policy. Currently^ duplicate payments by automobile and other
insurers for the same health care expenditures are estimatedtobe approximately
S5 billion per year. This represents about 40 percent of the total of $12.5 billion
of health care costs annually paid by automobile insurers. At a time when millions
of Americans have no health insurance coverage at all, it seems unthinkable to
allow such duplicate payments io continue.
Automobile rnsuranne System Savins!
"
Automobile insurance coordination would benefit automobile insurers and their
policyholders by extending any cost containment mechanisms applied in the health
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-3care system to medical care paidforby automobile insurance. By requiring
automobile insurers to reimburse health care plans directly for expenditures on
automobile accident-related care, coordination would prevent cost shifting to
automobile insurers and allow automobile insurers to "piggyback" on any managed
care guidelines applied by health plans.
Under the current automobile insurance system, there is no effective way for
automobile insurers to manage the extent and cost of health care provided for most
automobile accident-related injuries. Because most automobile insurance health
care payments are made under liability policies for treatment of persons other than
the insured, automobile insurers are not in a position to manage the types and
extent of treatment they pay for. Unlike health maintenance organizations and
preferred-provider network insurers, automobile insurers generally cannot, for
example, require that the medical treatment they cover under liability policies be
subject to utilization review or specific fee limits. By requiring reimbursement to
health care plans for their actual expenditures, automobile insurance coordination
would provide automobile insurers and their policyholders a means of sharing the
benefits of managed care techniques applied by the health care system.
The lack of cost management for auto accident-related medical services can create
perverse incentives for over-utilization of such services. In some cases, these
incentives may lead to abuse and even fraud. Any health care reform legislation
that aims to curb health care costs should include measures to eradicate these
incentives and their adverse results. Automobile insurance coordination provisions
would serve these goals.
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Closely related to the problem of uncontrolled automobile accident-related health
care expenditures is the problem of cost shifting. To some extent, all private
insurers of medical care are the victims of cost shifting, but the problem is
particularly acute for automobile insurers. Health care reform that fails to provide
for automobile insurance coordination will likely only exacerbate cost shifting to
automobile insurers, by excluding themfromnew protections against artificially
inflated charges.
Benefits far Consumers
9
Coordinating automobile insurance with the health care system would have
significant financial benefits for consumers. If properly designed, coordination
ultimately could reduce both automobile and health insurance premiums, because it
would eliminate excess health care charges, wasteful expenditures, and duplication
in payments for services provided. For example, coordinating automobile
insurance medical coverages with a reformed health care system in which health
care fees are subject to reasonable limits will ensure that health care providers do
not shift costs to automobile insurers and thereby effectively inflate automobile
insurance premiums.
8
The theory behind coordination of insurance coverages for health care is to ensure
. that a person receives treamient for injuries and illnesses, regardless of their
source, in a uniform manner with respect to the provider of the care, the quality
of the care, and the cost of the care. Under a coordinated health and automobile
insurance system, an individual injured in an automobile accident would receive
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-5medical carefromthe same provider group he or she has chosen for treatment of
injuries and illnesses generally. This would respect consumer choice: most
individuals would prefer to establish arelationshipwith one doctor or group of
doctors rather than changing doctors depending on the circumstances giving rise to
the medical treatment being sought.
Under a coordinated system, consumers would retain their right torecoverfrom
automobile insurers any deductibles and coinsurance they have paid or owe to
their health plans for treatment of auto accident-related injuries. Indeed,
consumers' ability to recover such deductibles and copayments would be facilitated
by coordination, because the states would berequiredto develop plans for the
efficient recoveryfromautomobile insurers of payments covering automobile
accident-related medical services,
Automobile insurance coordination would not interfere with consumers' rights to
recover both non-medical damages attributable to automobile accident injuries,
inchidingrecoveriesfor pain and suffering and lost wages, and any expenditures
on medical care that is necessary or appropriate but is not covered by the injured
individual's regular health plan.
Automobile insurance coordination would not alter the current risk-based system
for auto insurance coverages. Therefore, the party responsible for an auto
accident would continue to be accountable for the costs associated with the
accident. This would retain existing incentives for drivers to minimi^ the risks
that they pose to themselves and others. In addition, automobile insurers would
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stiUhave the incentive to advocate safer vehicles, safer highways, and more
prudent driving behavior, because automobile insurance payments would continue
to cover the medical costs associated with motoring.
Separation from Workers' Canmensation
0
Notably, the benefits to be gained through automobile insurance coordination need
not be weighed against concerns that might arise with respect to workers'
compensation insurance. There ire significant differences between automobile
insurance and workers' compensation insurance that counsel against treating the
two systems similarly in the context of health carereform.For example, there are
important questionsrelatingto the employer'sresponsibilityfor the course of
treatment for disabled workers under workers' compensation that are not relevant
in the automobile insurance context. Likewise, there are questions about
automobile liability insurance that have no corollary in the workers' compensation
context. Accordingly, action on automobile medical insurance coordination should
in no way be influenced by concerns about workers' compensation.
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�H E A L T H SECURITY EXPRESS
N LATE JULY and early August, Congress will
unions. National sponsors include: the American
weigh one of the most important legislative
Federation of State, County and Municipal
decisions of our time: whether to guarantee comEmployees; the National Association for Home
prehensive private health insurance to all AmericansCare; Families USA; Hospital Employees Local
insurance that can never be taken away.
1199; the United Auto Worker; Communications
Workers
of America; Alzheimer's Association;
Millions of Americans will follow the debate
Waste Management, Inc.; Laborers International
closely. Thousands of citizens will do more than lisUnion of North America; Service Employees
ten and watch. They will ride into history^-on
International Union; and United Food and
caravans of buses from every region of the country,
Commercial Workers. Oreanizations or individuals
aiTmng-oirbapntHyLr&f^v ec^nini^£Aueysat_
may sponsor a bus or donate supplies and services.
They will be nurses, doctors, working people and
retirees, celebrities, and political leaders. The "reform
riders" will be carrying hand-written messages from their neighbors back home,
addressed to elected representatives, askWcttem Rout*
ing-demanding-that Congress pass
Nortiicait Reuu
President Clinton's health reform.
PORTLAND
BOSTON
I
k
AMERICA RALLIES
ON THE WAY, they will attend electrifying events in cities around the country
with big name entertainers, state and community leaders and, we expect, the
President, the First Lady, Vice President
and Mrs. Gore, and Cabinet members. The
reform riders will be treated as honored
guests along the routes, where they will be
greeted by local officials and enjoy meals cooked by
church groups and community organizations.
Reaching Washington, they'll be greeted on
Capitol HiQ by leaders of the House and Senate.
The reform riders will deliver thousands of personal
messages to each member of Congress. Other events
in Washington that week may feature the First Lady
and Cabinet members, as well as entertainment
celebrities.
PURPOSE
• Demonstrate an outpouring of support for passage of national health reform.
• Influence swing members of Congress by holding
high-profile community events in their backyards.
• Enable supportive groups, businesses, and community leaders to join the groundswell of public support for health reform.
• Put the American people back in the driver's seat
of the health care reform movement
PROJECT SPONSORSHIP
The Health Security Express is supported by a
diverse group of organizations, corporations, and
INDEPENDENCE
AWweit Route >£/WASHINGTON DC
MEMPHISi"
Southern Route
SAN ANTONIO
ROUTES
Bus routes are planned to maximize media coverage in the districts of targeted lawmakers. Starting
in the West, Midwest, South, and Northeast, routes
will run from one to eight days.
The caravans will pass through many towns
without long stops. Nonetheless, photo and interview opportunities will be arranged for local media.
Reporters will be invited to ride with the Health
Security Express through their communities and
supporters will be encouraged to cheer the reform
riders as they pass through town.
HOW Y O U
CAN GET INVOLVED
The Health Security Express is gaining momentum. People from every cOmer of America are getting
involved. For more information about becoming a
sponsor or a reform rider, please call or write:
1-202-639-8868 or 1-800-368-8478
Health Security Express
Attention: Pamela Squires
1334 "C" St. NW, 3rd Floor
Washington, DC 20005
�HEALTH S E C U R I T Y EXPRESS - SPONSORSHIP OPPORTUNITIES
HE HEALTH SECURITY EXPRESS is pulling
out of the station. In late July and early
August, thousands of Americans from every
corner of the country will carry a single, unified message to Congress: pass President Clinton's health
reform now.
Three levels ofsponsorship luillget the Health Security
Express rolling wearing America's colors:
T
Red Tour Sponsors
White Tour Sponsors
Blue Tour Sponsors
RED TOUR SPONSORSHIP T H E NATIONAL TOUR
E
ACH RED TOUR sponsor will enable 40 citizens to go to our nation's capital and demand
universal health care for all Americans. The Red
Tours will be organized in every corner of the continental United States. A Red Tour Sponsor will pay
for the bus, driver and all meals and accommodations
needed for riders on their trip across the country.
Once in Washington, DC, bus tour participants will
go to Capitol Hill and personally lobby their members
of Congress for passage of the the President's health
reform act. Assembled from hundreds of communities
around the country, these folks will hand deliver messages fromfriendsand neighbors asking Congress to
pass this vital health care legislation.
• T-Shirts and Caps Each busriderwill be given
an official T-shirt and baseball cap. The sponsors'
names will be prominendy displayed on these items.
Riders will be encouraged to wear their shirts and
caps on the bus ride and on TV.
• Capitol Photograph A photograph of pur bus
and riders will be taken in front of the Capitol
Building in Washington, D C , and sent to both the
media and the sponsor.
Red Tour Sponsorships are $20,000. Half bus
sponsorships are $12,000, with publicity shared with
one other organization.
W H I T E TOUR SPONSORSHIP SINGLE DAY TOURS
T
HE WHITE TOURS will be organized in the
Mid-Atlantic region of the United States.
Sponsors will fund one bus to drive 40 citizens from
the region to Washington, DC. Meals for day trip
tours will also be paid for by the sponsor.
Once in Washington, DC,riderswill be taken to
Capitol Hill to join other tour participants from
around the nation. They will be given the opportunity to personally lobby members of Congress for passage of the Health Security Act, and hand deliver
messages from friends and neighbors asking
Congress to pass this imporunt piece of legislation.
Sponsors will be key participants in this nationwide
effort. They are assured thefollowing benefits:
White Tour Sponsors will be assured of the following
benefits:
• Bus Boards The sponsor's company name will be
displayed on the side of the bus for the entire trip to
Washington, D C (averaging five days). These buses
will be the tour's focus. Numerous side trips and
stops are planned for each bus. The media will be
welcomed along the route and at events.
• Events Each day events will be scheduled for the
buses. The sponsor's name will be included on event
banners and literature. The event would be hosted by
a celebrity or VIP who would announce and thank
the sponsoring organization.
• Media information Sponsors will be listed in
press releases and media packets. Special events and
daily rallies will acknowledge the sponsors. Written
materials prepared for the riders, including brochures
and flyers, will also feature information on the
sponsor.
• Bus Boards The sponsor's company name will be
displayed on the side of the bus for the one-day trip
to Washington, DC. The media will be welcomed
along therouteand at the large event planned for
Washington, DC.
• Events Each day events will be scheduled for the
buses. The sponsor's name will be included on event
banners and literature. The event would be hosted by
a celebrity or VIP who would announce and thank
the sponsoring organization.
• Media Information Sponsors will be listed in
press releases and in media packets. Specials events
and daily rallies will acknowledge the sponsors.
Written materials prepared for the riders, including
brochures andflyers,will also feature information on
the sponsors.
• T-Shirts and Caps Each bus rider will be given
�an official T-shirt and baseball cap. The sponsor's
name will be prominendy displayed on these items.
Riders will be encouraged to wear their shirts and
caps on the bus ride and on TV.
• Capitol Photograph A photograph of your bus
and riders will be taken in front of the Capitol
Building in Washington, DC and sent to both the
media and sponsor.
White Tour Sponsorships are available for $5,000.
It is possible to sponsor half a White Tour bus for
$3000. In this case, sponsors would enjoy all of the
same privileges listed above, however, all publicity
would be shared with one other sponsor. Partial
sponsorships are $2,000.
BLUE T O U R SPONSORSHIP G O O D S AND SERVICES
K
EY TO THE SUCCESS of Health Security
Express is the donation of goods and services.
Our outreach team is looking for contributions of
everything from computers to water botdes. As a
Blue Tour Sponsor, you can contribute by financing a
component of the project or by providing in-kind
goods or services.
Blue Tour Sponsors will be listed in tour literature
and mentioned in press packets and at special events.
Casb Sponsorship
Blue Tour Sponsorships are available for $1,000.
In-Kind Contributions
Organizations may choose to donate or lend any
of the following to the Health Security Express:
• Stuff Volunteer staff will be critical to the success
of the tours. We need skilled individuals for the following positions:
•
•
•
•
•
Field Staff
Advance Staff
Meal Coordinators
Day Trip Coordinators
Transportation
Coordinators
•
•
•
•
•
Computer Specialists
Lawyers
Insurance Professionals
Accountants
Database Managers
• Telecommunication
• Outreach
Specialists
Coordinators
• Graphic Designers
• Volunteer
• Printers
Coordinators
• Travel Agents
• Automobiles A team of volunteers and staff will
help on-site before and during the tour. Cars and
minivans will be needed at each location to transpon
volunteers, staff, media and VIPs.
• Events Events will be scheduled daily for each
bus. Services and equipment will be needed at each
event site. These services and equipment include:
• Lighting
• Banners
• Staging
• Flyers
• Sound
• Posters
• Security
• Signs
• Accommodations Rooms and meals will be needed for staff and volunteers traveling to the various
sites. Churches located at appropriate places along the
route are especially urged to contribute meals. In-kind
contributions may include any of the following:
• Hotel rooms for
• Meals for advance
advance staff, bus
people, bus travelers
travelers and press
and press
• Box lunches
• Press hospitality
• Reception
• Logisticai Needs Telecommunication services,
office machines and office space will be used to help
coordinate buses, people and events. Items needed
include:
• Computers
• Radios
• Software
• Office space with
• Printers
telephone, fax and
• Cellular phones
computer services
• Beepers
• Miscellaneous A variety of items will be needed
for the bus riders. These include:
• T-shirts
• Healthy snacks
• Baseball caps
• Fruit juices
• Travel care packages
• First Aid kits
• Water bottles
�HEALTH SECURITY
EXPRESS
Organization Assistance Form
Health Security Express
Needs Y o u r Help
ORGANIZATION:
T
IE HEALTH SECURITY EXPRESS
bus tour is an effort to make Congress aware of this countr/s urgent need
and support for President Clinton's health
carereform.People, funding, and in-kind
services are needed to ensure that the
Health Security Express is successful
Several ways you and your organization
can get involved are listed below.
C O N T A C T NAME:
ADDRESS:
TELEPHONE:.
FAX:
Please check those areas In which your organization could help.
Sponsor a bus
Red—National Tour sponsoring one bus across the country ($20,000)
White—Day Tour sponsoring one bus from the DC area to the Capitol ($5,000)
NOTES:..
Provide bus riders (cost per rider based on distance traveled)
NOTES:
Bring supporters to events
Cities:
Portland, OR
Independence, MO
Nashville. TN
Boston, MA
Washington. DC
NOTES:.
Endorse Health Security Express
NOTESL.
Provide in-kind goods or services
These may include staff, office equipment, transportation, hotel, meals, printed materials, etc.
NOTES:
Generate messages and letters to members of Congress on special
Health Security Express message forms
NOTES:
Identify people with personal and professional stories of health care difficulties
NOTES:
Please return this form to:
Health Security Express, Attn: Pamela Squires
1334 " G " Street NW, 3rd Floor
Washington, D C 20005
For further information please contact
Health Security Express at
1-202-639-8868 or 1-800-368-8478
�H E A L T H S E C U R I T Y EXPRESS - R O U T E S
�07/14/94
ATTN:
FR:
17:03
DNC COMMUNICATIONS •» Ulfl XPEDITE
NO.377
P003y007
HEALTH CARE CONSTITUENTS
DNC S P E A K E R ' S BUREAU
HEALTH SECURITY EXPRESS!
support universal coverage for every American - support the Health
Security Express bus tours.
We need your help! As melded committee b i l l s h i t the House and.
Senate f l o o r s next month, we need t o amplify our support f o r
Presicient C l i n t o n ' s bottom l i n e - u n i v e r s a l coverage.
The HEALTH SECURITY EXPRESS was created t o d e l i v e r a message t o
Congress from a l l of America.
Buses o r i g i n a t i n g from a l l parts of the country are scheduled t o
converge on Washington on August 3rd. Along the way, busses have
scheduled stops i n c i t i e s and towns f o r major health care events,
meetings and r a l l i e s .
Buses f i l l e d w i t h "reform r i d e r s " w i l l converge on our nation's
c a p i t a l c a r r y i n g hand w r i t t e n messages, from home addressed t o t h e i r
elected o f f i c i a l s - demanding health care f o r every American.
Your previous involvement i n Health Care Reform has been i n v a l u a b l e
and we would l i k e t o extend another opportunity t o help. Volunteers
are needed f o r r a l l i e s at each of the major stops around the
country, t o r i d e on busses, and t o lend f i n a n c i a l support f o r the
tours.
Attached i s an o u t l i n e of the bus tour i t s e l f , as w e l l as a l i s t of
contacts f o r each region.
As I mentioned before, t h i s i s a c r u c i a l time f o r h e a l t h care
reform - f e e l f r e e t o c a l l me w i t h any questions t h a t may come up
as you explore your options t o help w i t h the Health Security
Express (202) 479 5144.
Jason McManigal.
Democratic National^Committee
National Health Care Campaign
�Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
AND TYPE
001. memo
SUBJECT/TITLE
DATE
DNC [Democratic National Committee] Speaker's Bureau to Health
Care Constituents; re: Health Security Express! (2 pages)
07/14/1994
RESTRICTION
Personal Misfile
COLLECTION:
Clinton Presidential Records
Health Care Task Force
Walter Zelman
OA/Box Number: 3797
FOLDER TITLE:
Miscellaneous [Folder 1]
2006-0885-F
jp2839
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)|
Freedom of Information Act - [5 U.S.C. 552(b)|
PI
P2
P3
P4
b(l) National security classified information |(bXl) of the FOIA|
b(2) Release would disclose internal personnel rules and practices of
an agency 1(b)(2) of the FOIA|
b(3) Release would violate a Federal statute [(b)(3) of the FOIA)
b(4) Release would disclose trade secrets or confidential or financial
information 1(b)(4) of the FOIA|
b(6) Release would constitute a clearly unwarranted invasion of
personal privacy 1(b)(6) of the FOIA|
b(7) Release would disclose information compiled for law enforcement
purposes 1(b)(7) of the FOIA)
b(8) Release would disclose information concerning the regulation of
financial institutions [(b)(8) of the FOIA|
b(9) Release would disclose geological or geophysical information
concerning wells 1(b)(9) of the FOIA|
National Security Classified Information 1(a)(1) of the PRA|
Relating to the appointment to Federal office 1(a)(2) of the PRA|
Release would violate a Federal statute 1(a)(3) of the PRA)
Release would disclose trade secrets or confidential commercial or
financial information [(a)(4) of the PRAj
PS Release would disclose confidential advice between the President
and his advisors, or between such advisors [a)(5) of the PRA)
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(a)(6) of the PRA|
C. Closed in accordance with restrictions contained in donor's deed
of gift.
PRM. Personal record misfile defined in accordance with 44 U.S.C.
2201(3).
RR. Document will be reviewed upon request.
�HEALTH SECURITY EXPRESS - ROUTES
\
s
jv
Northeast Route
i-
« MITOUA
\
<
' niMMiAPOlil;
. „
^
. i
Western Route
—4
\
V
OMAHA*
MADItON
/
'xlAMIIHe
V
-.
' C t l MOINtJ
\
T
CHATTlU4o6CA C
Southern Route
W a s h i n g t o n DC
A u g u s t 2, J , & 4
!
fUOOM
Dallas
Wednesday, July 27
AID/KOUM.
^ f e ^ ^ N r " ^
.
^ NEW ORLEANS V ^ X ^
^
New Orleans
Wednesday, July 27
Wednesday, July 6, 5:37pin
s)
"0
LP
\
C3
S
Ti
I
II.
�07/14/94 17:04
J
NO.377
DNC CDMMUNI CAT IONS * UIA XPEDITE
HEALTH
ECURITY
PRESS
ORGANIZATION
P007/007
ASSISTANCE
Health Security Express
Needs Your Help
OUCANIZATION;.
T
IE HEALTH SECURITY EXPRESS
bus tour is an effort to make Congress
aware of this countiys urgent need and
support for guaranteed health security that
can never be taken away. People, funding,
and in-kind services are needed to ensure
that the Health Security Express is successful. Several ways you and your organization
can get involved are listed below.
CONTACT NAME:,
ADDRESS:.
TELEPHONE:.
FAX;.
Please check those areas In which your organization will participate.
Sponsor a bus
Red—National Tour sponsoring one bus across the country ($20,000)
White—Day Tour sponsoring one bus from the DC area to the Capitol ($5,000)
i
NOTES:
;
•
Provide bus riders (cost per rider based on distance traveled)
•NOTES:
Bring supporters and bus riders t o events
Portiand.OR
Independence, MO
New Orleans, IA Dallas. TX New Jersey Boston. MA Washington. DC
NOTES:
•
Provide in-kind goods o r services
These may include staff, office equipment, transporution, hotel, meals, printed materials, etc.
NOTts:
Generate messages and letters t o members of Congress on special
H e a l t h Security Express message forms
NOTES:
Identify people w i t h personal and professional stories of health care difficulties
NOTES:
Please return this form to:
Health Security Express, Attn:
1334 "G" Street NW
Heather
Washington. DC 20005
f o r further Information please contact
Health Security Express at:
Booth
(202) 639-8850 OR (800) 368-8478
FAX (202) 639-8661
�07/20/94
13:42
NO.924
AT&T 9500 PPF
r":
DDERTM. BRANDON
19QlXStreet N.W.
Hgton, D.C. 20036
FACSIMILE TRANSMITTAL
TO: \jJoQ^x^^,e'y^(Lv\
FROM:
COMPANY:
•ATE:
FAX:
qSl- 7Y3/
NUMBER OF PAGES:
inciuxling cover)
7 / rA\,,
?
MT
FACSIMILE: (202) 296
2
D01
�"^0/94
1
3:42
RT8.T 9500-PPF
JUL-15-91 FR1 2:31 PM
EALTH
ECURITY
r. L
NO. 924
• Put LIK; /Vnicrioan people hack in Uit drivtrs teat uf
the health care tefonri mw^xment,
PROJECT SPONSORSHIP
The Henltli Security Express i« aupporteet a
dtviric group of organisatioh*, eorporatloiu, and
unions. National ipontora Inrhide; the American
Fedeiatlou of Suw, County and Municipal
Employeei, HealthRICHl ) FamUiM USA; Hoapital
Cmp>luyeM Locil 1199; the United Auto Workew;
Commumcationi Woikeia of America; Alzheimer's
N LATB JULY tnd ejrlyAupwr, Cpnpew-will
AMOeiatlon; Watte Management, Inc.; Laboteu
weifjh one of the most important legldaclvK rfetisioiu IntenutioDsl Union of North Amcrieai Service
of our rime: whether to purantee compi ehenfjve pri Employees Intemedonal Unlonj »nd Unltefl Pood and
vite heilth in8ur»nce to «U Anjerlcirs- Imurance th»t
Commercial Workers. Oiganizationi or IndividutU
r»il never be taken v»vfm«y tponmr a but or donate supplies and ecrview.
MillioM e>f AmerJcans wJU follow the «Ieb«te
dosely. Thoiisindi pf citizeni will do more rK»n
listen and v»tth. Th«y will rirfr. Into hlstoiy-on
cuavint of buiti from every legion of the eoilntryi arriving on Capitol Hill at thi beginning uf
Augutt, They wiU be nunc*, doetort, working
people and retirett, celebritln, and political loadWMWiwr.ToM DC
ers. The "reform riden" will bt carrymg handwritten rn«t<aee« from their neigkbon back home,
addteoed to electedrepr**ant«tiv«e,deuundlng
rhat Congre*! fD»pond to Prwident ClintOfl'a laad'
ership for uniwaniil covarage and gHwantii fht no
mwms
I
AMERICA RALLIES
ON THE WAY, they will atttnd electrifying evenU in
citiei around the country •with big name efitertainep,
state »ml community leaders aniTwe expect, the
President, the Fitit Lady, Vict Pteaident and Mrs. Owe,
and Cabinet tnembcre. The reform riders will be treated
at honored gucata along the routes, where thoy will be
greeted by local official and enjoy mtak cooked by tellgiom uia communitj- otganiretloni.
Reaching Waahlngtou, they'll be greeted en Capitol
HU1 by leader* of the Houie and Senate. Th» rtfortn
ride™ will deliver thouaanda of pewonal mewagea to
each member of CwigreM. Other events In Washington
that week may feature th« Flrar Lady and Cabinet
membere, aa wall ac entei Uinmcnt celebrities.
PURPOSE
„
• iJ«mon«rr«t= an outpouring of lupport tot passage of
health reform.
• Ijifluence awing members of Congresi by holding
hlRh-proflle twi«nunity evenm in their baelcyaids.
Ii jr.nahle lupportive group*, busineaaw, and eotmnunity
Iradera to join the groundaWEll of public support for
liealth reform.
ROUTES
Bus rouMt are planned to mnximize media coverage
in the distrlcti of targeted Uwmakera. Suiting in the
Wear, Midwest, South, and Northeaat, routea will run
from one to eight dayi.
The taravana will p^a through many towns without long stops. Nonctheleaa, photo and intetview
rnjjurtunitiea will be arranged for loeal media.
Repcrtert will be Invited to ride with the Health
Security Exprese through their communitiea and aupportsra will DO encouraged to cheer the reforui rider*
a» they paw through town.
HOW Y O U CAN GET INVOLVED
Ths Health Security Expreas la gaining momtntum.
Peopleftomevery cwner of America ate getting
involved. Fbr more Infprmation about endorsing the pm»
Jcct or about becomhig a sponaer or a rafoim rider, please
call or write;
iH>2)
or f*00; Mf-M7f.
fax {Ml)
t39-it6l
Hea/th Security Rxpren, Attn; Heather Booth
13:14 **Cf" St. NW, WaeMnglen, DC JOOflJ
�07/20/94
13:43
AT&T 9500 PPF
NO.924
• • .101-15-94 FBI 2:32 PM
F. 3
H E A L T H SECURITY EXPRESS - SPONSORSHIP O P P O M U N t T l l S
T
HE HEALTH SECURITY EXPRESS 1« pulling
• T.Sh/rti ond Cops Eacli bus rider will be givch
out of the station. In late July and early
an olTlda] T-shirt and baseball cap. The sponsors'
Augmt, thousand! of Americans from every
namss will be prominently dltplaysd on these items.
corner of the country will carry a single, unified tnes- Kldars will be encouraged to wear their rhirls aiid
sago to Cong res J; past health re/omi that guarantees caps on the bus ride and on TV.
no American will over lose their health Insurance;
• Capitol Photegreph A photograph of your bus
Tbnt Uvtb fl/f/»M/w»4if vAllgtt T»t fitafrb Steurity
and riders will be taken in front of the Capitol
Exprtu rvlling tutaring Amtrieai rvlon:
Building in Washington. DC, and sent to both the
media and the sponsor.
Red Tbur Sponsors
Whlto ToUr Bpenaora
Blue lour Sponsor*
R&D TOUR SPONSORSHIP THB NATIONAL TOUR
E
ACH R E D ToUR ipontor will enable 40 citlteni to go to our nation's Capital and demand
universal health care for til Americans. The Red
Tours will be orgajiued In every corner of the continental UnitDd States. AfeedTbur Sponsor will pay
for the bus. driver and all mfcals and accommodations
needed for riders on their trip across tK* country.
Once in Waahltigton, IDC; bus tour participants will
go to Capitol Hill and pcisvnally lulby dieii n«mb«re
of Congress for passage ol health reform. Assembled
from hvm^redi of communities around the caUnrry,
tliose folks will hand deliver tnesaigttftomfriendi and
nelghbon asking Congtesatopus this vital heillh ears
legislation.
Efonten •uiiltht itypankipattB in thii HatfanDiidi
effbri. They t* iutund thtfilbvinf tirtiflti:
Red Tbur Sponsorships are 120,000. Half bus
sponsorships are 112,000, with publicity shared with
one other organisation.
WHITE TOUR SPONSORSHIP SINGLE bAT TOURS
T
HE WHITE TOURS will be orgsnitad In the
Mid-Atlaatic region of the United States.
SpOAtOtt will fund one bu» to drive 40 citluns from
the region to Washington. DC. Meals for day trip
tour I will also be paid fbr by the sponsor.
Oaee In Waehlngwn, DC,
will he tilern to
Capitol Hill tu Join othertourparticipants from
aiouud the uition. Thoy will be given the opportunity to personally lobby members of Congress for
action to guarantee health security that can never be taken «way.
Whirr Tbur Sf anion viU i$ utkrti
Umfitt;
oftitfrllwing
• SuafioorrfsThe eponeor'a company name wUl be
displayed on the tide of the bv* for the one-day trip
• Btia Beards The sponsor's compntty name will be
to Washington, DC. The media will be wdcotwd
dispUycd on the tide of the but for the sntira trip to
along the route and at the large event planned for
Washington, DC (enragingfivedava), TbMs buses
Washington,
DC.
'
will be th« tour's fbcua. Numeruuti side trips and
stops are planned for etch bus. The media will be. • Event* Each day events will be scheduled for the
buses. The spohsort nemo will be irteluded an event
wojeomed alone the route and it events.
• Events Each day events will be scbeduled fok the bannen and literature. The event would be hosted by
a eelabrity or VIP whn would announce and thank
buses. The spqnsot's name Vdll be Incltldod en event
banners and literature. The eventfcoiildbe hosted by the sponsoi ing uigaiilzatioa• Media Information Spontots will be Usted In
a celebrity or VIP who would antwunee abd thank
press xeleaies and in mMla pickets. Special* events
the iponsorlng organisation.
and dtUy rallies will acknowledge the sponsors.
• Msdlo' InfomtotJon Sponsors will be listed in
Written muleriels prepared for the riders, including
press releases and media packets. Special events and
brochures andflyers,will alto feature inforuuLtion on
daily rallies will acknowlsdge thf. uponwiis. Written
the sponsors.
materials prepared for the tidere. including brochures
• T-Shlrti; and Ca»< Each buariderwill be ({iyen
andflyais.will also feature information on the
an official T-shirt and baseball rap. The aponeor's
sponsor.
(
D03
�07/20/94
NO. 924
AT&T. 9500 PPF
13:44
Health Security Express
Date
Day
Titne
Dc»criptinn
FoodNeedi ffuf Meals
Wistem Route
Day One « Friday
12100 PM
2:00 FM
4:00 PM
9:15 JPM
Day Two - Satunky
7/2V94 8:30 AM
3.1:30 AM
4;30PM
Day Three-Sunday
-8:00
AM
mm*
11:00 AM
1:00 PM
6:30 PM
Day tour - Motiday
7/25/94 11:00 AM
12-Ofl PM
4:40 PM
7. :6 PM
7/26/94 10:00 AM
Day Five - Tue«diy
2:00 PM
5:00 PM
Day Sir. Wednesday 7/27/94 10:00 AM
LIOPM
•MS PM
Day Seven - Thursday 7/28/91 S:'i0AM
10:00 AM
12145 PM
*30 AM
Day Eight-Friday
7/29/94 9:00 AM
11:45 PM
4:30 PM
Day Nine - Saturday
7/30/9* 12:00 PM
••
£v»nt In Portland, OR
Lunch
Dcputi'wland.OR
Snack
Stu|)«'ThDDaUM,OR
Dianer
Axrivs in La Urandt, OR
Depait La Grande, OR
StoptfdaJcer, OR
LuAch. Suck
Amve in Boise, ID
Diflnet
Depart BoUe, ID
AniveinTirinFalld.lD
Lunch, Shark
Depart Twin FftUj, ID
Arrtvn M S»lc Lake Giy, I'JT Dinner
Salt Lake City
Lufich, Snack
Depart Salt Lake City
Reir Stop in Craad Junction, CO
Arrive in Vail, CO
Dinner
DepwrVai^CO ',
Lunch, Snack
Arrive, in Dtrwer.CO
Denver, CO
Dinner
Depart Denver, CO
Stop 9 Sterling, CO
Lunch, Snack
Arrive in Noah Plane, NE Dinner
9 North Pfciw.NE
Breakfast
Depart North Platte, N£
Stop 9 York, NE
Lunch, Snadc
Dinner
Anivc in Stlina, KS
Depart Salina,
Stop C? T'opakA
Lunch, Snack
Anive in Independence, MQ Dinner
Event in Independence
Boscd Lunch
160
' 160
Note: Weawrn koure now merges with Midwest route and tontiRuei on to Washington, DC
160
. 160
160
160
IbU
160
160
160
160
160
160
160
P04
�07/20/94
JUL-lb-M
*
13:44
TUE SWU (SH
u i 0 *«/mm
AW
fliaT
9500 PPF
NO.924
(
Hea/ti Security Express
Day
Date
Time
DescriptfM
FoodNeaett
•a
iofMeak
m i l — — — —
Midwest Route
7/30/94 12r0p PM .Event In Independence, MO BuxsdLuach
2:00 PM Depart Independence, MO
5:00 PM Stop 0 Columbia, MO
Dinner
Snack
9:00 PM Anive in Sr. Loni*. MO
Day -Twa - Sunday
7/31/94 9:00 AM . Depart St. Louis, MO
. 1:15 PM Stop0Evan»vill«,IN
Luachi Snack
Dinner Snack
6:15 PM Anive in Louiaville, KY
Day Thrw - Moiiriny
8/1/94 9:00 AM Depart Louisville, KY
Lunch, Snack
11:00 AM ' Stop ^ Lexington, KY
S-.30 PM Axrite in CharlBiton, WV . Dinner, Sniek
Day Four - Tuesday
8/2/94 8:00 AM Depart Charleston, WV
Lunch, Snack
11:15 AM Stop CP aukrturg, WV
Dinner
415 AM Anive in. Pittsbutgh, PA
Dty Five - Wednesday mm 10:00 AM Depart Pttnbuigh, PA
Lunch, Snack
1:00 PM Stop « Bedford, PA
Dinner
5130 PM Arrive in Frsderlek, MD
DaySis-Thuwdiy
S/-VV-1 8.-00 AM Depart Fndfdc^-MD
VrlOAM Arrive ift Washington, DC
Day One-Saturday
:
Unlud: 7/1S/V4
320
320
320
360
360
360
360
360
560
D05
�07/20/94
JUL-io-yt m
13:44
AT&T 9500 PPF'
NO.924 . P06
D.UO IM
Health Stcwity Express
Pete
Time
pcjcription
FoodNeedi
#bi'Mcala
Central Route — Dtf/Aix ZJC
Day One - Wednudi; 7/27/9<4 10;OOAM
12i00 PM
5:10 PM
Day Two • Tlmfatiay
7/28/94 10:OC» AM
12:40 PM
6:45 PM
Day Three • Friday
7/29/94 8:00 AM
1:15 PM
5:45 PM
Dc/ Four - Sa rtfrdny
7/30/94 9:60 AM
11:00 AM
4:00 PM
Day Five-BTinday
7/31/94 9:00 AM
11:30 AM
5:45 PM
3:00
AM
Day Six-Monday
8/1/94
11:10 AM
4:40 PM
D»y Seven - I'uetday
8/2/w 7:00 AM
10-.30AM
fivnu in Dullai.TX
Depart DalLm, TX.
Arrive in Oklalioma Gey. OK
Depart Oielahnma Cvy, OK Stop ^ Tuha. OK
Arrive in Spiingfield, MO
Depart Springfield, MO
Scop & St LULUS. MO
Arrive in Sprifigfcld, IL
Depurr Springlield, IL
Stop 9 Champaign, IL
Arrive iu Indiaaapolii, IM
Depart Indianapolii, IN
Stop t* Cincinnati, OH
Arrive In Colombia, OH
Depart Cdombus, OH
Btopfi'Wheelln^WV
Arrive in Cumberiaftd, MD
Depart Cumberland, MD
Arrive in Wathingrgn, DC
Boxed Lunch
DhuiCi' -
89
Lunch
Dinner
80
80
Lunch
Dinner
SO
80
Lunch
Dianer
SO
SO
Lunch
Dinner
80
80
Lunch
Dinner
80
60
�87/20/94
13:45
AT&T 9500 PPF
NO.924
Health Steurity Express
Dare
• Titno
' Peteripaou
Southern Route
Daj- One - Yhuxetef
Day-Two - Fiidity
Duy 'STtiut -. Saturday
7/28/94 10:00 AM
12:00 PM
Eva nr in W«w OTIMM, LA
Depart New Otleaa*, LA
im PM StoptfHattMburg, MS
6:4* PM Anivti in Meridian, MS
7/29/94 9:00 AM Depart Meridian, MS
12:15 PM Stup @ Birumisbam, AL
7:00 PM Arrive in Chamneap, TN
7/30/94 3:00 AM Deput OvMiM<3&, TN
liiOOAM Stopti'KAOwUis, T>r
Best Luitfitt*
' Snack
Dinner
Lunch ,
Dlnne»
SO
80
Lunch
io
ee
•iiuu f IvI
Duy Fuu/ * Stuuiuy
Day Fiw • Monday
Day vis • Tuesdv
Kivi>,4> >/}srt*
<t*tiAM
7/31/94 9-.O0AM DeputBiiitol, VA
l^:jt,t n v j
^top & K^anftic*, vx
4:15 PM Anivt Uv ChuiMwivUle, VA
8-1/94 10:00 AM Depart Charionewillc, VA
UQ0 PM Stop $ Richmond, VA
6:30 PM Arrive in Alexandria, VA
3/2/94 t:00AM Depart Alosandria, VA
AilO AM Arrive k DC
80
,60
i-uhrn
Dinner
aw
Lunch
SO
80
Dinner
80
007
�07/20/94
13:45
NO.924
flTg,T 9500 PPF
r. D
5: lit n\
Health Security Express
Dare
Day
Timr
DEXcrigtiou
Food Ncedt
# of Metis
Box Lunch
160
Northeast Route
Day One-Sunday
7/31/94 30(00 AM EventuiBo*ron,MA
1:00 PM Depait Baiten, MA
i'ilSPM Anive in Albany, NY
7:00 AM
11:45 AM
12:30 PM
3:00 PM
5.10 PM
Day ThreB-TUCK. Uy
8/2/94 l2iOOPM
1:00 PM
5:00 PM
Day Four - Wednesday 8/3/94 8:00 AM
9:15 AM
Day Two - Monday
RniuJi
//JJf/VM
0rH.lM
8/1/94
4
Depart Albany, NY
Arrive Injeney Gty, ISjJ
Emt in Jor»«y City, NJ
Depart Jenay City, NJ
Arrive in Philadelphia, PA
Dep«r Philndelphja
AirivoinWiUuBgt6u,SE
Arrive in Boldmoie, MD
Depart Baltimore, MD
Arrive in DC
Dinner
160
Box Lunch
ISO
Dinner
160
LuftcU, Suck
Dinner
IM
160
006
�FEE SCHEDULES AND BALANCE BILLING
PROVISIONS OF THE HEALTH SECURITY ACT
o
Each regional alliance must negotiate with providers to establish a fee schedule for feefor-service plans (and the fee-for-service component of any other health plan, Section
1322).
o
The fee schedule applies to corporate as well as regional alliance plans,
o
Providers may not charge more than the fee schedule (no balance billing, Section 1406).
o
Balance billing is no longer permitted under Medicare (Section 4032).
PROS
o
Avoids a two-tiered health care system, where the poor can't afford to see providers who
charge high prices.
o
If the premium caps are binding, the fee schedule provides a mechanism for enforcing
reductions in provider reimbursement. The prohibition on balance billing keeps total
expenditures in line with premiums.
However, note that the uniform fee-schedule is no longer uniform under this
scenario. Non-complying fee-for-service plans are required to lower their rates
below the fee schedule under the current provisions for enforcing the caps
(Section 6012).
o
Standardization of provider reimbursement facilitates comparison-shopping among plans:
higher premiums imply more services.
CONS
o
Risk of setting the wrong level. If the fee schedule is too high, costs will be too high
and providers will have less of an incentive to negotiate with HMOs and PPOs. If too
low, providers will go elsewhere (into HMOs, other geographic locations, or clever
arrangements that get around the rules). A fee schedule that is too low will impede,
rather than guarantee, access to fee-for-service medicine.
o
Some providers may only be available to very wealthy patients who can afford to go
outside of the insurance system.
-1-
�o
A uniform fee schedule would not adequately reward providers of above average quality
and skill. The incentive to provide services of superior quality is weakened.
o
Balance billing could reduce some of the risks associated with premium caps, serving as
an automatic "safety valve" to avoid rationing and other disruptions if the caps are too
tight.
POSSIBLE MODIFICATIONS TO THE HSA
o
Eliminate the FFS fee schedule, and let competition set provider reimbursement rates,
o
Eliminate the FFS fee schedule for corporate alliances, even if not for regional alliances,
o
Keep the fee schedule, but allow balance billing.
o
Allow balance billing, but require providers to publish their fees-preferably as a
percentage of the alliance fee schedule-so that individuals can better choose among
providers. (Recently endorsed by the AMA).
o
Allow balance billing, but offer incentives (as under the current Medicare system) to
accept the fee schedule as payment in full.
o
Allow balance billing, but limit providers to some percentage above the fee schedule (as
under the current Medicare system).
o
Allow balance billing for corporate alliances, even if not for regional alliances.
-2-
�JUSTIFICATION FOR
1.
Consumer p r o t e c t i o n and c l e a r e r c o m p e t i t i o n : W i t h balanced
b i l l i n g , i t i s hard f o r consumers t o know t h e a c t u a l c o s t o f
a f e e f o r s e r v i c e ( f f s ) p l a n . Consumers may t h i n k an
i n s u r e r i s paying 80% o f b i l l s , when i t may be p a y i n g much
less.
•
2.
BANNING BALANCED BILLING
T h i s problem c o u l d be addressed, i n p a r t , t h r o u g h
d i s c l o s u r e o f t h e r i g h t o f p h y s i c i a n s t o balance b i l l ,
and t h r o u g h a mandate on p h y s i c i a n s t o d i s c l o s e i f t h e y
balance b i l l .
T o l e r a n c e o f balanced b i l l i n g c o u l d l e a d t o f f s p l a n s b e i n g
a v a i l a b l e o n l y t o t h e wealthy.
Premiums may l o o k low b u t
a c t u a l c o s t s might be beyond range o f many. T h i s problem
c o u l d be aggravated i f f f s premiums are c o n s t r a i n e d by
premium caps. The premium o f f f s plans w i l l be l e s s and
l e s s r e f l e c t i v e o f t h e a c t u a l c o s t o f those p l a n s .
JUSTIFICATION FOR
A FEE SCHEDULE
1.
A f e e schedule and balanced b i l l i n g :
I f balanced b i l l i n g i s
banned a f e e schedule would appear t o be mandatory.
Without
it,
f f s p l a n s would be paying p h y s i c i a n s a t d i f f e r e n t
r a t e s , some o f which might be unacceptably low t o many
physicians.
I f s i z a b l e numbers o f p h y s i c i a n s r e f u s e d t o
accept t h e r a t e , i n s u r e d s i n t h a t p l a n would f i n d t h e y
d i d n ' t r e a l l y have a f f s p l a n . Rather, t h e y would f i n d
themselves e n r o l l e d i n what was, i n e f f e c t , an unorganized,
i m p l i c i t preferred provider organization.
2.
A f e e schedule, c o m p e t i t i o n , and consumer p r o t e c t i o n :
C o m p e t i t i o n between i n s u r e r s should n o t be over what t h e y
a r e p a y i n g p h y s i c i a n s w i t h whom t h e y have no c o n t r a c t s .
A l l o w i n g them t o pay based on d i f f e r e n t f e e schedules
undermines c o m p e t i t i o n based on e f f i c i e n c y and v a l u e .
•
Lower p h y s i c i a n payment
t o a t t r a c t more i n s u r e d s
r a t e . However t h e v a l u e
and t h e consumer may not
r a t e s c o u l d enable an i n s u r e r
by o f f e r i n g a lower premium
o f t h e p r o d u c t may be l e s s ,
know i t .
T h i s w i l l occur whether or not balanced b i l l i n g i s
allowed.
I f t h e r e i s no balanced b i l l i n g , many
p h y s i c i a n s may n o t see p a t i e n t s o f p l a n s p a y i n g t o o
little.
Thus t h e i n s u r e d doesn't r e a l l y have a f f s
policy.
I f t h e r e i s balanced b i l l i n g , t h e consumer i s
s u b j e c t e d t o out o f pocket c o s t s based on t h e fees p a i d
by t h e i r i n s u r e r . The u l t i m a t e c o s t o f t h e p l a n may
t u r n o u t t o be h i g h e r , even though t h e premium i s
lower.
(And t h e consumer w i l l have no way o f knowing
this).
�3.
Premium caps and a f e e schedule.
Making f f s a r e a l o p t i o n
may, u l t i m a t e l y , r e q u i r e a fee scheule.
I f f f s plan
i n c r e a s e s a r e c o n s t r a i n e d by premium caps
ONE RELATED PREMIUM CAP PROBLEM
Our premium cap mechanism does pose one problem i n t h e f f s
mechanism. I f , t o achieve premium cap t a r g e t s , an a l l i a n c e pays
a p l a n a reduced amount, t h a t p l a n passes t h e r e d u c t i o n o n t o i t
p r o v i d e r s . I n t h e case o f a f f s p l a n t h i s means t h a t such a p l a n
would be a l l o w e d t o pay below t h e f e e schedule.
Thus, an
i n e f f i c i e n t p l a n would be a l l o w e d t o pay p r o v i d e r s l e s s .
Balanced b i l l i n g i s s u e s c o u l d compound t h e problem.
A p o t e n t i a l s o l u t i o n t o t h i s problem: Do n o t a l l o w f f s
p l a n s t o pay below t h e fee schedule.
I f t h e y cannot
g e t premiums down t o acceptable l e v e l s w i t h o u t d o i n g
so, t h e y can be excluded from p a r t i c i p a t i o n .
BALANCED BILLING AND FEE SCHEDULES:
SOME OPTIONS
1.
A l l o w balanced b i l l i n g , impose no f e e schedule and a l l o w t h e
market t o s o r t t h i n g s o u t . Presumably i n s u r e d s would be
d i s s a t i s f i e d w i t h p l a n s whose payments t o p h y s i c i a n s
r e s u l t e d i n major balanced b i l l i n g problems. These i n s u r e d s
could switch t o other f f s plans, o r t o non-ffs plans.
2.
A l l o w a l i m i t e d amount o f balanced b i l l i n g (as i n M e d i c a r e ) ,
and t r e a t t h e consumer p r o t e c t i o n i s s u e s w i t h d i s c l o s u r e .
•
•
An a l l i a n c e might d i s c l o s e t h e e x i s t e n c e o f balanced
billing.
P r o v i d e r s might have t o d i s c l o s e whether o r n o t t h e y
used balanced b i l l i n g , and i f so, how much above a
s t a n d a r d r a t e t h e y charged. (Presumably t h i s
d i s c l o s u r e would encourage p r o v i d e r s t o n o t engage i n
balanced b i l l i n g ) .
NOTE:
3.
Even t h i s approach would
schedule o f some k i n d .
would be p a i d a t t h e w i l l
s t a r t r e j e c t i n g insureds
probably r e q u i r e a f e e
Without i t , p r o v i d e r s
o f i n s u r e r s and might
from c e r t a i n p l a n s .
A l l o w an a l l i a n c e o r s t a t e r e g u l a t o r t o r e q u i r e f f s i n s u r e r s
t o submit t h e i r fee schedules, and a l l o w t h e
a l l i a n c e / r e g u l a t o r t o r e j e c t plans ( n o t a l l o w them t o
compete) i f t h e i r f e e schedule was unacceptably low.
I n t h i s way, t h e r e might be an i m p l i c i t f e e schedule - - o r a t
l e a s t a payment r a t e below which i n s u r e r s c o u l d n o t go.
NOTE:
Insurance commissioners c o u l d p r o b a b l y impose such
a r u l e today.
�
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
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William J. Clinton Presidential Library & Museum
Identifier
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2006-0885-F
Text
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Paper
Dublin Core
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Title
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Miscellaneous [Folder 1]
Creator
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Task Force on National Health Care
White House Health Care Task Force
Walter Zelman
Identifier
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2006-0885-F Segment 2
Is Part Of
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Box 46
<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/12093090" target="_blank">National Archives Catalog Description</a>
Provenance
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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-12093090-20060885F-Seg2-046-015-2015
12093090