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Clinton Presidential Records
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Health Care Task Force
Series/Staff Member:
Health Care Interns
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4712
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Health Care Polls and Clips [4]
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53
7
7
1
�SURVEY: Clinton Wins Broad
Support for Health Care Plan
uncertain whether their coverage ments underpinning it.'
will improve or their costs will rise
Three-fourths of those polled
are now inclined to give Clinton agreed ihat business should " e
b
the benefit of the doubt: at least required to contnbute to their
three-fifths of both groups support employees' health care coverage.''
the plan.
Just 1 in 5 respondents disagreed.
Likewise, opinion on the plan By virtually the same split. Amenvanes little between those who cans said thai they support a new
said that their health care coverage tax on cigaireues io help pay for'the
has changed substantially in ihe plan. A little more than iwo-ihirds
last five years and those who of those surveyed said that ihey
reported Utile change, among those support the establishment of a
who consider their finances shaky National Health Board "to moniior
and secure, those who work for and regulate heaith care benefits
large employers and small employ; and costs."
ers and among those who consider
And the call to extend universal
their own health good or poor.
coverage to all Amencans-which
The plan has support from those Clinton has portrayed as the plan's
on Medicare and Medicaid, those non-negotiable core—was supwho receive health insurance from ported by a.78% to 1 % margin.
7
their employer, those who lack When supporters were asked in an
heallh insurance and those who open-ended question why they
buy it themselves.
back the plan, by far the most
Nor are many of the demograph- common response was thai it proic distinctions ihat often guide vides universal coverage.
public opinion playing much of a
role. Support for the plan varies
t first hearing, the public also .
little by income or education: sinlargely endorsed the fundagle women and married men—two mental arguments on which Clingroups typically at opposite poles ton constructed his proposals. Just
n other issues, the poll found on most issues—expressed virtual- under three-fifths of those surAmencans still divided over- ly identical degrees of support for veyed said that "health care is a
and uncertain about—the North the package. To the extent a demo- right all Amencans are entitled to.
Amencan Free Trado^Agreemcnt^ graphic disparity emerges, it is receive from the government."
that Clinton is urging Congress Ui" concentrated on race (57% of Lati- while only 38% described it as "a
approve this fall. In the survey, , nos and 67% of blacks expressed privUege."
31% of those polled said they support for the plan, compared to
But these opinions do not appear
oppose the plan. 28% expressed only 52% of whites) and on age set in stone-, not surprisingly, only
suppon for it and 37% said they , (those over 45 are somewhat more 21% of those surveyed said ihey
were unaware of it Despite inten- supportive than younger Ameri- know a great deal or a good amount
sifying public debate in the last cans).
about tht proposal, while 39%
several weeks, thote numbers are
More decisive, for now. art tra- know only soma and an equal
little changed since June—or, for ditional partisan divisions. Among number "not much."
that matter, last fall.
Democrau. 64% said that they
Even within that framework of
Some demographic divides are support the plan and only 12% said uncertainty, tha poll pinpoints aremerging in conaderaUon of the they oppose it Republicans oppose eas of vulneraMUty that cntics will
agreement though. While whites it by 38% to 45%. Liberals endorse
tly seek to eqiloit in the weeks
generally oppoae the agreement the plaa 82% to 15%i conservaand blacks split evenly on it Uti- tives by a more equivocal 48% to
Already, many Americans worry
noa now support it by mon than 3 38%. •
that tha plan will coot jobs and hurt
to 1. Among eoOegc graduates,
Asked in an open-ended ques- small hustnsss About 1 in 3 of
sivport is twice as great as among tion why they dislike tht plan. thost poiltd Mid that the plan is
those Amencans with a high school . opponents cited Ideological eoa- likely to reduce employment while
education or less. Union members cerns aa often aa practical onaai only 1 In 6 said they believe it will
it by 2 to 1. Non-union 22% raised "big fovemmont" aa add jobs.
nbers essentially split over the their objection, while another 12%
Thost alio is only limited willQuest ton
derided the idsa as socialised medi- ingness to pay increased taxes to
Perhaps more tellingly, almost cine. As GOP pollstsr Glen Bolgtr . expand health care coverage if
half of those surveyed said that put it oppositioo now is centered Congress rejects CUnton's claim
they expect tht treaty to cost on those who believe If Clinton that tht reforms can be financed .
primarily through savings in tht
American jobs, while just 1 in 7 says it it must be bad."
respondents accepted Clinton's
But in this first round of debate, existing system. About one-fourth
contention that it will produce net Clinton is holding tht independents of those pollsdssid thai they would
employment gains. Those senti- who provide tht critical swing be tnwiUing to pay any new taxes
ments vary little by partisan or margin in public opMoa Indt- to fund universal coverage;, anothideological affUUtion-which sug- pendents expressed smart for tht er fourth said that they would be
gests that the Administration still plan. 55% to 21%. By 73% to 17%. willing to spend less than $200.
has an uphill struggle ahead to they said that Inaction poses a Just ont-ftfth of those surveyed
build a base of public support for greater danger than CUnton's plan. said that ihey would accept 1200 or
the agreement
And by 57% to 29% they rejected mon in new taxes to expand care,
On health care, those who think the idea that tha plan ts an esces- while 28% said they did not know.
Taxss remain a particularly vulthat the plan will diminish their sive intrusion of government powntrahlt issue for Clinton: 51% of
own cart now overwhelmingly op- er into the private sactor.
With independents n d Dsmo- thon surveyed said they considpose it while those who expect it to
improve their personal coverage crats on board, and Reputottcans end tht Prttidem a tax and
si^port it by lopsided numbers. divtdsd in their opinions. Ctatoo vaadT Democrat while only 33%
But ths large grot* that expects to now DM Strang pubtfc sivport bed! r^sctsd that charactemauon.
Americana are also leery of
pay mors actually supports tha for key elements of eha plan and
plan by 45% to 36%. And thoae for tht broad philntnpWral argu- granting government too much
CMtlaa«4 from A l
X
2
2
C
•7
<
Z
<
optunutic. Only 10% of those,surveyed said ihat they expect to
•pend less for heallh care under
the plan; 30% said that ihey do not
expect iheir bills to change. And
fully half said they expect their
costs to nse.
But such personal calculations
appear to be less imporunt in
guiding reaction to the proposals
than broader considerations like
partisanship, ideological views
about government's role in the
economy and the degree of urgency Amencans feel about reforming
the heallh care system. So far, the
poll suggests. Amencans seem to
be asking not what the plan will do
for them but what it will do for the
country—and. largely. if tenuuve ly. answering that tt will do more
than the sutus quo.
"Here's the issue: As they fill in
details on how tt will affect them
personally will that become a larger determination for people or will
they conunue to judge it on how it
affects the nation?" Brennan said.
A
O
control over the systtmi by ai duding those who support tht
51%-33% count those poUed said overall plan and thoae who do
they believe that private industry not—old they oppose Including
would do a better job than govern- funding for abortions in health can
ment of managing tht health care reform." Newly twice as many
Americans strongly appose coversystem.
Abortion promises to be another ing abortion as stronglytavoriu
stumbling block) Clinton's plan inclusion.
Overall, when ssked whkh perty
would include abortion in tht
standard package of benefits but would do a better job of handling
the nation's moat important probby 54% to 40%. those poUed-in-
lem, those polled gave Democrau a
narrow 36% -32% edge-virtually
imehanged since June.
But public ississminta of CUnton's performance have picked up.
In the new survey. 42% gave him
positive ratings tar handling the
acooomy. up fan 36% in June»
50% srid they now spynve of hia
handling of foreign affairs^ f
44% tn June.
*
»
•7
�THE TIMES POLL
Reaction to the Clinton Plan
Iniliai support for the Clinton health care proposals is broad but tenutive. A majority backs the plan,
mostly because it will offer universal coverage. But most doubt their own health care will improve
and half expect to pay more.
Approval of the plan varfes by group
• Do you approve or disapprove
of the health care reform
proposals Clinton has presented
to Congress?
Approve
Disapprove
Don't know
Theeweiiy
Anglos
Blacks
Latinos
The uninsured
Those who get company or
union insurance
Those who buy their own
Democrats
RopuMceno
Independents
Sl%
Knowledge of the plan
le limited
No change expected by
almost half
• How much do you know
about the details of
President Clinton's health
care proposals?
• Do you think you and your
immediate family are likely
to end up with better health
care coverage than you .
haverightnow, or worse, or
don't you think your health
coverage will change?
A good amount
18%
Clinton pushes plan last
u%
•7%
87%
S4%
U%
,
•*
•%
aa*
2S%
40«
m%
27%
U%
4t«
21%
U.%
!•%
sa %
34%
LS%
21%
a«%
24%
17«
24%
Too early
to say «%
in Rorida.
Foare of paying more are Mgh
10%
2*%
Many say change la i
• What is the greater danger:
that Clinton's proposals will
hurt the country or that doing
nothing at all will hurt the
50% country?
a Do you think you and your
immediate family are likely to
pay more or less?
• Do we need to effect changes
in the American health care
system as quickly as possible or
would it be better to phase in the
changes over time?
flCHnton plsn wtB hurt iM/%
Oemgnottfrmmhurt .
> eeriy to say 4%
lOonTknow 6%
AMiy they approve of the plan
(up to two responses •ceepted*)
• PmMse cere tar eMryono
• System needs to change
• Can i
• Will hotd down costs
• WV be etieaper forms
Don't know 8%
kn
44%
j?**
Why they dhapprove of the plan
(up to two responses soespttd*)
• OBansiiaitllitaisien
.."
ts
u%
KnTiwSHnr
• Won't wofk/badlytfwu^K out
1
i
• RwNihurtbuslnesaos
now T C POU « M CONOUCTB): T*» Tknw Mi MMTHMtd l.Ml
M
• nfu+m aid SeMi.
13
Mnt* <B eomamwoi mnum *90m iv Ma. net. m . l O W " • * W *<«• (atMpMnn.flwma«n nr
Mrs MMOIdW
LORBla DflGUB / Ua Aaf\m TIB-.
LOS ANGELES TIMES WASHINGTON EDITION THURSDAY. SEPTEMBER 30. I W
�1
gKNEFITS: LONG TERM CARE
10. As far as you know, does the Clinton plan include any kind of a long-term care
benefit (home care, services in a residential setting in the community, nursing home
care)?
30.2%
32.2%
37.4%
0.2%
1
2
D
R
Yes
,
No
(DO NOT READ) Don't Know
(DO NOT READ) Refused
CONTlNUEWITHQ.il
SKIP TO Q. 12
SKIPTOQ.12
SKIPTOQ.12
11. Does it provide extensive coverage for:
7.1 %
6.1 %
48.0%
38.0%
0.7%
(ROTATE 1 AND 2)
1 Home and community-based care only, that is, care in one's home, adult day
care, or services in an assisted living facility
2 Nursing-home care only
3 Both home/community-based and nursing-home care
D (DO NOT READ) Don't Know
R (DO NOT READ) Refused
s
12. The Clinton proposal, as we currently understand it, would provide new home and
community-based care benefits for severely disabled persons of all ages and
incomes. If such a home and community-based care benefit were included in a
health-care reform proposal, would it. . .?
(READ UST)
26.2%
30.8%
33.8%
3.0%
3.7%
2.5%
0
5
4
3
2
1
D
R
Make you much more likely to support it
Make you somewhat more likely to support it
Make no difference
Make you somewhat less likely to support it, or
Make you much less likely tb support it
(DO NOT READ) Don't Know
(DO NOT READ) Refused
13a In the Clinton plan, the long-term care benefit would not guarantee services for
individuals, but would provide a set amount of money to states who would
administer the program and decide which benefits you would receive. Would this
provision...?
8.1%
16.6%
27.9%
19.7%
24.8 %
2.7%
0.3%
5
4
3
2
1
D
R
Make you much more likely to support it
Make you somewhat more likely to support it
Make no difference
Make you somewhat less likely to support it, or
Make you much less likely to support it
(DO NOT READ) Don't Know
(DO NOT READ) Refused
-7-
I C R Survey Research Group
�13b If these new benefits were included but were not fully phased in for another 5 to 8
years, would that...?
5.6%
15.2%
42.1%
15.8%
17.9%
3.4%
0
14.
5
4
3
2
1
D
R
Make you much more likely to support the plan
Make you somewhat more likely to support it
Make no difference
Make you somewhat less likely to support it, or
Make you much less likely to support the plan
(DO NOT READ) Don't Know
(DO NOT READ) Refused
Some health-carereformplans have included coverage for long-term care. If only
some coverage is possible, which type of long-term care coverage would you prefer
to see in a health-carereformplan? Would you prefer...?
62.2% 1
Coverage for home and community-based care (home care, respite care, adult
day care), or
29.7% 2 Nursing home coverage after you pay for thefirstsix months of care
7.1% D (DO NOT READ) Don't Know
1.0% R (DO NOT READ) Refused
15. What are the chances that, within the next five years, you or someone in your
extended family (spouse, children, parents, or grandparants) will need long-term
care to help with their chronic physical or mental impairments? Do you think that
is.
12.6%
18.4%
47.3%
19.5%
2.0%
0.1%
4
3
2
1
D
R
7
Certain
Very likely
Possible, but not likely
Not at all likely
(DO NOT READ) Don't Know
(DO NOT READ) Refused
MANAGED CARE
16.
22.4%
Assuming the same benefit coverage, which of the following three types of health
plans would you choose if you had to choose only one?
1
51.2% 2
23.0%
3
2.8%
0.6%
D
R
A managed-care plan with the greatestrestrictionon choice of physicians and
hospitals but at the lowest cost to you
A managed-care plan that allows you to go outside the list of approved
physicians at a somewhat higher cost to you when you do so
A fee-for-service plan with no restrictions on choice of doctors and hospitals,
which would cost you more than either of the other two types of plans
(DO NOT READ) Don't Know
(DO NOT READ) Refused
-8-
ICR S r e R s a c Go p
u v y ee r h r u
�FINANCING
27.
President Clinton proposes financing his health-care reform plan in the following
ways. I am going to read you four differentfinancingtypes; for each means of
health carefinancing,please tell me if you favor or oppose it (strongly or
somewhat)?
First/Next...
4
3
2
1
D
R
Favor - strongly
Favor - somewhat
Oppose - somewhat
Oppose - strongly
(DO NOT READ) Don't Know
(DO NOT READ) Refused
Favor
64.5% a. Imposing an additional tax of 75 cents a pack on cigarettes
61.1% b.Requiring that employers pay most of the cost of health insurance premiums for
their employees
61.1% c.Imposing a one percent tax on large coiporations that choose to offer their own
health plans
66.1 % d.Restraining increases in Medicare costs by imposing limits on payments to doctors
and hospitals
COST CONTROLS
28.
11.2%
3.7%
54.5%
24.5%
6.1%
0.1%
Do you think that overall health-care budget limits or caps (in terms of the
percentage increase over the previous year's costs) should be applied to...
1 Govemment-fimded health care (Medicare, Medicaid) only
2 Private-sector-funded health care only
3 Both government-funded and private-sector-fimded health care
4 Neither of these
D (DO NOT READ) Don't Know
R (DO NOT READ) Refused
ROLE OF AARP
29. How familiar are you with the role that AARP has played thus far in promoting
health-carereform?Are you...?
5.2%
35.1%
59.0%
0.7%
0
3 Very familiar
2 Somewhat familiar
1 Not at all familiar
D (DO NOT READ) Don't Know
R (DO NOT READ) Refused
CON TINUE WITH Q.30
CONTINUE WITH Q.30
SKIP TO Q.32
SKIP TO Q.32
SKIP TO Q.32
-12-
ICR Survey Research Group
�1
3
The \MMarris Poll FV
THE HARRIS POLL 1994 #24
For release: Wednesday, April 20, 1994
t
•
PUBLIC SUPPORT FOR CLINTON HEALTH PLAN
DECLINES BUT SUPPORT FOR FUNDAMENTAL
REFORM STILL VERY STRONG
Reduced majority still favor Clinton plan.
by Humphrey Taylor
Almost nine out of every ten Americans believe it is important to
have fundamental reform of the health care system, and well over half believe this is
very important. However, support for the president's health care plan continues to
slip, with only just over half of all adults now in favor of it. This slippage probably
does not reflect much detailed knowledge or understanding of what is in the
president's plan; most people appear not to know much about it. Nor is it based on a
growing acceptance of the status quo. Rather the trend reflects growing skepticism
about what the plan would actually achieve.
These are findings of a Harris Poll of 1,255 adults surveyed between
April 4 and 7, 1994.
There are several indications of how enthusiasm for President
Clinton's plan has slipped:
-- It is now favored by a 53-38% majority. In October last year, a
64-30% majority favored it. In February a 59-34% majority did so.
- Only 57% now believe that the president's plan would provide
universal health insurance, compared to 70% last October.
Louis Harris & Associates
630 Fifth Avenue NYC
(212) 698-9697
�-- The public is split 48-46% on whether it would help control the
total cost of health care. Last October a 59-36% majority thought it would do so, as
did a 51-42% majority in February.
In spite of this declining support for the president's plan, the public's
desire for sweeping changes remains very strong. Only 10% of the public believe that
fundamental reform of the health care system is not needed, while fully 57% feel that
such reforms are very important and 31% believe they are somewhat important.
Unsurprisingly, Liberals and Democrats are more supportive of fundamental reforms
than Conservatives and Republicans.
However, the public is deeply divided about whom they should trust
on this issue. When asked to choose between eight people or groups of people who
are involved in the health care debate, no one person or group was preferred by more
than the 20% who mentioned President Clinton; however, a ftirther 9% did pick
Hillary Rodham Clinton. When asked whom they trusted least, no one group or
person was mentioned by more than the 18% who picked the health insurance
companies and the 17% who picked the pharmaceutical industry.
The next few months will determine whether or not the Congress can
pass a health care bill which President Clinton is willing to sign. The public clearly
wants to see major reform which offers universal coverage and the hope of cost
containment. The majority support for the president's plan reflects his success in
responding to the public mood. The decline in this support reflects the success of the
president's critics in raising doubts about whether and how well his plan would work
in practice.
Humphrey Taylor is the President and CEO of Louis Harris and Associates, Inc.
-2-
�TABLE 1
ATTITUDES TO PRESIDENT CLINTON'S HEALTH CARE PLAN
"Overall, do you favor or oppose President Clinton's plan for
reforming the health care system?"
1993
October November
1994
February April
%
%
%
64
30
6
Favor
Oppose
Neither
%
58
34
7
59
34
7
53
38
9
TABLE 2
ATTITUDES TO AND EXPECTATIONS FOR
CLINTON HEALTH PROPOSAL
"From what you have heard of it do you think President Clinton's health
care plan, if it is passed by Congress and implemented, would (READ LIST) or not?"
1993
1994
Oct.
Nov.
Feb.
April
%
%
%
%
Require a big increase in taxes
Would
Would not
Not sure
75
21
4
74
22
4
74
22
4
76
19
5
Ensure that everyone has
health care
Would
Would not
Not sure
70
26
4
64
32
3
62
33
5
57
37
6
Be better than the system than
we have now
Would
Would not
Not sure
67
23
10
59
35
5
57
36
7
53
39
8
Help control the total cost of
health care
Would
Would not
Not sure
59
36
5
51
43
5
51
42
7
48
46
6
-3-
�TABLE 3
HOW IMPORTANT THAT W E HAVE LEGISLATION
WHICH FUNDAMENTALLY REFORMS HEALTH
CARE S Y S T E M
"How important do you think it is that we have legislation which
fundamentally reforms the health care system -- very important, somewhat
important, not very important, or not at all important?"
Total
%
Very important
Somewhat important
Not very important
Not at all important
Not sure
57
31
5
5
2
PARTY I.D.
Republican
Democrat
%
%
45
34
10
9
2
Independent
%
67
27
2
3
2
POLITICAL PHILOSOPHY
Conser- Modvative
Liberal
erate
%
%
%
50
33
8
8
1
55
34
4
4
2
59
31
4
4
3
67
27
3
2
2
TABLE 4
WHO TRUSTED MOST AND LEAST ON HEALTH CARE REFORM
"Which ONE of the following do you trust the most to produce good
policies for health care reform? "
"And which ONE do you trust least?"
Most
%
20
15
13
10
9
9
8
2
9
5
President C l i n t o n
Doctors' organizations
T h e R e p u b l i c a n s in C o n g r e s s
Business
Hillary R o d h a m C l i n t o n
T h e D e m o c r a t s in C o n g r e s s
Health insurance companies
Pharmaceutical companies
None (vol.)
N o t sure
-4-
Least
%
11
15
13
5
8
7
18
17
2
4
�pitals an acceptable way t
lower health costs.
MONEY readers are ju
about evenly divided ovi
whether the primary goal i
health reform should be t
guarantee coverage to all, n
move barriers to obtainin
nsurance or to reduc
health costs. Readers agreec
by a 2-to-l margin, that, i
contrast to today's private ii
surance system, the serious:
ill should not have to p;
more for coverage tha
healthy people and the e
derly should not have t
shoulder more costs tha
younger people. In additioi
an overwhelming 77% be
lieve that a family of fou
should not bear more tha
$5,000 in out-of-pocket cosi
annually for medical cart
excluding insurance prem
urns. President Clinton
plan sets the annual cap f(
families at $3,000, or $50
less than the typical annu;
out-of-pocket medical co:
for a family of four.
D
espite the near-yearlong
national debate about
health-care reform, most
Americans aren't sure
what ought to be changed.
Not MONEY readers, whose
median household incomes of
$56,000 put them in the top
23% of the U.S. population.
More than 6,000 of them responded with stunning conviction via mail and fax to our
April Newsline 23-question
poll on the best ways to fix
America's health system. As
the keyfindingsfrom a cross
section of the responses at
right show, our readers not
only prefer to buy their own
coverage but are even willing
to pay more, if necessary, for
the freedom to choose their
own doctors. They'll be
watching Congress closely
too; 73% of the respondents
said that where congressional
candidates stand on health reform would be the main
issue—or at least a very important one—in their November vote. The details:
Nearly two-thirds of respondents don't want a government-sponsored overhaul
of the health system but instead merely some tinkering
around the edges. " ;- Bill
Konowitz, 41, a medical
equipment salesman from
Elkton, Md.: "When everything is paid for by somebody
else, there's an incentive to
overuse the system."
Surprisingly, well over half
r
of readers are willing to pay
for their own health insurance, rather than letting the
government or their employer
pay. In fact, 55% said they are
willing to ante up $2,500 or
more in yearly premiums.
But listen up, Congress:
Don't restrict the public's
Our poll, like the one v\
published in the July 199
issue, also reflected the pul
lie's keen suspicion th;
health reform might triggc
higher taxes or lower wage
Says Cynthia Fennick, 60, c
Summit, N.J.: " I prefer to sc
exactly what [health reform] :
costing me."
Perhaps the biggest sui
| prise is that 70% of our reat
ers blame lawyers for risin
health-care costs. Other tai
gets are insurance companic
(54%), federal bureaucrai
choice of doctors. True, fully (44%), hospitals (41%), dru
63% of respondents are cur- ^mpanies (40%) and doctor
rently free to select their (36%). Don't bother tellin:
<
' own doctors but only 12% readers that no one is t
1 would be. willing to pay the blame, though. Fewer tha:
full cost themselves for the 2% of respondents offeree
: . ability to keep doing so. And that dodge,
just 4% consider limits on
—Lani Lucian
the choice of doctors or hoswith Jaime River
16 M O N E Y • J U N E 1994
7;-.^V-
-
��Capital Notebdbk
7)
Leprechaun Memo Yields Wrath of Iris
Bv Guy Gugliotta
Wauunpor Prut Stiff Wnter
T
his month's Man of La Mancha Award for illtimed crusades goes to Rep. Scott L. Klug (RWis.). a well-intentioned budget zealot who
earned recent notoriety by blaming leprechauns for
the nation's fiscal woes.
Thumbing through the 1994 "Pig Book." put out
by Citizens Against Government Waste. Klug discovered the International'Fund for Ireland: a $228.7 million (to date) foreign aid piggy bank tor projects in
Northern Ireland and the Irish Republic so that Protestants and Roman Catholics will leam to live together in peace.
Klug noticed that.the fund listed pony trekking
centers and a golf video among its accomplishments
and that it also won honors from the National Taxpayers Union as "Outrage of the Month" (April
199.1). He wondered what this had to do with peace.
So on May 27, Klug sent a "Dear Colleague" letter
soliciting cosponsors for a bill to get nd of the fund,
sounding the alarm in block capitals: "THE LEPRECHAUNS ARE LOOTING OUR GOLD!"
Oops.
This missive festered in House in boxes for 12
days, until seven members of Congress (six New
Yorkers and a Pluladelphianj sent Klug a "Dear
Scott" letter. Amencan society, the letter said, "is
based on a colorful mosaic of various cultures and
ethnic, groups." Klug's reference to leprechauns was
"insulting to many Amencans of Irish heritage."
Anyone is free to oppose the fund, the letter continued, but "we feel a line, must be drawn" about using "racial Stereotypes" to "promote those positions."
Therefore, "we request that in the future you refrain
from the use of epithets and other derogatory terms
when discussing issues of concern to people of Irish
and other backgrounds."
The ink was scarcely dry on "Dear Scott." when a
two-page, single-spaced, finger-wagging "Dear Mr.
. Klug" arrived from Irish Ambassador Dermot A. Gallagher, who explained "why the International Fund is
so important" and why Klug's reference to leprechauns was "not only misplaced and insensitive, but
seriously trivializes the significance of U.S. support
in advancing peace and reconciliation in Ireland."
Not surprisingly, Klug's bill is not prospering (four
cosponsors and holding),.but political incorrectness—real or imagined—is only part of the story. •
The fund has survived this latest challenge mostly
because it is perhaps the mother of all sacred cows.
The House.established it in 1986 partly as a farewell
gift to retiring House Speaker Thomas P. "Tip" O'Neill
^D-Mass.). who handed off to new Speaker Thomas S.
Foley .(D-Wash.). another Irish Amencan. Foley's Rules
Committee chairman, who decides what gets to the
House\Hoorand wfiat doesn't, is Rep. Joe Moakley (DMass.). of South Boston.
Throw ih.the Kennedys (Sen. Edward M. and Rep.
Joseph P., U), the "Dear Scott Seven" (all but one with
senous Irish Amencan constituencies), and a few dozen _
other Irish boosters, and you can appreciate why Las
Vegas wiil let you name the odds on Klug's chances of
getting rid of the fund before the next millennium.
"Events suggest that we're not going to get a debate on the floor," Klug said. Good thinking. Scott.
It is also unlikely there will be any debate anywhere else. Besides pony trails and videos, the vast
majonty of the fund's 2,800 projects are deemed
worthy by_.both its boosters and detractors.
But that says nothing about the larger question of
why the United States contributes millions of dollars
per year ($19.6 million for 1995) to Ireland and the
United Kingdom, both members of the European
Union, the most powerful economic bloc on Earth.
"I'm not saying Ireland is a Third World country,"
said Rep. Thomas J. Manton (D-N.Y.), one of th$
"Dear Scott Seven." "But they still have a way to go.
Ireland is still a rather pristine country."
And. despite everything, it is also famous for lepre-
=3
chauns. Klug, a .Roman Catholic whose not.her wa.;
Insh .Amencan. remair.i unreptntant. lUggestir.g tht
"Dear Scott Seven" "write a letter to Notre Dame,
and tell them to drop the leprechaun 3? a mascot."
and "boycott Blockbuster Video for renting 'Darby
O'Gill and the Little People.' "
Manton nevertheless insisted that Klug's letter
was "somewhat insulting m these davs of political
correctness" but acknowledged .that "personally I'm
not going to lose any sleep over it."
Still, ii you're Tom Manton, Queens County Democratic Party boss, distnct headquarters in Sunnyside. N.Y.. both parents born in Ireland, the fund is
something sacred.
When your enemy gives you an opcnir.g, you'd be a
fool not to take it.
7
THE PRESIDENT AND HEALTH CARE
RESULTS OF A WASH'NG"". POST-ABC NEWS P G -
Q.
From what you know of it. do you aporove or disapprove of Presiaer:
Clinton s health care plan?
60^'
Who do you trust to do » better job handling heatth care retorm—Clinton
i or the Congress?
June 26
•Clinton
36^
Congress
Neaner (voianteereoi
16
( • Do you think Clinton's health eare plan is better or worse than the
present system?
/
Do you think basic heatth insurance should include inturanc* coverage for
• abortion, or not?
June 26
•^rv -*
a" -
I
1
Should net
;
56
| I'm going to nome tonic suntsMons for ckMfts in tfto health can system,
[ a PtoMt tell me M you sumMft or oppose otdi item I nome:
{Percentage who strongy or somewnat suooort eacn /ten-.;
June 26
7fl •
A system oroviding universal heaitn coverage tor a'l Arrenca-i
Federal price controls on medical expenses such as doetorV lees,
hospital charges and drug pnees
A federal law reauirmg all employers to provide neaitn insurance
to their full-time employees
A program in which oeopie paid more money to cnoose the;' own
Ooctor. ana less money if they went to an assigned docto'
NOTE: Figu'es ray not add to i o O ' i whe* "".o oo'n.oi" is not ncmetd. jy** ' a^is a-"
tram a wasnmpon Post-ABC News teiepnone oo'i -J '..53: rar.ac^'v se-ewo'dci/i;
mterviewea June 23-26. Otner r suits are f-o-r. Wasn-ngtsn Post-ABC
so- > v.
sar.3:es ot sinrnar S!:e. Ma'-j:-. -if sarr;f-.g e-cr f v a' c' r t c: v
~
J:
serce.rta'ge carts sve'a'i. %amc> r.g error <i. T-se.-e'.
.• c-e r
" . s " . -' v . " . * zi
e-or in tnese or any po^s interviewing was cc'ojcteo oy Cv-O" fiesfci'^ - Rasry. Pa.
!
PHOTOCOPY
PRESERVATION
.
Compiled by Sharon Warden
�06/22/94
(gjOOl
WHITE HOUSE
11:55
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*** ACTIVITY REPORT ***
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TRANSMISSION O
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TX/RX NO.
4059
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CONNECTION TEL
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�with insurance companies, risk-bearer, as are insurance comumers' interests were to be panies.
"They are asking the insurance
inount, and there would be
aimed at avoiding conflicts companies to sharpen their pencils to deliver a better deal to cusrerest by board members,
ie one thing they were very tomers, and the agents themselves
about was that people who have sharpened their pencils to
providers and insurers should cut their marketing and sales
be involved in the govem- costs," Winegarden said.
." Sofeer said.
Even within the burgeoning priit mandatory alliances have vate sector purchasing coopera-.
been well received
is. Most bills iand p r o p o s a l s - . . ^ j . ^ on the table ^ ^ f b i ^ ' v E ^ ^ ^ ^ ! P u l p B $
/ alliances, with b o a ^ 'coni-;^
^ d of employers and con- ' "As"'^so6ri^M5?y6u§
e
iners. Of the states, only- people in there -whoVareioon .
shington and Vermont are sated as a .percentage, bf-'tKe pi^fj^
ving toward mandatory allianc- mium; .the people' running ^ef; m
show no longer have any reason '
^ least eight states are moving to keepiithe premiums low" said
ead with^publicly .run health- John Polk, - director of Cleveland's ;
re purchasing"": alliances.. So far, . Counciliof Smaller .Enterprises,
wever; only California and Flor- • which" fnegOtiates health plans for
a actually have' them up and- 150,000 beneficiaries.' u\u?:-3r , i k
nning.
;;
'' - ^-The^uhcil^was one of the first.
Texas is believed to be the only,' employer-run purchasmg-coopera
ate other than. Iowa and Ohio fives. Polk believes those^who pay
iat has passed legislation al- for^'tfa^^licie^ttie-^ployer^.
wing private sector purchasing
liances. The Texas law says such liance governance...National Snudl^
Uiances or cooperatives' may be Business'^United and other small'
lunched by any two employers, business^orgaiuzatioris agree,
kow and other agents see this as ' But Skbw argues that the forman invitation to agent-run cooper- tion of the alliance by agents will
tives.
,•: •
•
X/iji:. v r-v^- put them jsquarely in the camp bfj
:
:
;
:
:
;
:he
, , , •.
~
wiB have ^ • A ^ ^ ^ : W ^ c m ' M } « y i ^ ^ ^
iumers, with the*bpti6hT6f?eyentu§^dy<^^^
insm^ce.';;
ally expanding"ttf'incii!^
consumers. The alliimce^wiUvi^ryfr^
small ."employers and individu^0^"N^w>a^wio|j«
health-care consumers. Employees'^; Afrllnramtoe^
will selectfirommultiple plans, f • —- ' "We - thinky tliis • is a win-win
paradigm,'^ Skoj^said.yH'he agent
INSTBUCHONS ONP^;2.VSECT10N:ljfe
makes money.'tlielTOmpany makes
money, aiA:c!a^SSSm^ve. more A Clinton adminlstratton arniy^t^^.thev;*^
money in thdr^po^Ee^^|£wntiul-: - country In'last pitchforhealth:refbm>. W526'
ilr.-pcicket'stEventualf
i
J
l
ASSOCUTEO PRESS
- l ^ ^ ^ ^ B ^ ^ ^ g ^ l ^ l ^ e s * .
„
President Clinton's h e & ^ i i i S ^ M ^ ^ M ^ f f l ^ ; ^
resident;
an slipped to. its lowest
]^^M0^^m^^M^m0^^
plan slipped to;its lowest ievet:^
new ABC News/WashingM^
r u s t ' p O l L ^ ^ ^ ^ v-;,,;. ; , • . r ^ ^ ™
Forty-two percent of Americans Sipsgf
approve of ithe/plaiii^down .flroni aM^S?
higlv^r:56 ^eix»ht:,who ^ppor^apt^^^^g
health-care
thepbUj
•••th«ri'4<r'
VcliaggesJ
moi
.RBtrrERS':«,n.
�O POLITICS
N
BY MICHAEL BARONE
Paying a price for his shortcomings
T
his has been a sickening season for those who have
had bright hopes for the Clinton presidency. Before the Paula Jones lawsuit, it was widely believed
that Bill Clinton wasn't suffering much from doubts
about his character: Liberals smugly bragged that voters
knew bad things about him and elected him anyway,
while conservatives angrily complained that voters
weren't punishing him enough. But both sides were
wrong then and are more wrong now, because Clinton is
paying a clear and measurable price for voters' concerns
about his character. His job approval ratings are way below where they should be.
The previous three presidents, in times of perceived
economic growth, had much higher
job ratings: George Bush's Gallup approval hovered around 70 percent
from spring 1989 to summer 1990;
Ronald Reagan's was in the mid-60s
from summer 1985 to fall 1986, and
Jimmy Carter's was between the mid60s and the low 70s in the first half of
1977. In contrast, from last December
through February, when voters were
responding to the strong fourth-quarter surge in the economy, Clinton averaged only 52 percent approval (and
reached 60 percent only once) in 25
polls tallied by American Enterprise
magazine. Since the spate of Whitewater stories in March, his approval
has fallen, hovering below 50 percent. All of this suggests that Clinton
was paying a 15-point penalty for his
personal shortcomings before the
Whitewater story took off; it has now
grown to around 20 points and may
go higher. Clinton defenders are
quite right in saying that a 50 percent president can be re-elected. But
no politician gives up 20 points happily. Clinton is a strong and spirited
horse. Still, he is carrying an awful
•
lot of weight around the track.
His problems are not helping him on his issues-most
notably on health care finance reform. Public support for
the Clinton plan is now stuck far below 50 percent, and it
is a dead letter in Congress. The lead there is being taken
by dedicated and talented Democrats who want a bigger
role for government in health care —Edward Kennedy,
Dan Rostenkowski, John Dingell and Pete Stark. Bui
none has yet put together a majority in his full congressional committee, much less on the floor.
Health-reform blues. There is a growing possibility that
Clinton's plan will crash and burn. Liberal leaders see
this as perhaps their only opening in a quarter century to
build a government-guaranteed health care system, and
they may hold out so long for a maximalist plan as to
leave no time to patch together a less ambitious ap-
proach that could easily win a majority. Clinton strategists have long argued that public demand for reform is
so great that Democrats and even Republicans dare not
go home to voters this fall without passing a major bill.
But recent polls say just the opposite. Some 59 percent
in an April USA rorfay/CNN/Gallup poll say they would
rather see Congress change the health care system gradually. And a 58 to 34 percent margin in the May
UBC/Wall Street Journal poll says Congress should act
next year rather than this. In an era of distrust of government action, the evidence is strong that voters would
prefer no action to the risks they see in a legislative redesign of one seventh of the economy.
The operative precedent for memCHCKWRRmr-USMWB
bers of Congress, Clintonites have argued, should be the 1991 Pennsylvania
Senate victory of Democrat Harris
Wofford, who called for health care
reform legislation about which his opponent was indifferent to hostile. But
the operative precedent in the minds
of many key Democrats on health-bill
writing committees is the catastrophic
health care act. It was passed overwhelmingly by Congress in 1988 but
repealed in 1989 after angry protests
that included a mob of elderly citizens
surrounding Rostenkowski's car in
downtown Chicago. For lawmakers, it
would be worse to pass something
bad-and many now think Clinton's is
bad —than to pass nothing at all. Clinton originally hoped that public opinion and the force of his leadership
could pass his health plan. Now, neither is working, and he is hoping that
parliamentary legerdemain-a favorable rule in the House, draftsmanship
behind doors in a conference committ e e - w i l l result in the passage of
something that can plausibly be deal
scribed as similar to his proposal.
Clinton pollster Stan Greenberg is
one of many liberals who hoped that Clinton could transform his 43 percent 1992 victory into success for a program of government benefits for the middle class and a
solid Democratic majority in 1996 and after. He hasn't
made much progress yet. A CNN/USA Today/Gallup poll
in late March showed Clinton trailing "the Republican
Party's candidate for president" by 50 to 43 percent. And
Republicans stand to make gains —possibly big gains —in
the 1994 off-year election. The assumption around Washington is that Bill Clinton will probably be re-elected in
1996. But Clinton, personally mistrusted and programmatically unfulfilled, may find himself in the uncomfortable position of a candidate whose re-election strategy
has as one of its essential steps: "Your best hope-the
other guy screws up."
•
He's paying a 20-point
penalty for questions
about his character.
38
U.S.NEWS & WORLD REPORT, MAY 23,1994
�m
The MMarris Poll l i l l l S I
THE HARRIS POLL 1994 #24
For release: Wednesday, April 20, 1994
PUBLIC SUPPORT FOR CLINTON HEALTH P L A N ^ ' ^
DECLINES BUT SUPPORT FOR FUNDAMENTAL
REFORM STILL VERY STRONG
Reduced majority still favor Clinton plan.
by Humphrey Taylor
Almost nine out of every ten Americans believe it is important to
have fundamental reform of the health care system, and well over half believe this is
very important. However, support for the president's health care plan continues to
slip, with only just over half of all adults now in favor of it. This slippage probably
does not reflect much detailed knowledge or understanding of what is in the
president's plan; most people appear not to know much about it. Nor is it based on a
growing acceptance of the status quo. Rather the trend reflects growing skepticism
about what the plan would actually achieve.
These are findings of a Harris Poll of 1,255 adults surveyed between
April 4 and 7, 1994.
There are several indications of how enthusiasm for President
Clinton's plan has slipped:
~ It is now favored by a 53-38% majority. In October last year, a
64-30% majority favored it. In February a 59-34% majority did so.
~ Only 57% now believe that the president's plan would provide
universal health insurance, compared to 70% last October.
Louis Harris & Associates
630 Fifth Avenue NYC
(212) 698-9697
�TABLE 1
A
TTITUDES TO PRESIDENT CLINTON'S HEALTH CARE PLAN
"Overall, do you favor or oppose President Clinton's plan for
reforming the health care system?"
1993
October November
1994
February April
%
%
64
30
6
Favor
Oppose
Neither
%
58
34
7
59
34
7
53
38
9
TABLE 2
ATTITUDES TO AND EXPECTATIONS FOR
CLINTON HEALTH PROPOSAL
"From what you have heard of it do you think President Clinton's health
care plan, if it is passed by Congress and implemented, would (READ LIST) or not?"
1993
1994
Oct.
Nov.
Feb.
April
%
%
%
%
Require a big increase in taxes
Would
Would not
Not sure
75
21
4
74
22
4
74
22
4
76
19
5
Ensure that everyone has
health care
Would
Would not
Not sure
70
26
4
64
32
3
62
33
5
57
37
6
Be better than the system than
we have now
Would
Would not
Not sure
67
23
10
59
35
5
57
36
7
53
39
8
Help control the total cost of
health care
Would
Would not
Not sure
59
36
5
51
43
5
51
42
7
48
46
6
-3-
�TABLE 3
HOW IMPORTANT THAT WE HAVE LEGISLATION
WHICH FUNDAMENTALLY REFORMS HEALTH
CARE SYSTEM
"How important do you think it is that we have legislation which
fundamentally reforms the health care system -- very important, somewhat
important, not very important, or not at all important?"
PARTY I.D.
Total
%
Very important
Somewhat important
Not very important
Not at all important
Not sure
57
31
5
5
2
POLITICAL PHILOSOPHY
RepubIndelican
Democrat pendent
%
%
%
45
34
10
9
2
67
27
2
3
2
Conservative
%
Moderate
%
Liberal
%
50
33
8
8
1
59
31
4
4
3
67
27
3
2
2
55
34
4
4
2
TABLE 4
WHO TRUSTED MOST AND LEAST ON HEALTH CARE REFORM
"Which ONE of the following do you trust the most to produce good
policies for health care reform? "
"And which ONE do you trust least?"
Most
%
20
15
13
10
9
9
8
2
9
5
President C l i n t o n
Doctors' organizations
T h e R e p u b l i c a n s in C o n g r e s s
Business
Hillary R o d h a m C l i n t o n
T h e D e m o c r a t s in C o n g r e s s
Health insurance companies
Pharmaceutical companies
N o n e (vol.)
N o t sure
-4-
Least
%
11
15
13
5
8
7
18
17
2
4
�PA5E
3
LEVEL 1 - 17 O 102 STORIES
F
Copyrigftt 1994 The National Journal, Inc.
The National Journal
April 2, 1994
SECTION: INFOFILE; A Digest of Studies, Surveys and Books; Health; Vol. 26,
No. 14; Pg. 803
LENGTH: 149 words
HEADLINE: Second Opinions: Americans' Changing Views on Health Care Reform
BD:
OY
In this report, John Immerwahr and Jean Johnson of the Public Agenda
Foundation (a nonpartisan research and education organization founded dy
public opinion analyst Daniel Yankelovich and former Secretary of State Cyrus R
.
Vance), discuss the results of the foundation's recent study of public opinion
toward health care reform. The study was designed to test the firmness of
Americans' views on health care by asking nearly 600 respondents a series of
questions before and after they watched a presentation of the arguments of
proponents and opponents of major reform proposals as well as general
information on health care. From the results, the authors conclude that
Americans are strongly committed to the goal of universal coverage but skeptical
about government's actual role in health care reform. Public Agenda Foundation,
6 E. 39th St., N w York, N Y , 10016. 40 pages. $ 15.
e
..
LANGUAGE: ENGLISH
L A - A E M C April 13, 1994
ODDT-D:
LEXIS-NEXISm LEXIS-NEXISW LEXIS-NEXIS*^
Services of Mead Data Central, Inc.
�Americans want Congress to be cautious about health care reform, with many suggesting that changes should be
phased in over time. This "go slow" attitude also undermines tne notion that the public sees the health care system in crisis. Levels of knowledge about the Clinton plan remain low.
Question: Do you think health care reform is so important the
Congress and the president should act on It this year or do you think
the problem is so complicated that they should take another year to
work out the details?
Question On another subject, do we need to effect changes in the
American health care system as quickly as possible or would it be
better to phase changes in over time?
5% Don't know
4% Don't know/other
Health care reform is
so important that the
Congress and the
president should act
on it this year
So complicated
should take other
year to work out
the details
We need to effect
changes in the
American health care
system as quickly as
possible
Better to phase
changes in over
time
Source: Survey by CBS News/New yorf< Times. June 1-3, 1993.
Source: Survey by tne Los Angeles Times January 15-19. 1994
Question: What do you think Congress should do with Clinton's
health care plan...?
Question: Do you think Congress should pass the health care plan
basically as Bill Clinton has proposed it?
Congress should...
Congress should...
Pass the
plan without
any changes
Minor
changes
Major
changes
No
opinion
Not pass
any of it
E3 Pass the
plan as he has
proposed it
EE Major
changes
(T Reject
plan
No
opinion
Sep. 1993
sgv; 11%
i.ufs.:
Oct.
29%*i h7%*
M
6
%
Nov.
Jan 1994
Source: Surveys by ABC Hev/slWashington Post, latest that of January 20-23. 1994.
Source: Surveys by the Gallup Organization tor USA Today and CNN. latest that of January
28-30. 1994
Question: As you may know, President Clinton presented his health
care reform proposals to Congress and the American people. How
much do you know about the details of President Clinton's health
care proposals—a great deal, a good amount, only some, or not
much at all?
Question: Thinking about the current proposals to change our health
care system, would you say you understand them very well, only
somewhat, or not very well?
How much know about the details of Clinton's
health care proposals
Understand the current proposals to
change our health care system very well
A great
deal
Good
amount
Only
some
Not much
at all
i'
Don't
know
6%
5%
1%
y 57%
^21%
1%
Dec.
Wi 21%
Only somewhat
Not very well
Sep. 1993
m
Source: Surveys by the Los Angeles Times, latest that of December 4-7. 1993.
76
THE AMERICAN ENTERPRISE
Note: In a February 1994 CBSINYT survey 83% of respondents said no when asked "Is there
another health care plan you've heard about that you think would be better than the Clinton neaith
care plan.''
Source: Survey by Yankelovich Partners for Time and CNN. February 10. 1994
�PG
AE
LEVEL 1 - 21 O 102 STORIES
F
Copyright 1994 Informatian Access Co., a division of Ziff Communications Co.;
Copyright Manisses Communications Group 1994
Alcoholism & Drug Abuse Week
March 14, 1994
SECTION: Vol. b ; No. 11 ; Pg. 2; ISSN: 1042-1394
LENGTH: 368 words
HEADLINE: Poll: public supports inclusion even i f i t costs more; of mental
health and substance abuse benefits in health care reform package
BD:
OY
Sixty-five^ percent of voters support inclusion of mental health (including
substance abuse) benefits iTFRearth care reform, accord inq__to a Februan/PQll
conducted-for-the-Bareion-eent^r-^gr-fl^a'^H^rtirLa^. Qverail, the~poir~5"hQW5
"strong, i f nti-t-dg-cts-i-ye—suppOTr~foF~many of the field's health care reform
positions.
Perhaps most encouraging is that the poll — conducted by the Washington,
D.C, research firm of Mellman, Lazarus and Lake — found that 82 percent of the
800 likely voters said that mentally i l l people are just as sick as physically
i l l individuals, and 62 percent agree that addiction and mental health problems
should be treated on a par with physical ailments.
However, only 43 percent of the poll's voters that were surveyed attached
importance to including these benefits in health care reform. An equal
percentage said that including chemical dependency/mental health (CD/MH)
benefits was only "somewhat" important. And, while 22 percent of the voters said
inclusion would make them much more likely to support a reform plan, 20 percent
said i t makes no difference.
Because cost has been such an integral part of the debate on inclusion, also
noteworthy is the fact that 60 percent of the surveyed voters said they would
support including a C / H benefit even i f i t would cost them $ 100 more per
DM
year.
Poll respondents looked most favorably upon coverage for children with
mental illnesses — a group whose care, in fact, is very much in doubt under the
Clinton administration's reform plan. Eighty-five percent of respondents said i t
was very important to provide coverage for children with mental health problems,
and a majority favored f u l l coverage for children even i f care for adults were
phased in.
Although the addiction and mental health fields have made phased-in coverage
a bone of contention, 48 percent of the respondents favor the idea.
Many (39 percent) of the respondents reported that someone in their
household had experienced an addiction problem and/or mental illness. When
respondents were asked to identify their major concerns, crime and drags topped
the l i s t s of 32 percent. Some 22 percent of respondents cited health care.
IAC-NUMBER: IAC 14984170
LEXIS-NEXIS• LEXIS- NEXISm LEXIS- NEXIS
Services of Mead Data Central, Inc.
�PG
AE
a
Alcoholism & Drug Abuse Week, March 14, 1994
IAC-CLASS: Health
L N U G : ENGLISH
AGAE
L A - A E M C June 09, 1994
ODDT-D:
LEXIS-NEXISW LEXIS-NEXISm LEXIS-NEXISW
Services of Mead Data Central, Inc.
�THE PRESIDENT AND HEALTH CARE J
RESULTS OF A WASHINGTON POST-ABC NEWS POLL
i Do you think
[•worse than the
HILLARY CUNTON'S
C M O F Y TRADES
O M DT
CUnton's health care plan is better or
system?
Yesterday, the White House
released the following
figures on Hillary Clinton's
commodity trades:
Total 1978-79 gam on L
$1,000 investment: f ,
June July
1993
Aug. Sept. Oct. Nov. Dec. Jan. Feb. March
'
1994
1979 net gain: $72,996
IS109.600 prohs oftM by
136.600 eul
Q
Do you think President Clinton's plan creates too much
• government involvement in the nation's health care system, not
enough government involvement or about the right amount?
Too nrach
hwotwowl
1978 net gain
12A341
About the
•Ifkl wnowrt
47%
40%
.14%
6
% 5%
11V10 3/77
1993 l t » 4
lOaO 177
1M3 1M4
1010 377
1M3 ItM
1M3 1M4
Q
How likely do you think it is that the Clinton administration and
• Congress will end up making significant improvements in this
country's health care system?
Uktty
Uniikefy
No
154%
NOTt r « m s pmnOm3 dy the wrote
House, sen* «re roundta
1 2%
%
lOTi 177
1993 1994
103 V27
1993 1994
I C . S < &D » :
M »» H N : N C-
10/3 377
1993 1994
NOTE N.—at'i T i , -oi a « »31: 100 oe'tent Otf t: tovnO'ng Sesuits arc bases on
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Statement from Hillary Clinton's initial commodities account shows trades In cattle futures in October 1978.
�Poll Finds Public Is Still Doubtful
Over Costs of Clinton Health Plan
By ADAM CLYMER
Six months after unveiling its plan plaining how this approach of ours will
with a flourish, the Clinton Administra- guarantee health insurance to a l l "
tion has made almost no progress in
After examining the poll results,
convincing Americans that its ap- Mrs. Clinton said: "One thing we have
proach will solve the nation's health not done in an organized and coherent
care problems, the latest New York way for the last couple of months is to
Times Poll shows.
be very positive in getting out the same
Just as It did last September, the message over and over again, and in
public overwhelmingly backs Presi- asking people to compare the alternadent Clinton's goals of providing health tives. In many ways the worst alternainsurance for all and making sure it tive is the status quo."
During six months of argument in
cannot be canceled. But just as it did
then, the public fears that the Clinton Washington over the Clinton plan and a
advertising
campaign
plan would raise costs, while many also television
expect it to expand an already exces- against it by the insurance industry,
sive bureaucracy and decrease the public attention has generally focused
less on its goals than on the means to
quality of medical care.
achieve them. And with a plan as comHillary Rodham Clinton, in a teleplicated as Mr. Clinton's, many of those
phone interview from Boulder, Colo.,
means have proved vulnerable to critiwhere she made a health care speech
cism.
yesterday, said the poll "reaffirms
Committees in Congress expect to
public support for the major principles
shape legislation in April and May and
in the President's plan." But she acknowledged that Administration officials "have to do a better job in exContinued on Page B8, Column 1
�Public Wary of Health Plan, Poll Finds
Continued From Page Al
begin floor debate this summer. Mrs.
Clinton said that after meeting about 80
senators or representatives in the last
two weeks, she was convinced that "we
are really making progress inside the
Congress."
Clear Message to Congress
No rival plan commanded either understanding or support in the poll of
1,107 adults. The survey also carried
the message to Congress that .the public expects action, if not this year then
soon after.
Fears about costs remain the public's biggest health care concern. When
asked what was the nation's biggest
health care problem, 44 percent volunteered cost-related answers about "exorbitant costs" or "hospital rip-offs."
That was more than any other group of
answers, although 18 percent said coverage for all was their biggest concern.
When people were asked to identify
what they liked best about the Clinton
plan, only 2 percent said it would save
money, making it clear that the Administration had not convinced the public
that its insurance-purchasing alliances
would negotiate lower rates.
Cost-Related Worries
Thirty-seven percent did cite the
Clinton plan as positive for promising
universal coverage. The poll, taken
from last Tuesday through Friday, had
a margin of sampling error of plus or
minus three percentage points.
Worse yet for Mr. Clinton, when telephone interviewers asked the respondents to name their biggest worry about
his plan, 23 percentvolunteered costrelated answers like " I ' m sure our
taxes will go up," as one respondent,
Patricia Ann Hymer of Loganville, Ga.,
put it in a follow-up interview. She is
disabled and uninsured and supports
the Clinton plan.
Fifty-seven percent of those polled
said they thought the Clinton plan
would raise their own health care
costs. This proportion has been steady
since last fall, apparently impervious
to Administration arguments that 70
How fhe Poll Was Conducted
adjust for variations in the sample relating to region, race, sex, age and education.
In theory, In 19 out of 20 cases the
results based on such samples will differ
by no more than three percentage points
in either direction from what would have
been obtained by seeking out all American
adults.
For smaller subgroups, the potential
sampling error is larger. For example, for
the group most knowledgeable about
President Clinton's health care plan, it is
plus or minus six percenuge points.
In addition to sampling error, the practical difficulties of conducting any survey
of public opinion may introduce other
sources of error into the poll. Variations in
question wording or the order of questions, for instance, can lead to somewhat
different results.
The latest New York Times Poll is
based on telephone interviews conducted
on March 8 through March 11 wilh 1,107
adults around the country, excluding Alaska and Hawaii.
The sample of telephone exchanges
called was selected by a computer from a
complete list of exchanges in the country.
The exchanges were chosen to insure that
each region of the country was represented In proportion to its population. For each
exchange, the telephone numbers were
formed by random digits, thus permitting
access to both listed and unlisted numbers. Within each household, one adult
was designated by a random procedure to
be the respondent to the survey.
The results have been weighted to take
account of household size and number of
telephone lines into theresidenceand to
Still, the poll made it clear that the
percent of the public would pay the
same or less, saving an average of $61 public expects action from Congress.
"Anything would be better than what
a month each.
"We are going to have to get our we have now," said William Vance, a
arguments out more effectively than letter carrier in Shohola, Pa. " I f you
we have," Mrs. Clinton said. "1 think could guarantee health insurance for
we have effectively countered some of the 40 million who don't have it, then it
the early attacks, like choice of doc- would be worth it."
tors, but now we have got to deal with
Distrust of the Government
the cost issue."
Only a quarter of those polled said
Prof. Robert J. Blendon, chairman ot
the department of health policy and they thought legislation would be
management at the Harvard School of passed this year, as the President and
Public Health, was skeptical. " I think Democratic Congressional leaders
they have lost the moment of opportu- have promised, and the doubters were
nity to convince people the cost will be , evenly split between those who thought
partisan bickering would prevent aclower," he said.
tion and those who thought the issue's
That perception had taken root al- complexity was the obstacle.
most instantly, said Mr. Blendon, a
But 45 percent said they were conleading student of public opinion on
health care. "It's not a function of the cerned that they might lose their health
advertising campaigns, not an issue in insurance in the next five years, and 30
any ads," he added. "They believe the percent said they were very concerned.
President isn't telling them the truth." More than two-thirds said they would
But if support for the Clinton plan is be disappointed if Congress failed to
soft, with 44 percent of the public un- act in the next few years.
A major reason for the distrust apable to say what they like best about a
system that would have employers pay pears to be the public's view of the
most of their workers' insurance costs, Clinton plan as government-run, even
support for alternatives is almost non- though the Administration says it is
existent. Only 10 percent of the public merely expanding the existing private
said they had heard about another plan insurance system.
they liked better, and a fifth of them
even forgot what it was.
1
:
�Views on Health Care Reform
The pubic supports the goals of th* CUnton plan . . .
That every
American receives
health insurance
coverage Is: ; •',
^ e ^ a t l r ^ p r t a n t 16%;;
— No answer 1%
That heal^i ;
insurance can;:
never be lost or •
c a n c ^ .fdrjwy :
reasohat'aBi^JrV^t
:
i plan
adopted, AW« the .
amount you pay for
health care:
Bill Clinton's - , ^ '
Jlihton's
proposed heaith
care reform ptan Is:
' Increase'
57%
'
'
,
_—
ii%
ii^^^^^l^^>;HV^AH t
Fair to people
like you 44% "
;
Dbhlknow enough/
noainswerl<%
reform plan In the naxt f«w year*.
If Congress never
passes any health
care reform plan
and the current
system continues,
' -Pleafeed 21%
Disappointed
No answer 8%
71%
would you be:
Based on telephone Interviews with 1,107 adults conducted nationwide
March 8-11. Figures are rounded.
TheNrwYorK Times
u
" I think it's a bureaucratic nightmare," said Sue Eilers of Mamaro• neck, N.Y., a computer programmer.
Six months into the campaign to enact health care legislation, the public
does not claim deep knowledge of the
plan. Only 34 percent said they had a
good understanding of it, and about a
quarter of that group did not know that
the plan requires employers to pay
most of the costs.
Those who claimed a good understanding and met that minimal knowledge test were slightly less sympathetic than others, which suggests that the
Administration's hopes that greater
discussion of the plan will bring more
support may be wishful thinking.
For example, 41 percent of that
knowledgeable group said the Clinton
plan would make the quality of their
own health care worse, while 9 percent
said it would make it better. In the
overall sample, 34 percent said the
Clinton plan would make their care
worse, while 11 percent said it would
make it better. The percentage expecting their care to get worse has hardly
varied since last fall.
The public did differentiate among
critics of the Clinton plan, taking small
business more seriously than doctors
or insurance companies. Sixty-three
percent said insurance companies that
oppose the plan fear making less money, and 65 percent attributed that same
motive to critical doctors.
But when asked about complaints by
small businesses that they could not
afford the coverage required of them
by the plan, 54 percent said they
thought small-business owners believed what they said, while 39 percent
said they were saying that to keep
profits up.
Stan Polasik, a pool cleaner in Covina, Calif., said, " I t would destroy small
businesses," and added, "They will be
forced to lay people off and even worse
go under."
Faye Abney a medical office manager in Ringgold, Ga., said, "Business
won't be able to afford it, and it will
affect the wages they will be able to
pay after providing these benefits."
The support for universal insurance
that cannot be canceled — "health care
that is always there," as the Administration puts it — remains very high.
Eighty-two percent said it was " v e r y
important" that "every American receives health insurance coverage."
Last September 83 percent took that
stand on a similar question. Eighty-two
percent also called it very important
"that health insurance can never be
lost or canceled for any reason at a l l . "
A similar question in September drew
80 percent agreement.
�A'
Effects of the Clinton Plan
In the next few years, If the Clinton health care reform plan fs adopted. do you think It will make health care
in the United States better, make health care worse, or wont have much impact one way or the other?
Bettor
Not much
hnpact
Not much
Intact WorMr'
Worse
FAMILY INCOME
POLITICAL PHILOSOPHY
Under $15,000
43
32
17
Liberal
49
31
17
$15,000 - $30,000
38
28
25
Moderate
38
30
23
$30,000 - $50,000 ;
37
28
29
Conservative •
27 -
22
43
$50,000 - $75,000
33
24
40
Over $75,000
27
21
.44
^^^^^^^^^
27
24
POLITICAL AFFILIATION
Democrats
Independents,
•-
31
•
,
33
33
v
13
28
49 -
31
' '
Blacks
"83
32
PERCEIVED URGENCY
Say there is a crisis in
health care in the U.S.
40
• Say there is not a^criste Sj8
j
'
^
KNOWLEDGE OF THE PLAN
^•B—ed on naflowfcfctelephoneInterviews with 1,1fi7
T adUte conducted March S-11. Those with no opinforf
not shown.
C
J
But those polled also showed considerable interest in an approach, backed
by Representative Jim Cooper, Democrat of Tennessee, that would not provide universal insurance coverage.
The respondents were asked if employers should be required to pay most
of their workers' insurance costs, or if
it was enough that employers offer
their workers a chance to buy it. Fortyfour percent said they employers
should pay, as the Clinton plan directs,
but 42 percent said it was enough to
offer the insurance, as Mr. Cooper's
plan would require.
The Cooper plan, which attracted
heavy interest in Washington a couple
of months ago, has received little attention in any of the committees dealing
with health care legislation.
The public was about evenly divided
in its opinion of how Mr. Clinton is
handling health care, with 42 percent
approving and 46 percent disapproving, roughly the range he has been in
since January. But the percentage who
say the country is having a "crisis in
health care" declined, from 84 percent
in a Gallup Poll in January to 72 percent now.
A slight plurality of 44 percent said
they thought the Clinton plan would be
fair to people like them, but 40 percent
Alan Si. waner lor I nc Nf w Yorn l imes
said it would be unfair. Those numbers
"I'm sure our taxes will go up," Patricia Ann Hymer of Loganville, Ga.,
are about where they have been since
said of the Clinton plan. Disabled and uninsured, she supports the plan.
last fall.
�U.S. Reservations About Reform
A majority believe that the cost of their health care will increase under the Clinton health care plan. Twice as
many think the quality of the care available to them will decline as think it will improve, though 4 in 10 think it will
stay the same. Concerns about reform are contributing to a "go slow" attitude about its pace.
Question: Under Clinton's plan, would you expect the total amount of money you pay for medical care—including health insurance—to increase,
decrease, or stay about the same?
Question Under Clinton's plan, would you expect the quality of medical care available to you to improve, decline, or stay about the same?
Under Clinton's plan, expect the...
Under Clinton's plan, expect the...
Amount you pay for medical care
Quality of the medical care available to you
§§ To increase
g | Decrease
. 3 Stay about
the same
No opinion
Decline
To improve
Stay about
the same
V No opinion
Sep. 1993
Oct
2%
Oct. 1993
Apr. 1994
Question: Do you think Congress should pass the health care plan
basically as Bill Clinton has proposed it, pass it, but only after
making major changes, or reject this plan?
20% 139% * ^
Question: Do you think Congress should deal with health care reform
on a gradual basis over several years, or should Congress try to
pass a comprehensive health care reform plan this year?
Congress should...
p|
Pass the
Clinton plan
unchanged
Pass it after
making major
changes
Reject it
:.; No
opinion
4% No opinion
Should try to
pass a
comprehensive
plan this year
Source: Surveys by Gallup Organization lor USA TbtJayand CNN. latest that ol April 16-18. 1994
90
IHE AMERICAN ENTERPRISE
Congress should deal with
health care reform on a
gradual basis over
several years
�E X E C U T I V E
O F F I C E
30-Jan-1994
TO:
P R E S I D E
12:20pm
J e f f r e y L. E l l e r
O f f i c e o f Media A f f a i r s
SUBJECT:
T H E
(See Below)
FROM:
OF
A.M. H e a l t h Care C l i p s
POLL FINDS MOST AMERICANS WANT HEALTH CARE FOR ALL
WASHINGTON (Reuter) - N e a r l y two o u t o f t h r e e
Americans b e l i e v e h e a l t h insurance should cover a l l
i n d i v i d u a l s , b u t o n l y one i n f o u r a r e w i l l i n g t o
pay?higher?taxes f o r i t , a c c o r d i n g t o
a U.S. News and World Report p o l l .
The p o l l , r e l e a s e d Saturday, found 64 p e r c e n t o f t h e
1,000 r e g i s t e r e d v o t e r s q u e s t i o n e d c o n s i d e r e d i t v e r y
i m p o r t a n t t h a t every American have h e a l t h care coverage.
Another 22 p e r c e n t c o n s i d e r e d i t somewhat i m p o r t a n t .
S i x t y - t w o p e r c e n t s a i d t h e y f a v o r e d a?combination o f ?
P r e s i d e n t C l i n t o n ' s p l a n , which would r e q u i r e a l l
employers t o c o n t r i b u t e , and a Senate Republican p r o p o s a l
f o r a l l i n d i v i d u a l s t o buy i n s u r a n c e , w i t h s u b s i d i e s f o r
low-income f a m i l i e s .
But o n l y 26 p e r c e n t were w i l l i n g t o pay?higher
taxes?or
premiums f o r u n i v e r s a l coverage.
Another 30 p e r c e n t s a i d t h e y would be w i l l i n g t o
accept a l i m i t e d choice o f d o c t o r s o r w a i t l o n g e r f o r
nonemergency care i n r e t u r n f o r more widespread coverage.
The p o l l was taken January 17-18 and had a margin o f
e r r o r o f p l u s o r minus t h r e e p e r c e n t , the magazine s a i d .
REUTER
CLINTON CALLS HEALTH SYSTEM
By Laurence McQuillan
"RIGGED"
WASHINGTON, Jan 29 (Reuter) - P r e s i d e n t C l i n t o n
Saturday s a i d the n a t i o n ' s h e a l t h insurance system i s
* ' r i g g e d ' ' a g a i n s t o r d i n a r y f a m i l i e s and s m a l l businesses
and s a i d c o n g r e s s i o n a l
c r i t i c s do n o t understand t h e
c r i s i s most Americans f a c e .
''This year we must make h i s t o r y by r e f o r m i n g t h e
h e a l t h care system and p r o v i d i n g guaranteed p r i v a t e
i n s u r a n c e t o every American,'' ? C l i n t o n ? s a i d i n h i s weekly
�4.
President Clinton's plan for health-care reform would guarantee health insurance for all
Americans regardless of whether they change jobs, become unemployed, or develop a major
illness. If it also would involve some restrictions on choice of doctor, a bigger role for
government in health care, and higher costs or taxes, would you favor or oppose this plan?
Favor
53%
Oppose
43%
Not sure
4%
5. Some Clinton Administration officials are considering a pension reform plan which would
ensure that employees who change jobs can take their retirement benefits with them, so that
workers who change jobs several times won't be left without a nest egg. If the cost of doing
this forced employers to reduce retirement benefits or pay lower wages, would you favor
or oppose this plan?
Favor
47%
Oppose
48%
Not sure
6. The Clinton Administration is proposing adding 100,000 local police paid for by the federal
government at a cost to taxpayers of $1.6 billion a year. The money would have to come
from additional taxes or cuts in other government programs. Would you favor or oppose this
plan?
Favor
7.
52%
Oppose
44%
4%
Other countries take a more active role in promoting industry, and making their business
more competitive abroad. Would you like to see the federal government take a more active
role in helping specific industries, or should it leave it to the free market?
Take a more active role 36%
Leave to free market
58%
8.
Not sure
Neither (vol.)
Not sure
2%
4%
The Clinton Administration believes that America has to make major changes - some of
them painful, some of them costly - in order to provide Americans with economic securir
in the future. Do you tend to agree or disagree with this?
Agree
1 2 2 1
67%
Avenue ofthe Am •
Disagree
29%
Not sure
4%
�The
arris
THE HARRIS POLL 1994 # 35
For release: Monday, June 6, 1994
HEALTH REFORM: THE PUBLIC WANTS IT A L L -CHOICE, UNIVERSAL COVERAGE, COST CONTROLS
ONLY A MODEST TAX INCREASE AND
UNIVERSAL COVERAGE
// forced to choose among 6 desirable goals, a large plurality picks
universal coverage as single most important
By Humphrey Taylor
Any health care reform bill that the Congress passes this year, if it passes one,
will look very different from the Clinton Bill. But when the president drew his line in the sand
and said he would not sign any bill which would not provide universal health insurance
coverage, he got it right politically. The public wants many conflicting things from health
reform, but when asked to choose between six very desirable goals, a substantial plurality pick
universal coverage as their top priority.
The problem for the Congress as it struggles to reconcile many goals, and respond
to the powerful pressures involved, is that these goals conflict. The experts may know that
tough choices have to be made; the public usually does not.
Large majorities of the public believe six different goals are all absolutely
essential or very important:
•
84% believe it very important to give people a choice of a wide range of doctors.
Louis Harris & Associates
630 Fifth Avenue NYC
(212)
698-9697
�•
81% believe it is very important to give people a choice of different types of
health insurance plans.
•
77% believe it is very important that everyone has health insurance.
•
71% say it is very important NOT to have a big tax increase.
•
74% say it is very important to control how much the country spends on health
care.
•
63% say it is very important to control how much individual consumers spend.
These are the results of a Harris Poll of 1,253 adults surveyed between May 23
and 26, 1994,
The problem for policymakers is that universal insurance coverage is expensive,
and that managed care, designed to contain costs, limits choice. So how to reconcile these
conflicting goals? When the public is forced to pick one of these goals, a 40% plurality picks
universal coverage ("ensuring that everyone has health insurance"), with not having a big tax
increase (16%) a poor second, and a wide choice of doctors (13%) in third place.
Universal coverage is the top priority for all of the many demographic groups in
the survey -- men and women, young and old, rich and poor, Republicans and Democrats,
Conservatives and Liberals, even though the numbers vary. Not surprisingly, Liberals and
Democrats are much more likely to pick universal coverage as the most important goal, while
fewer Republicans and Conservatives do so. Women are also slightly more likely than men to
make universal coverage their top priority.
Unfortunately for the legislators in Congress, the public (unlike the people
surveyed in this Harris Poll) are not forced to make this choice or to prioritize their goals for
health reform. Any reform plan which fails to satisfy all of these "very important" goals is
vulnerable to attack from those where it falls short, as all realistic plans must.
Humphrey Taylor is the President and CEO of Louis Harris and Associates, Inc.
�TABLE 1
IMPORTANCE OF SIX DIFFERENT GOALS FOR HEALTH REFORM
"As the Congress debates health care reform, they must consider several different
goals. Please say for each of the following whether you think it is absolutely essential, very
important, or not important?"
Absolutely
Essential
Very
Important
Somewhat
Important
Not
Important
Not
Sure
%
42
42
12
3
2
Giving people a choice of a
wide range of doctors
Ensuring that everyone has
health insurance
Giving people a choice of
different types of health
insurance plans
%
38
39
13
8
2
%
36
45
13
5
2
Not having a big tax increase
%
30
41
20
7
3
Controlling how much the
country spends on health
care
%
29
45
17
6
3
Controlling how much
individual consumers spends
on health care
%
21
42
20
12
5
�TABLE 2
WHICH ONE OF SIX GOALS FOR HEALTH REFORM
IS MOST IMPORTANT
"Which one of these six do you think is most important for the Congress to achieve?"
Sex
Total
%
Ensuring that everyone has health
insurance
Not having a big tax increase
Giving people a choice of a wide range
of doctors
Giving people a choice of different
types of health insurance plans
Controlling how much the country spends
on health care
Controlling how much individual
consumers spend on health care
Not sure
Male
%
Female
%
Republican
%
Democrat
%
Independent
%
40
16
36
19
44
13
29
19
49
14
42
16
13
11
14
15
13
12
11
10
12
15
9
10
10
11
8
10
9
10
6
4
8
4
4
3
8
5
5
2
6
4
Political Philosophv
Total
%
Ensuring that everyone has health insurance
Not having a big tax increase
Giving people a choice of a wide range
of doctors
Giving people a choice of different types
of health insurance plans
Controlling how much the country spends
on health care
Controlling how much individual consumers
spend on health care
Not sure
Conservative
%
Moderate
%
Liberal
%
40
16
32
16
43
19
55
9
13
15
12
12
11
13
10
8
10
12
9
7
6
4
6
5
5
2
6
2
�ine next two montns.-
•. . - - i t ,
VI-IMIJ
***tt
i^ts
t*tJA<:
u>
;ver health care they
President Clinton tor Ws signature, likely in October.
runcua wiil join tne two Demo- for their bottom-up approaches to
cratic majority leaders — Missouri's health reform, a combination of in- • Down to the wire, IA
> m^ency
f
arries grow
I
Clinton health-care plan losing favor
^ A USA TOOAYA>IN/Qaflup Poll shews
sm^pooplewar^aptento
^ H K I M who tavwjtw CIMon plwv
60%
Most support plan
covwtng everyone
77%
mum
Support Oppoee
HWortty want Mil without
t;<^
universal coverage vetoed ;
^
How many think Clinton should vetoabffl
that improves heatm-care system but does
not guarantee coverage for everyone:
,
Veto
62%
Sign
Cataaliophlc COT inoet bnpotteitf berigro?^.^ _..
VWM) benefit people consWw theflretor second most bnportant
f;r
1M3
: Hore of I M M wtio rael
< HUM MWU Of^lOSa p m i
r
$50,000 +
30%
58%
If f
Mi
By Charles Tasnadl, AP
IT: Hillary Rodham Clinton and Health and
;retary Donna Shalala at a health-care rally
Linton met with heatth organizations.
•-, . . ,.. ..
rating?." \
trouble on
r makers
ts of it to
se. Twoiupport a
making
only helps those who are currently without insurance,'' and
foil to see that everyone is at
risk of losing coverage, says
Robert Blendon, public opinion
and health-policy expert at
Harvard.
If CUnton's bill passes, he
vant the says, "your employer can nevhealth- er give up on it"
ep. Bill
Blendon offers the White
;n of the House some advice: Get the
i Cam- president on the road selling
e more the need for universal coverit), the age. "He should drop discussions about anything else in the
for re- plan," Blendon says,
e past
The White House has begun
51%, doing that The president and
t
1
1 . .
T V 2 1 I
T * _
J t
*
••s:; :>
31%
Behind On:
Souree:AUSATQOAY/CNH/Qaft^natk)naltatsphm
Guaranteed Coming
ocverage uninsured
June S»38.tto#n ofinw ±9 pneermtge pefirw.
t-
i .4
�bon ito date) foreign aic piggy oank tor projects u
n
Northern IreJand and me Lnsh Republic so that Prot- something sacred.
estants and Roman Cathoucs will leam to Lve togethWhen your enemy guc= vou JP. opcnx^. vcu d oe J
er in peace.
fooi not to take it.
Klug noticed that the timd lasted pony trekking
centers and a goif video among its accomplishments
and that it also won honors irom the National TaxPESL'LTS OF A W A S H " , : - ; - , p ; " - - 3 C NE.V5
payers Union as "Outrage of the Month" (April
1991). He wondered what this had to do wuh peace.
From what you know of it. do you aporove or disaoorove of Presiaer:
So on May 27. Klug sent a "Dear Colleague" letter
i Clinton s health care plan'
soliciting cosponsors for a bill to get nd of the fund,
sounding the alarm m block capitals: "THE LEPRECHAUNS ARE LOOTING OUR GOLD!"
Oops.
This missive festered m House in boxes for 12
days, until seven members of Congress ISLX New
Yorkers and a Philadelphian) sent Klug a "Dear
Scott" letter. American society, the letter said, "is
based on a colorful mosaic of vanous cultures and
ethnic groups." Klug's reference to leprechauns was
"insulting to many Amencans of Insh hentage."
Anyone is free to oppose the fund, the letter continued, but "we feel a line must be drawn" about using "racial Stereotypes" to "promote those positions."
Who do you trust to do a better job handling heatth care reform—Chnton
Therefore, "we request that in the future you refrain
• or the Congress?
from the use of epithets and other derogatory terms
June 26
when discussing issues of concern to people of Insh
and other backgrounds."
C:"Hon
25^
The ink was scarcely dry on "Dear Scott." when a
Co gresi
--i
two-page, single-spaced, fmger-waggmg "Dear Mr.
Neitner (vo.untee'ea/
16
Klug" arrived from Insh Ambassador Dermot A. Gallagher, who explained "why the International Fund is
Do you think Clinton's health care plan is better or worse tnan tne
so important" and why Klug's reference to lepre• present system?
chauns was "not only misplaced and insensitive, but
seriously tnvializes the significance of U.S. support I 70°= •
in advancing peace and reconciliation in Ireland."
IBETTER
Not surprisingly, Klug's bill is not prospering (four
cosponsors and holding), but political incorrectness—real or imagined—is only part of the story.
The fund has survived this latest challenge mostly
because it is perhaps the mother of all sacred cows.
The House estabbshed it m 1986 partly as a farewell
gift to retiring House Speaker Thomas P. "Tip" O'Neill
(D-Mass.). who handed off to new Speaker Thomas S.
Feo. Marcn »zSect Oct. Ncv. Ce:.
.
f.-'d,
jv-'e
Foley (D-Wash.). another Irish Amencan. Foley's Rules
1993
Committee chainnan. who decides what gets to the
House floor and what doesn't, is Rep. Joe Moakley (DDo you think basic health insurance should Include innnnct covinp tor
Mass.). of South Boston.
• abort mi, or not?
Throw in the Kennedys (Sen. Edward M. and Rep.
June 26
Joseph P.. II), the "Dear Scott Seven" (all but one with
senous Irish Amencan constituencies), and a few dozen _
Snould net
56
other Insh boosters, and vou can appreaate why Las "
Vegas will let you name the odds on Klug's chances of
getting nd of the fund before the next millennium.
I'm going to nome some suggostions for ehoagM m tho health care system.
"Events suggest that we re not going to get a de• Ptooso toil mo If you support or oppos* oocfc itom I nomo:
bate on the floor," KJug said. Good thinking, Scott.
(Percentage who strong'/ or some.vnar supoort eacn irerr.
It is also unlikely there will be any debate anyJune 26
where eise. Besides pony trails and videos, the vast
A system proviamg umve'sai heain coverage tor a'l Arrenca-j
3'.
majonry of the fund s 2.800 projects are deemed
Federal price controls on medical expenses such as aoctors' fees
worthy by both its boosters and detractors.
hospital chaqjes and drug pnees
But that says nothing about the larger question of
A federal law reauirmg an employers to orovice r.eaitn insurance
"2
why the United States contnbutes millions of dollars
to their full-time employees
per year ($19.6 million for 1995) to Ireland and the
United Kingdom, both members of the European
A program m whicn oeopie paid more money to cnoose tre-' o-.v6'.
doctor, ana less money if tney went to an assigned doctor
Union, the most powerful economic bloc on Earth.
"I'm not saying Ireland is a Third World country,"
said Rep. Thomas J. Manton (D-N.Y.), one of th$
NOTE- Figu'es '-ay not afld to !0C°s v f t " " c CD'n;o->" 'S not iiciucea. j J "" ' SJSS a-e
"Dear Scott Seven." "But they still have a way to go.
from a wasnirpon Post-ABC News te'ecnone oo •:' I.:3, rar.a:""/ se ec.ea dcu i:
Ireland is still a rather pnstme country."
irtervieweo Jjie 23-26. Otner results are t's-i ^vasr, rj;;n Post-iBC 'xv.i i : , : sar-p es or smuar s ;e Ma-; * c: sarrj—g e-:' * i ' a o' r* s: , •. : - i :
.> :
And, despite everything, it is also famous for lepre-
W
THE PRESIDENT AND HEALTH CARE
Q
n
(
Q
(
T
n
1
oe'certage coi-ts Ove'a". SaT' rg ere is. n c - " •' c-e :•
t r t " r \Z.".K
e-or in tnese or any po.-s. intenoe^mg was o;-o«::e: Of Cn-'.on Heifci'CT z' Rac-:'. Fa
Compiled by Sharon Warden
�pitals an accepta
lower health costs
MONEY reade
about evenly di\
whether the prim,
health reform shi
guarantee coverag
move barriers to
insurance or t
health costs. Readi
by a 2-to-l margi
contrast to today's
surance system, th
ill should not ha
more for cover,
healthy people ai
derly should not
shoulder more c.
younger people. In
an overwhelming
lieve that a famil
should not bear n
$5,000 in out-of-po
annually for med
excluding insurant
urns. President (
plan sets the annu;
families at $3,000.
less than the typic.
out-of-pocket mec
for a family of four.
D
espite the near-yearlong
national debate about
health-care reform, most
Americans aren't sure
what ought to be changed.
Not MONEY readers, whose
median household incomes of
$56,000 put them in the top
23% of the U.S. population.
More than 6,000 of them responded with stunning conviction via mail and fax to our
April Newsline 23-question
poll on the best ways to fix
America's health system. As
the key findings from a cross
section of the responses at
right show, our readers not
only prefer to buy their own
coverage but are even willing
to pay more, if necessary, for
the freedom to choose their
own doctors. They'll be
watching Congress closely
too: 73% of the respondents
said that where congressional
candidates stand on health reform would be the main
issue—or at least a very important one—in their November vote. The details:
Nearly two-thirds of respondents don't want a government-sponsored overhaul
of the health system but instead merely some tinkering
around the edges. ' - Bill
Konowitz. 41. a medical
equipment salesman from
Elkton. Md.: "When everything is paid for by somebody
else, there's an incentive to
overuse the system."
Surprisingly, well over half
r
16 MONKV • JUNK 1994
of readers are willing to pay
for their own health insurance, rather than letting the
government or their employer
pay. In fact, 55% said they are
willing to ante up $2,500 or
more in yearly premiums.
But listen up, Congress:
Don't restrict the public's
Our poll, like th
published in the J
issue, also reflected
lie's keen suspic
health reform migl
higher taxes or low
Says Cynthia Fennii
Summit, N.J.: " I pre
exactly what [health
costing me."
Perhaps the big
prise is that 70% of
ers blame lawyers i
health-care costs. C
gets are insurance c
(54%), federal but
choice of doctors. True, fully (44%), hospitals (41
63% of respondents are cur- -impanies (40%) ar
rently free to select their (36%). Don't both
own doctors but only 12% readers that no c
.would be willing to pay the blame, though. Fe
full cost themselves for the 2% of respondent;
ability to keep doing so. And that dodge,
just 4% consider limits on
—Lai
the choice of doctors or hoswith Jaii
�A18 THE WALL STREET JOURNAL THURSDAY, JUNE 1 ; i"994^& ^ "
6
:
' - " ^ ' ~
Americans StiH Support Reform for Health
Fear of Char
But Poll Finds
By GERALD F. SEIB
And HILARY STOUT
Sfa// Reporters O / T I I E WALL STHKET JOURNAL
r;
'5
1
m
Mil
WASHINGTON - Watching the pounding the Clinton health plan is talcing in
Congress, it would be logical to conclude
that the public has lost its desire for
health-care reform.
Logical, but not quite right.
As the congressional debate on health
care enters its most critical phase, a new
Wall Street Journal/NBC News poll, as
well as a review of polling data over the
last year, suggests that Americans retain a
strong underlying desire for changes in the
health-care system. Asked in the new
survey whether they think Congress and
the president should continue their efforts
to reform the system or leave it as it is, an
ovewhelming 71% favor reform.
But the public has lost both its passion
for change and much of its confidence in
Washington's ability to make the right fix.
An improved economy has lessened people's fears that they could lose their jobs
and their health insurance at any moment.
Meanwhile, fears of lost health insurance
have been overshadowed by a different
set of fears: that most health-care reforms
will translate into taxes and more government control.
"People both want major changes and
they fear the changes they want," says
White House pollster Stanley Greenberg.
Opponents Take to the Air
Meanwhile, to make the administration's sales job even tougher, some of the
best-known opponents of the Clinton plan
are returning to the airwaves. The Health
Insurance Association of America said
yesterday it plans to air two new "Harry
and Louise" spots blasting the price controls and some insurance market reforms
in the adminstration's approach. "It's
quite possible Louise will mention the 'R'
word," said an association spokesman,
suggesting an assertion that current proposals would lead to rationed health care.
Overall, in the last year people appear
to have gone from looking at health-care
reform as a tonic that will make them feel
better to seeing it as bitter medicine they
think they'll have to swallow eventually.
The new poll shows that people tend to
believe that reform, while necessary, will
increase the cost of care, erode its quality
and leave availability about the same as it
is now. And health care has slipped down
the list of most pressing issues.
Yet the underlying level of support for
doing something remains high largely becausL' of a vague sense that the current•••'str-m. •? |i--f! i;nrnformi;(i. ••.vnuld bo oven
cans like that idea far more
government-run insurance systc
about the same as a Republican
«^(k«pMMdthBpwltteirtc«tto«B
tive of requiring individuals to obt;
their eftftftternietmtta twalttt-care systaB, own insurance.
•,,m}tm Km W W I w r . ^ l ^ S ^ ^ ' : = '•
And a substantial majority, 6
price controls on insurance premii
limits on medical fees as the besi
refMsaftwb
pay for guaranteed health insuram
^liiinnsysieit'
Americans.
astttt
. So why has political support
president's initiative eroded so ba
D B yon w m w w tBsapprwo ef tie Joh
President Clinton himself at
Bill Cllrrton fs £ 8 8 Hi haudUHf Iwltti-care
118
much of the problem to the heavy p
he took from his political critic
politically crucial early months
oisappraw
year. In remarks yesterday to
group of columnists, Mr. Clint
the campaign against his health i
^' >^h£ ....,^.,. .... , ,,
..... "classic example" of the kinds o
mounted to scuttle overhauls of th'
Cbngnn it dolns l» hantfldg tl» issue ot 3 care system in the past.
And he suggested that he agr
' Iwaltfcctw'nionBr.v: :; ^w®^ •• - x «.
analysts who assert that much of t
to focus attention on the controve
the Whitewater scandal grew oi
foes' desire to scuttle his health
still think we have a chance to get
Clinton said of his health pla:
T E W L S R E J U N L /NBC NEWS POLL biggest enemy we have is the
H AL T E T O R A
cynicism of the American people.
"What's happened is the president's plan Lack of Confidence Overall
scared people, and the effect of being
In fact, the new poll reveals ;
scared is to make people much niore public confidence not only in Mr.
cautious about what is to be enacted." , but in all the major players on hea
Mixed Message V, ;
^x^.;^$x,:^
Confidence in Congress is down e\
The public jitters are being read in than confidence in the presider
Congress, where lawmakers are reacting 47% of those.surveyed said they di
by moving away from the Clinton plan. But of the job Mr. Clinton is doing o
the frustration for the administration is care, 61% disapprove of Congre
that, as public support for its plan has formance. ..
Confidence in Democrats gene
steadily declined over the last year, the
public consistently voices approval for the dropped. A Journal/NBC poll la:
main elements of the administration's ap- indicated that the share of th
thought Democrats would do a b
proach.
'
, -.•y-^.: ,.
That remains generally true in the new on health care had fallen to 26% ;
survey. Overall approval of the Clinton shortly after Mr. Clinton took of
health plan held steady at 38%,roughlythe faith in Republicans didn't go u
same level as in March but well below the only 17% said the GOP would d
5'% iminediately after the president un- Instead, a plurality of America
veiled it in a nationally' televised speech said both parties were about
the issue.
f v^UvP ""
last September. ti^M M&t
But beyond such general do;
But even as the president's critics hammer away at his call for "universal cover- president's problems also cleat
age" as an overly costly dream and. pro- from a failure to better sell the ad.
pose instead more modest steps to make tion's approach to the public,
insurance more affordable, the public doubts about the president's p:
strongly backs universal coverage. By a grown most markedly among
57% to 34% margin, Americans said the groups that should be most strong
main goal of reform should be universal him-Democrats and Clinton vote
coverage rather than insurance reform. support for the Clinton plan 1
And 41% say covering the underinsured eroding across the board, approv
and uninsured is the most important rea- Democrats has fallen an especia
"•n :'"r :-"fnnn. far more than cite reducing 1! percentage noinls in the
OfTwdWind^
U
u
<«™r
•-
}
r
t <i
1
:
�INSIDE POLITICS
JACK W. G R O D AND JULES WITCOVER
EMN
CLINTON'S PARADOXICAL POLL STANDING
T
here is a clear anomaly in recent public opinion polls that
should be disquieting to Democrats looking ahead not only
to the November midterm elections but also to the 1996
presidential campaign that begins almost immediately thereafter. Though the economy has been improving markedly over
the past several months, there has been a steady rise in the number of Americans who believe the country is "off on the wrong
track" rather than headed in 'the right direction."
In the most recent survey for The Wall Street Journal early last
month, for example, poll takers Peter D. Hart and Robert M.
Teeter found that only .10 per cent of Americans believed the
countn. to be headed in the right
direction and that 50 per cent
believed it to be off on the wrong
track. Other polls have produced
similar results, with the "wrongtrack" number inching up toward
60 per cent in some cases.
Among professional politicians,
the wrong-track number is taken
very seriously indeed because it is
so often an early indicator of troubles ahead for incumbents. Their
studies have shown that voters who
believe the country is off on the
wrong track split heavily against
those in power. In the most recent
^ ^ M H
presidential election campaign, for
instance, the wrong-track number
rose steadily during the last few months of 1991 and throughout
1992. foreshadowing President Bush's defeat.
Most often—and this was true in Bush's case—there is some
clear correlation between the wrong-track number and the condition of the economv: Voters become more pessimistic about
national directions when they feel that their own jobs or businesses are being threatened. What makes this situation different
is that there is no such correlation.
It may be that many voters are not yet personally convinced
that the economy has improved that much or arc harboring
unrealistic expectations. As Harrison R. Hickman, a Democratic
pollster, put it. many people have "a much sunnier memory" of
their economic situation in the 19S0s than the facts might justify
and thus may be more disgruntled than you would expect.
Another explanation, accepted by some Democratic as well as
Republican strategists, is that the high wrong-track number
reflects President Clinton's political weakness and his consequent inability to foster national optimism. "He's wearing thin."
a leading Democratic consultant said.
New opinion polls tend to support that judgment. The most
recent survey conducted by Louis Harris and Associates Inc.. for
example, found C'^'on getting negative ratings on his job performance from 56 per cent of respondents and positive marks
from only 42 per cent. Among white males, his negative rating
rose to 63 per cent. Unpublished polls show that the reaction
against Clinton is strongest in the South and the border states
but not necessarily limited to those regions.
Figures such as those in the Harris survey—coupled with such
election returns as those from Kentucky's special House election—are sending tremors of political uneasiness through the
Democratic Party. The possibility that the GOP could gain the
seven seats it needs to control the Senate is now viewed by pros
in both parties as at least realistic if unlikely. The prospect that
Democrats may lose more than 25 scats in the House—enough
to give hostile conservatives a de facto majority—is seen the
same way.
Some strategists also believe that the perception of Clinton's
weakness may make him even weaker by limiting his ability to
lead. "He's frozen at a level too low to pass legislation." a veteran Democratic consultant said.
The operative question is whether Clinton's political weakness also leads more congressional Democrats to bail out on
him. But campaign managers say
that the Democrats already understand that they need to show independence and have figured out
how to demonstrate as much by
citing cases in which they voted
against the Administration. "They
don't need much help on that."
pollster Hickman said.
What is trickier—but essential if
Democrats are to avoid a disaster
in November—is making the case
for the votes they have already east
with Clinton on such issues as the
tax bill and the North American
^mm
Free Trade Agreement and for
those that they may east with him
in the days ahead.
Some party strategists argue, along with the White House,
that the question of who holds the political momentum in the
November campaign won't be answered until the agenda for
that campaign is finally written. And that won't happen, they
contend, until there is a decision on health care reform. If a
health care bill is enacted. Democratic media consultant Frank
Greer said. Democratic candidates can go before the voters saying that they have broken gridlock in Congress. " I think that's a
very positive issue," he said.
Others agree, and they also agree that it doesn't matter a
great deal precisely what is in the bill so long as it looks enough
like the Clinton plan that he can claim parentage. "Just some
vague resemblance would be fine," a House Democrat said.
Thus, you have a situation in which, first, success on health
care has enormous potential political consequences and. second,
Clinton is weakly positioned to achieve that success. Or, in
blunter terms, his poll numbers might rise significantly if he
could score on health care, but the low numbers he brings to the
table make that more difficult than it otherwise would be.
What is plainest is that the stakes are very high. A Democratic
defeat in November would reinforce the picture of Clinton as a
politically crippled Presidem to be shunned by Democrats in
Congress, who always recognize that, as Adlai E. Stevenson
once put it, "the first duty of a politician is to get elected."
But success on health care reform would have the potential to
transform the political atmospherics overnight. If the Democrats
hold their losses to a minimum in November after passing
health care reform, Clinton will be positioned to claim credit for
a signal success in domestic policy—one dramatic enough perhaps so that fewer Americans will be convinced that the country
is off on the wrong track again.
•
Success on health care
reform could boost
Clinton's poll numbers,
but his low numbers
today make that success
harder to achieve.
NATIONAL JOURNAL 6/4/94
1313
�HEALTH CARE
WASHINGTON P S POLL
OT
Do yon think the CUnton
• adminlstntioabasa
Health Plan Doubts Aboiu
B
ey Shows Skepticism About Cost, Completeness
reform, or donl yoareaHythink
they have a compfete pUn yet?
By Richard Morin and David S. Broder
'
Wuhington Put Stiff Whten
Almost three weeks after President Clinton launched his campaign for health care
reform, large majorities of the American
people doubt tlfet he actually has a plan for
curing the ills in the medical system.
Among those who think there may be a
Clinton plan, worries are increasing about
its costs and its impact on both health services and the U.S. economy.
Complete plan
The findings of a Washington Post poll
17%
and an evening of discussion with a dozen
NOTE. Conducted Oct. 7-10
typical residents in a Cincinnati suburb inTHt WASHINGTON POST
dicate that despite the burst of publicity
produced by the president's Sept. 22 address to Congress on health care and the
unprecedented round of congressional committee appearances by First Lady Hillary
Rodham Clinton the following week, doubts
have grown about the efficacy—or even the
existence—of the Clinton plan.
Eight out of 10 of those polled said they
do not think Clinton has a complete plan in
— Frank Duvall, machinery operator hand for restructuring the huge health care
"Everybody talks
about the plan. I
haven't seen any
plan."
system. Seven out of 10 said that he has not
told the public everything it needs to know
to judge its effects.
"Everybody talks about the plan," said
Frank Duvall, 62, a machinery operator. "I
haven't seen any plan. I don't know of anybody that can hand ine a paper and say,
'This is the plan.'"
Duvall is one of the 12 Blue Ash, Ohio,
voters who watched Clinton's Sept. 22 address and gave their generally favorable
reactions of it to two Washington Post reporters, then recraivened last Wednesday to
review what they had heard and learned
since then about the administration's most
important domestic policy initiative.
Most of these Ohio voters were notably
more skeptical about the Clinton proposal at
their second meeting than they had been
immediately after hearing his speech.
Jeff Byington, 30, a self-employed painter
and carpenter, chuckled sheepishly when he
recounted how impressed he had been with
Clinton's initial presentation! He compared
See POLL, A7, C L 1
o
�1
MANAGEMENT INITIATIVES
SEC. 4031. REPEAL OF SEPARATE MEDICARE PEER REVIEW PROGRAM.
P a r t B o f t i t l e X I o f t h e S o c i a l S e c u r i t y Act (42 U.S.C. 1301
e t seq.) i s amended by adding a t t h e end t h e f o l l o w i n g new
section:
~"termination
""Sec. 1165. The p r o v i s i o n s o f t h i s p a r t s h a l l t e r m i n a t e
e f f e c t i v e upon t h e a d o p t i o n o f t h e N a t i o n a l Q u a l i t y Management
Program under s u b t i t l e A o f t i t l e V o f t h e H e a l t h S e c u r i t y A c t .
Any r e f e r e n c e t o t h i s p a r t o r any s e c t i o n i n t h i s p a r t s h a l l n o t
be e f f e c t i v e a f t e r such d a t e . .
1 1
SEC. 4032. MANDATORY ASSIGNMENT FOR ALL PART B SERVICES.
S e c t i o n 1833 (42 U.S.C. 13951) i s amended
(1) by r e d e s i g n a t i n g t h e s u b s e c t i o n ( r ) added by s e c t i o n
4206(b)(2) o f
OBRA
1990 as s u b s e c t i o n ( s ) ; and
(2) by adding a t t h e end t h e f o l l o w i n g new s u b s e c t i o n :
" " ( t ) ( l ) N o t w i t h s t a n d i n g any o t h e r p r o v i s i o n o f t h i s p a r t ,
payment
under t h i s p a r t f o r any i t e m o r s e r v i c e f u r n i s h e d on o r a f t e r
January 1, 1996, may o n l y be made on an a s s i g n m e n t - r e l a t e d
basis.
2) Except f o r d e d u c t i b l e , c o i n s u r a n c e , o r copayment amounts a p p l i c a b l e
under t h i s p a r t , no p h y s i c i a n , s u p p l i e r , o r o t h e r person may b i l l o r
c o l l e c t any amount from an i n d i v i d u a l e n r o l l e d under t h i s p a r t a b i l l
f o r an i t e m o r s e r v i c e f o r which payment may be made under t h i s p a r t .
No such i n d i v i d u a l i s l i a b l e f o r payment o f any amounts b i l l e d i n
v i o l a t i o n o f t h e p r e v i o u s sentence.
3) I f a p h y s i c i a n , s u p p l i e r , o r o t h e r person k n o w i n g l y and w i l l f u l l y b i l l s
or c o l l e c t s an amount i n v i o l a t i o n o f paragraph ( 2 ) , t h e S e c r e t a r y may
apply s a n c t i o n s a g a i n s t such p h y s i c i a n , s u p p l i e r , o r o t h e r person i n
accordance w i t h s e c t i o n 1 8 4 2 ( j ) ( 2 ) . Paragraph (4) o f s e c t i o n 1 8 4 2 ( j )
s h a l l apply i n t h i s paragraph i n t h e same manner as such paragraph
a p p l i e s t o such s e c t i o n . .
1 1
. 4033. ELIMINATION OF COMPLEXITIES CAUSED BY DUAL FUNDING SOURCES AND
RULES FOR PAYMENT OF CLAIMS.
I n General. The S e c r e t a r y o f H e a l t h and Human S e r v i c e s s h a l l t a k e
such s t e p s as may be necessary t o c o n s o l i d a t e t h e a d m i n i s t r a t i o n
( i n c l u d i n g p r o c e s s i n g systems) o f p a r t s A and B o f t h e medicare
program (under t i t l e X V I I I o f t h e S o c i a l S e c u r i t y A c t ) .
(b) Combination o f I n t e r m e d i a r y and C a r r i e r F u n c t i o n s . I n
t a k i n g such s t e p s , t h e S e c r e t a r y s h a l l c o n t r a c t w i t h a s i n g l e
e n t i t y t h a t combines t h e f i s c a l i n t e r m e d i a r y and c a r r i e r
f u n c t i o n s i n each area except where t h e S e c r e t a r y f i n d s t h a t
s p e c i a l r e g i o n a l o r n a t i o n a l c o n t r a c t s are a p p r o p r i a t e .
(c) Superseding C o n f l i c t i n g Requirements. The p r o v i s i o n s o f
s e c t i o n s 1816 and 1842 o f t h e S o c i a l S e c u r i t y Act ( i n c l u d i n g
p r o v i d e r n o m i n a t i n g p r o v i s i o n s i n such s e c t i o n 1816) a r e
superseded t o t h e e x t e n t r e q u i r e d t o c a r r y out t h i s s e c t i o n .
�Supreme Court Mlies Brighten Drab Routine;
As Justices Return Rom Break, Observers Recall a Few Moments of Disorder in the Court \
ByJoanBiskupic
You know the Supreme Court is'a
place cloaked in predictability and,.It
order when a few gold stripes on the "
arms of Chief Justice William H.
Rehnquist's black robe makes the
national news. During the court's
oral arguments, ritual reigns.-• '
But every now and then, there's
disorder in the court. An officer
misses his cue. A lawyer takes a misstep. The justices get punchy. Here,
as the justices return, today from a •
midwinter recess and begin another,
. .i two-week round, of arguments,, are
. some of the recent lighter moments. •
'They.show, that while the Supreme'
Court is in a world of its own,, it's
i .still of this world. •. • " ,
4
'Walt, Wait, Wait'
Richard Stanley, a Houston lawyer representing Asgrow Seed Go:
in a patent dispute, was ready, for his
. first argument before the Supreme
Court. He'd outlined his case and
carefully arranged it by sections in a
notebook. He annotated and marked
the "plant-variety protection" statute
that was at the heart of the matter.
He had even planned at what moments he would. hpld.up the statute
PHOK) iLlUSTRATlOrj Hf THt WASHINGTON POJT
for emphasis.
Justice David H. Souter't Yankee accent caused contusion In the court.
Stanley's case was the second one
up on Nov. T.'He^recountedi'The
Justice Stephen G. Breyer: "It • the bench, whispered to Breyer that
clerk had told everyone that there's
he had to tell the audience that the
not much time between cases, so as might have helped you, actually."
ruling was not unanimous.
soon as the first case ends, move iip"
e
to thetablesreserved for the law- N w Justice Gets His Moment "Oh, there was a dissent as well,"
yers whose case is being heard.
.When the court issues a decision, Breyer responded and mused aloud
So, as soon as the first case end--"- fhe'justice who has written the ma- that he was surprised he could have
ed, Stanley began transferring his jority opinion briefly summarizes it forgotten to mention it. Actually,
. materials up to the lectern. But un- from the bench before the written there were two dissenting opinions
beknown to him, the lawyer who had document is released. The author and a concurring opinion as well.
just finished had not yet cleared notes for the record whether anyone
away all of his papers. Still in a bit of dissented or wrote separate opin- A Special Request?
a haze from his Q and A, that lawyer ions.
Laurence Gold, general counsel
swept everything up, stuffed it into
On Jan. 18, Stephen Breyer, the
; his brief case and began walking out court's newest and most exuberant for the AFL-CIO, was at the lectern
last term arguing that a huge conof the courtroom.
justice, announced his first majority
"I looked down and I said, 'Oh, my opinion for the court in a conflict tempt fine against the United Mine
i god,' " Stanley recalled. "I turned over arbitration law. But when he Workers should be reversed. In the
! around and saw him [the other law- began explaining his opinion, he got middle of the half-hour argument,
yer] walking out of the courtroom. I . so carried away about the law, so en- Justice Girisbiirg decided she needed
ran after him. I'mtapping[him] on thusiastic about the case (which hap- . a particular document related to the
the shoulder and I'm saying, 'Wait. pened to arise out. of a termite con- case. She gave her request to a mes..Wait. Wait,'.':
.,.„„,
; tract) that he forgot to point out senger who delivered a note to Gold
• Before, the departing^jgjn'er i there was a dissenting opinion.
as he was speaking. "The messenger
knows what's happening.TJtaflley
Both Clarence'Thomas, who sits; / 'put the note down in front of me,"
' gets him to open his brief , case: "I to Breyer's rtghti'ind'CMef faMcdOKiGdld recounted; "and to be frank. I
reached in and scooped the papers Rehnquist, who's at the cento- ..f • w:is Imvim. ir.,„i.i
iout. Literally as I was turning
around, the chief saysj&WKitif!Stthe
; petitioner's lawyer?' »' i'f;-;: j
1 went sprinting up. I had a split
", second where I thought I should say,
'Sorry I'm late.' But I stifled
that...'. Needless to say, it got my
adrenaline up higher than it had
• been."
. (
:
'Let's Kill All the Lawyers'
One of the liveliest arguments this
term occurred over a Florida Bar
rule that prevents lawyers from
sending solicitation letters to accident victims within 30 days of the
accident. Bruce Rogow, challenging
the law on behalf of a firm named
"Went for It," argued that the rule
keeps victims from getting useful legal information.
Rogow: "The high road is to let
the jpublic know . . . that lawyers
serve important purposes, righting
wrongs, redressing grievances. .."
Chief Justice Rehnquist: "Well,
what if the Florida State Bar tries
that and it just doesn't work. People
still think lawyers are greedy?"
(Laughter)
Rogow: "We have fought an image
issue for a long time, Mr. Chief Justice. It's not going to be remedied
simply by precluding these letters
[to victims], certainly not under the
constitutional standards that have
been set by this court."
Justice John Paul Stevens: "We
should probably pass a statute saying
you can't say un-nice things about
lawyers."
(Laughter)
Justice Ruth Bader Ginsburg:"...
And not read Dickens or Shakespeare."
JusUce David H. Souter:"... And
not admit greedy people to practice
;
V.
argument] that 1 decided to not look;',
at the note and just keep arguing." j
, But Gold's opponent, court offi-;
cials and other spectators wondered •
'
what was happening. Rarely is an ar- • •
gument interrupted, and justices are I
not supposed lo engage in secret 1
conversations with lawyers about •
their cases. But it turned out the;
message wasn't intended for Gold.;
Ginsburg, who was in her first term •
at the time, had told the messenger,* '•
who also was in her first days on the •
'
job, to retrieve the petitioner's docu-!
• ment. Ginsburg did not mean .that 1
...the messenger, should get it from j
"the petitioning lawyer.,
•
"The next day, I got a message to '
call the [Supreme Court) clerk im- •
mediately and speak to him person-1
ally. And I thought 'My god, I've !
been disbarred,'" Gold said. But the j
call was to explain the mix-up: "the j
clerk said the young lady was sup- |
posed to have gone to the document ;
room." Gold won his case, and the '
messenger still has her job.
j
You Say Flaw; H Says Flawr ; j
e
When the justices last month ; ;
heard an affirmative action case, the ; '
courtroom was packed. Retired Jus- '
tice William J. Brennan Jr. was in the
hushed audience for the important •'.
arguments.
On the. bench, Justice David Sou- •
ter asked some of the most scrutinizing questions of William Perry Pen- •
'.
dley, the lawyer challenging a •
government contracting program ;
that specifically benefits racial and '
ethnic minorities.
• Souter, whose distinctive Yankee j
accent reveals his New Hampshire |
roots, asked Hendley: "Did your \
complaint specify the presumption j
'[that-racial minorities are economi- |
cally disadvantaged] as being the •
flaw in the statutory scheme . . .?" '
Pendley: "Excuse me, your honor, • •
the floor?' '
'
Souter: "No, flaw"
Pendley: "Oh,
flaw."
Ji
Souter: "The constitutional infir- jj
mity. I'm sorry."
I
J
Pendley: "Excuse me, your hon "[j
or."
'5
' Souter: "It's my regioiiai iiccenf.yi ,
j
(Laughter)
.*
1
�i
f}J;:::}j, ;>
-f : / ; svernmgflp should provide
health
%
_63
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~1
ease
: : . t . • • . •.•.Ufa' • ,
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48
52
:
HsaUU ' : •
!
- 92," survey of 1,C*C'c-dults c-.jn&?3j&k£&5Si£±
:-,v. . i- icfit Research.Injstltute.
June.ii&^J^&±~=L^
:
ary role tn prgvidin$&i&SBGh Jn,Mz.&i'zahs •ftrt-r ontrolling
health^sm^W^
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.
mil t n t
•-•t;e sector
['TTi-'
: l
' MIX. . JL*l F'^.V:'^
60
34
6
lucted for the Kaiser Founilatlori-^aad fijerssn
1992.
ifc should take ihe-tead^in chang%
Neither
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cted for the Kaiser Foundation and the
992.
PHOTOCOPY
PRESERVATION
�Clinton Steps /
On Strike Seen^
As an Exception
Labor Secretary Expects
Intervention in Disputes
Only in Unusual Cases
By DAVID WESSEL
SiafJ f t f a a n e t o; T H E W * L I . S T R E E T Joi--n><ti.
WASHLNGTON - Labor SecretiO' Roben Reich said President Clinton and his
cabinet are "very conscious of the potential danger ot presidential involvement" in
labor disputes, and he expects Mr. Ginton
to intervene only when there are "exceptional, extenuating circumstances."
Mr. Clinton recently helped end a strike
by flight attendants at AMR Corp.'s
Amencan Airlines by calling leaders of
both sides and urging them to submit their
differences to binding arbitration Robert
Crandall. A.MR chairman, said he had
been leaned on" by the president, and
some other chief executives have criticized
Mr. Clinton's conduct.
A president risks "politicizing labor
disputes" if he intervenes too readily. Mr.
Reich told a small group of reporters
yesterday. "You simply don't want to
make members of Congress fall under
some pressure from either labor or man'
agement to get the White House involved."
he said. Frequent presidential interference
might also encourage unions and employers to circumvent the existing government mediation mechanisms.
Asked what criteria the president
should use in deciding wbether to get
involved in a labor dispute. Mr. Reich said,
"The basic criterion is: No. In other words,
there is a very, very high burden of
proof."
"All 1 can say is that there were enough
exceptional, extenuating circumstances
that he did get involved" in the case of
American Airlines, the labor secretary
said. He cited two such ' exceptional d r
cumstances": that the parties were already moving toward some sort of mediation or arbitration, and that the strike
threatened - to disrupt travel for the
Thanksgiving holiday. Even though
American -Airlines had rejected a union
proposal to seek federal mediation. Mr.
Reich said, "the president would not have
gotten involved had it not looked as though
the parties were moving in that direction."
As Transportation Secretary Federico
Pena did in the American Airlines case,
Mr. Reich drew a distinction between the
federal government's helping to push the
parties toward mediation, which he said is
appropriate, and trying to settle disputes,
which isn't. Mr. Reich said he was reluctant to get involved in the six-month-long
United Mine Workers strike, but in September asked former Labor Secretary William Usery to serve as a special mediator
Please Turn lo Page A€. Cblwnn 1
Labor Secretary Sees \^
Intervention in Strike
As Exceptional Case
Continued From Page A3
because he couldn't "in good conscience'"
stand by any longer.
The Clinton administraDon has demonstrated a particular willingness to.get
involved in airline industry mattera.
Messrs. Pena and Reich have been in
touch with management and union leaders
at UAL Corp.'s United Airlines, which is
considering giving the unions a majority
stake in exchange for concessions or shedding flight and maintenance operations
and contracting out thousands of jobs.
Separatelyi Mr. Reich said he is
"doubtful" that Congress will agree to
another extension of federal emergency
unemploymeni benefits, which provide
benefits to certain jobless workers after
their regular state benefits expire. After a
lengthy debate over how to finance the
benefits. Congress recently extended the
emergency benefits to Feb. 5. Mr. Reich
said his staff is working on proposals
to improve the unemployment benefits
program.
THE WALL STREET JOURNAI, TUESDAY. NOVEMBER 30, 199:
�1994 PAY LEVELS UNDER CONSIDERATION
president
Clinton today will decide whether to grant locality pay
1 raises to white-collar federal tooriters iu 28 geographic areas.
The increases are designed to close the hometown Pay gaps between
federal and private sector salaries over a nine-year period The
. 1994 raise proposed by the Federal Saiary Council is 4.23 percent
, for most of the nearly 400,000 civilian federal workers in the
Washington-Baltimore pay area'which extends from the West
Virginia border to the Chesapeake Bay.
Federal employees who already are paid higher rates because of
• tkeir jobs—engineen, scientists and most clerical employees—will
; not get a locality pay adjustment until the percentage amount ofthe
GSIml
1
.. ;v.'* '':
-
3
5
;
7
»
9
10
11
...12
13
14
15
2
Stepl
$12,406
. " •13.948.;
15.221
. ' .17,086
19.116
21,308
23.678
" ' 26.223
28.964
31,898
35.045
,42.003
49.947
59.022
69.427
3
$12,820
$13,232
4 '•
locality increase exceeds their occupation-based differential. Postal
workers, federal retirees and military personnel will not get the
locality raise.
White-collar federal workers originally were due two pay raises in
1994, a 2.2 percent national adjustment and a locality increase.Congress and the White House decided not to grant the 2 2 percent
national raise.
The pay chart below shows what the 1994 pay scale would look like
for most white-collar federal workers in this area. But it is unofficial
. until approved by the White House. If authorized, the raises will be
effective with the first pay period beginning on or after Jan. 1.1994.
S
6
7
$13,644
$14,058
$14,300
$14,706
Jift743':.v:.:iS.135s ; c / i 5 . 3 ( » 7 n r i 5 ; 7 5 4 . •,. ••16,205
16.236
16,744
18.266
.17.251
17>59
18.225 •; i.l8.794::S- > 19,363
19:932; ~ ;2D,501..'':j
"22.937
20.389
21,026 . 21,663 •
22.300
22,727.^ :...?3,437 ,J ; ; 2 4 , M 7 i ^ 2 4 ^ 5 7 : — £ £ 5 , 5 6 7 ; .
25.256
26.045
26,834
27,623
.28.412
27.972
. 28.847 :r "29.721 . : ; 36,596 ' 31.470 "
30.895
31.860
34.755
32.825
33.790
. 34,024 •." '35.087
36.150 ..££37.213
Z- ' .•38,276
39.719
40,687
37.382 '
38.551
42,066
44,802 / .46,202: -^47,602 ;:.:-.49,oo2;:'.. •;50,401 '
54,941
53,276
59!934
56.605
58,270
..62.958 ..- 64.926;.
74.054
76.368
78.682
80.996 •
83.310
:
15.728
17.656 ....
19.753
.22,018:
24,467
27.098 '
29.930
32.961 ,
36,214- •
43,402 :
51.612 "
60.990
71.740
t
;
:
r
S
9
Danger Seen in Falling Jobless Rate
Administration Official Fears Increases in Inflation, Interest Rates
By Frank Swoboda and John M. Berry - V
WMhitftoft FW Sud V r n m
V
The economic recovery could send the nation's unemployment rate below 6 percent next year for the first
time since 1990, threatening an increase in inflauon and.
with it. nsmg interest rates, a top Clinton admiiustrabon
offidaJ said yesterday.
That assessment comes as President Clinton's National Economic Council began a weeklong series of meetings to set budget priorities under the budget law's limits
on spending for nonmilitary programs.
The president must send Congress his proposed budget
for fiscal 1995, which begins Oct. 1, in late January amid
indications he will be forced to recommend major spending
shifts among the various departments charged with such
programs as job training, welfare and education.
In its latest forecast, the administration predicted that
the unemployment rate, which was 6.8 percent last
month, would decline to about 6.5 percent by late next
10
$15,116
$15,521
$15,135
16,655.; . : : : i 7 , i o 5 . ..17.555
18.774
19.282
19.789
:2l';070,21.639
••22.208:
23.574
24.847
24,211
:26.276' . ; ; ; 26,986 - ..'-27.696.'
29.201
29,990
30.779
32^45. ...33^19
34.094
35.721
36.686
37,651
39^40 •;.:40,403
-'41,466
43.224
44,393
45,561
51.801 . .'..'.53.201.
'54.601
61.599
63.263
64.928
.72,797 ...74,765
76,733.
85,624
87.938
90.252
1 can't see the official forecast changing very much,''
either in terms of economic growth or unemployment,
Laura D'Andrea Tyson, cbairman of the president's
CoundJ of Economic Advisers, said in an interview yes^
terday. Administration economists are working on an updated forecast to be nsed in the president's budget subHowever, some other administration officials think a
much faster drop in unemployment is possible, partly because of the relatively rapid increase in jobs over the
past year.
Since October 1992. the number of people with jobs
has gone up by about 2.5 million and the unemployment
rate down by 0.6 percentage points. Some analysts beBeve the decline could be greater in the coming year as a
result (rf faster economic growth.
T would say that in the next year we could be down to
5.8 IpercentJ, in the range of 5.8. 5.9, under 6," said the
top administration official, who asked not to be named.
If jobiessness does'come down that fast, the adminis6 « UNEMPLOYMENT, D2, CoL 1
Concerns About an Increase in Inflation Cited V
employment, the admimstration needs to develop costly
UNEMPLOYMENT. From 01
training and income maintenance programs at a time
tration and the Federal Reserve Board both would likely when concern over the federaJ budget deficit has all but
seek to slow growth so that the economy would not over- eliminated fiscal policy as an economic tool for the White
beat and generate stronger inflation.
.House.
When the unemployment rate fell below 5.5 percent in
The administraticm will be faced with an addiuonal po1988. pnces began to go up and the Fed raised short- htica! problem early next year when the Labor Departterm interest rates to cool off the rising inflation.
ment changes the way it surveys U.S. households to deSome administration officiate have expressed concern termine the unemployment rate. These revisions are
that the nation is not far from the point where broad eco- expected to add more than a half-percentage point to the
nomic policy measures can no longer be used to deal with official unemployment rate.
tbe problem of unemployment without triggering more
This week, the National Economic Council will considioQauon and a response by the Fed.
er a comprehensive training and adjustment assistance
However, with a national unemployment rate of 5.8 program to aid workers who have lost their jobs through
percent, there wou)d be pockets of much higher unem- cuts in defense spending, trade and environmental poliployment in some states—including politically important cies or any other government policy initiatives. Clinton is
Calilamia—as well as m many inner dties.
expected to outline the program in his January State of
To deal with these problems of so-called structuraJ un- the Union address to a joint session of Congress.
�Clinton Presses Ukraine on Disarming
9
Kravchuk Told of U.S. 'Concern Over Nuclear Treaty Conditions
By Ann Devroy
President Clinton complained
yesterday in a phone call to Ukrainian President Leonid Kravchuk
that hjs country is failing to meet its
pledge to give up ils nuclear arsenal. White House officials said.
The White House said the 30minute Clint on-Kravchuk conversation produced a pledge by Kravchuk to resubmit to a new parliament to be elected in March the
ratification of the START I treaty
and Ukraine's adherence to the nuclear Non-Prolif era tion Treaty.
The Clinton administration has
spent nearly a year trying lo coax
Ukraine, with hints of vague security guarantees and economic assistance, to fulfill its pledges to give
up the nuclear weapons left on its
territory when the Soviet Union
collapsed.
TODAY IN CONGRESS
SENATE
Not I T VRWon
Cotrmittce.
R n m c * — 1 0 a m HMtth (or l * m i l * *
and the uninsured subc. Chitdren %
hMitfi unflet healtfi care reform. 215
Otftaen Office BUg.
HOUSE
Not in sewon
Committees: none.
White House press secretary
Dee Dee Myers said Clinton "expressed his stprt-of unhappmess"
and hjs "concem" about the "incomplete action" taken by the Ukrainian
parliament last week in ratifying
the START I treaty with so many
conditions attached it was considered a negotiating document, not a
true ratification.
The conditions include a demand
for substantial financial compensation for giving up the weapons
and security guarantees from the
West and Russia to protect
Ukraine once it becomes a non-nuclear state. Ukraine also commits
itself only to a stage-by-stage disarmament of the 176 former Soviet nuclear missiles and 1,700
warheads on its soil.
"The president expressed his
concern . . . about this incomplete
action on START I and the protocol." Myers said, adding. "We
expect Ukraine to live up to its
nuclear obligations.!? She said- the
two leaders discussed "economic
cooperation" .but would not say
whether they - discussed precise
levels of U.S. or Western aid to
Ukraine.
The START I treaty requires
nuclear reductions by the Soviet
Union and United^tates. When the
Soviet Union collapsed, the four
republics where nuclear weapons
are located. Russia. Ukraine, Be-
larus and Kaiakhstan, were to ratify
the treaty and the May 1992 protocol that calls for the four to abide
by the nuclear Non-Proliferation
Treaty.
Myers, who described the conversation as "frank and open." said
Clinton
welcomed
Kravchuk's
promise to resubmit the treaty. But
officials could not explain why they
anticipated any different result in
March than that produced last
week. Kravchuk has since publicly
said the West should concentrate
less on treaty ratification than on
providing the economic and other
assistance needed to destroy the
weapons.
Ukraine has received a string of
high-ranking Clinton administration
officials, including the secretaries of
state and defense, but the nuclear
issue remains unresolved. Kravchuk
has twice put off trips to the United
States because of the dispute and
Clinton will not meet with him in
Ukraine when bennakea a brief toot,
of the region in January. Tbe president is now scheduled to visit Moscow and Belarus.
Myers also told reporters that
Clinton phoned German Chancellor
Helmut Kohl to discuss world trade
talks and the January NATO summit that Clinton is scheduled to attend. China also was discussed, she
said. Clinton met earlier this month
with the Chinese president and
Kohl recently visited there.
�Hospital Association rees Add
Millions to Patients' Expenses
Industry Defends Costs of Lobbying, Research, but Critics Scoff
governments are trying to control
health care costs.' Hospitals in the Washington area
Johns Hopkins. Hospital spent spent about $5 million last year to
J 111.000 this year to be a member be members of statewide hospital
of an association that lobbies the associations. Pan of that money
Maryland General Assembly: In the went to support legislative lobbyDistrict, Washington Hospital Cen- ing, and hospital officials said it was
ter spent $185,000 to make sure its a legitimate expense representing a
voice was heard by the.D.C. Coun- fraction of their annual budgets and
cil. And in Virginia, Fairfax Hospital costs bome by patients. For examspent $78,000 for lobbying and otliT ple, the amount Fairfax Hospital
er services.
spent last year is a tiny part of its
In the case of those and dozens of overall budget of $335 million.
other area hospitals, the fees were
"My association exists to put the
ultimately paid by patients, and in- facts before tbe decision makers,"
dustry critics say those expenses said Richard H. Wade, a senior vice
are^unfair. especially at a time when president at the American Hospital
the Clinton administiation and state Association and a former spokesBy Thomas HtaUi
HOSPITALS, From Bl
5
1
tion for us, and they have not done
so."
Charles Inlander of the People's
Medical Society in Allen town, Pa., a
health care consumer group, said
hospital association dues "are an
absurd fact of life."
"In every one of your hospital
bills, you are paying the hospital to
go to Washington or the state capitol . . . to make sure we have no
power in the system," Inlander said.
In retuni for association membership, hospitals get a public relations, research and lobbying nel" work that tries to have an impact on
national, state and local legislation,
as well as on regulatory matters.
Like other trade associations, those
serving hospitals have staff researchers and policy specialists
trained for rapid response to legislation and regulatory proposals
that can affect members* interests.
"The hospitals" imprint is enormous," said Maryland state Sen.
Thomas P. O'Reilly (D-Prince
George's), chainnan of a key committee and one of the architects of
landmark legislation designed to
overhaul Maryland's health care
system. They may speak grandiosely about how the world is going
to be better if certain legislation
passes, but in fact their role is looking out for the hospitals."
In recent years the Maryland
Hospital Association has helped
form legislation affecting competition with physician-owned businesses and state payments for
emergency room visits. Last year in
Richmond, tbe Virginia Hospital
Association led the way in defeating
a proposed "sick tax" that Gov: L
Douglas Wilder tried to impose on
hospitals across the state.
Nationally, about 4.900 hospitals
are members of tbe American Hospital Association, which has headquarters in Chicago and maintains a
70-member Washington office just a
few steps from Capitol Hill. Smaller
hospital associations are in nearly
every state, and they share infoimation, intelligence and research
with the AHA through an alliance
agreement.
Another giant is tbe Federation
of American Health Systems, which
represents about 1.400 for-profit
hospitals. There also are several
. other associations representing
Catholic. Protestant, childrens' and
other hospitals. Most associations
man for the Maryland Hospital As-,
sociation. "Without as. the public
would lose representation that af- •
fects the quality of hospitals. The
benefit to the public far outweighs
the money."
Critics said hospital associations
are of questionable value to patients
because the associations are chiefly
looking out for the interests of their
member hospitals.
"It's not clear to anybody that
there's any benefit to the patient."
said Lowell S. Levin, a professor of
public health at the Yale School of
Medicine and a frequent cntic of
the U.S. medical industry. "The
hospitals have to answer this quesSec HOSPITALS. BT. CoL i
HOSPITAL ASSOCIATION DUES
H
ospital associations charge their members
annual dues to cover most of their costs Critics
say those dues are unfair because it is unclear how
patients, who pay for such expenses, achieve any
benefits. Here is a breakdown of selected hospital
association dues:
D.C HOSPfTAL ASSOCIATION
Members: 17
Annual dues
• Highest: $185,000
• Average: $57,000
• Uwest- $10,000
-
VWQHU HOSPfmL ASSOCUTWM
Members: 120
Annual dues
• Hiftiest $26,489
• Average: $10,800
• l o w e s t $2,650
•MmriJUtD HOSPTTAL ASSOCUTKM
Members: 68
Annual dues
• Highest: $115,000
• Average: $32,900
. • U w e s t $1,000
AMEnCAN HOSPITAL ASSOCUTKM
Members: 4.900
" Annual dues
• Highest: $80,000
• Average: $10,000
• Lowest: $950
SOURCE.
and many have political action com- university official said the hospital
probably recouped its $115,000
mittees that donate to candidates.
In nearly all cases, hospitals pay membership fee through saving on
dues based on their size, with the purchases made through an arm of
biggest paying the largest shares. the association.
The AHA takes in $61 million annuDena Michaelson of Washington
ally in membership fees; state hos- Hospital Center, the largest nonpital associations and other trade profit hospital in the District, said
groups take in well over $50 million a the hospital's $185,000 annual dues
to the District of Columbia Hospital
year, according to industry officials.
The 68 member hospitals in Mary- Association buys it a unified voice
land's statewide association pay an on hospital issues.
"It's the single voice that gives us
average of $32,900 in annual dues.
Virginia's 120 members pay an av- the opportunity to comment on legerage $10,000 apiece and the Dis- islation or regulations that affect all
trict's 17 members pay $57,000 ourpatienis."-Michaelson said.
. Levin, of Yale's medical school,
apiece, according to those hospital
associations. Dues for members of said the membership dues are not
the American Hospital Association "wholly wasted." but questioned
range from $80,000 for the group's . how much of the money actuary
22 biggest members to a low of about helps patient services.$1,000 for some government insti"If they want us to believe
tutions. The AHA average is about $185,000 on membership is worth
$10,000, according to officials.
it. 1 want to know how that benefits
In response to the concern over the patients," Levin said. "Hospitals
costs, the Massachusetts Hospital have not accounted for that benefit.
Association froze its dues this year, It raises a serious question of acand several other state groups are countability to the public." •
Spokesmen for several hospitals
considering doing the same, assosaid it is impossible to calculate any
ciation officials said.
The associations say their job is financial benefit that patients get
to be advocates for the hospitals, when their hospital is a member of
but add that they perform other an association. But specialists say
functions as well. The groups hold the cost to patients is minuscule.
educational seminars and conven- Everett Devaney. administrator at
tions, share research to improve Fairfax Hospital, estimated that
quality, save hospitals on large drug membership in the Viiginia assopurchases and advise members on ciation costs each patient admitted -"y
to his hospital about 50 cents.
employee development.
There is no fat." said Campbell
The University of Maryland
Medical Center employs its own Thomson, director 'of communicaa™..
lobbyist, but also is a Tnem^T nf ih* tion^ far | h „ p ^ ^ f r . "
�VR OTR SE
EMNES EK
LE A O HAT
EWY N EL
Criticism F r o m Insurers
The Clinton plan did noi escape criticism. Veronica Celani. a member of the
state Heallh Care A u i h o r i t y . said she
feared its cuts in Medicare and Medicaid would be too deep Pat Nowak!
representing insurance agents, object'
ed to the proposed limits on how fast
insurance premiums could go up, saying. " A lid on a pressure cooker ihat
keeps boiling w i l l cause an explosion."
Jeanne Keller, speaking for the Vermoni Employers Health Alliance ar
gued against the Clinton plan's approach of having only one insurance
purchasing cooperative in an area. She
contended lhat competition among
such cooperatives, called " a l l i a n c e s "
in the Clinton plan, would reduce costr
and improve service
Governor Dean said he had noi rec
ommended a single-payer plan — instead, he proposed one in which em
• plovers pay half their w o r k e r s ' premium's — because a single-payer scheme
flew in the face of "political reality " ll
would be politically impossible, he said
to raise taxes $600 million lo fmance s
single-payer system But many of his
constituents disagreed.
Michael J. Daley, speaking for the
Vermoni Consumers Cobperaiive for
Health Care. said. " T h e smgle-payei
approach may not appeal to Congresr
or the President, but ihe people know
what is in their best interest. So what
ever gets done on the national level
please leave stales like Vermont free
to choose the best solution."
State Senator Peter J. Shiimlm ol
. Wyndham County, another of the 42
speakers at the daylong hearing, insisted: " W e in Vermont can conquer the
insurance industry. I t ' s going to hap
pen state by state."
Senator Jeffords told t h e m repeated
ly that he was committed to making
sure that' the option for a state tc
choose a single-payer system, which is
p a n of Mr. Clinton's proposal, remained in the legisianon.
State With Own Ideas on Care
Asks Senators tor Choices
:
By ADAM C L Y M E R
S p r o i l i e TTw N r * Y o r k T i m r ^
V BRATTLEBORO, Vt., Nov. 29 — Vermoni is ready to revamp ils health care
svsiem on us own and wants the Federal Governmeni io get out of the way.
or maybe help jusi a liitle. dozens ol
wnnesses lold two Uniied States Scnalors lodav.
" W e will need some help f r o m ihe
Federal Government." said Gov. Howard Dean, who is a pediatrician. For
one ihmg. he warned assurances thai
ihe stale could require employers io
pay health insurance premiums regardless of the fate of Presidem Clinton's effort to require thai nationally.
Several speakers wanted to be sure
thai Federal legislaiibn would permit
Vermont to impose a '•single payer"
svstem — that is. one financed entirely
by siaie government. Oihers_ urged
Washington to reward Vermont's etf o n s to hold down Medicare and Medicaid costs.
Senators Edward M Kennedy of
Massachusetts, chairman of the Senate
Labor and Human Resources Committee. and James M. Jeffords of Vermont,
^.the only Republican co-sponsor of the
Climon health care legislation, kept
reassuring the Vermonters. " W e ' r e
i r y m g 10 give a lot of f l e x i b i l i t y to the
slates." Mr. Kennedy said.
In the Vanguard
The speakers ai the hearing today,
one of dozens on health care that lawmakers will conduct before Congres;
reconvenes on Jan. 25, was very supportive of Mr. Clinton's proposals, with
Governor Dean, a Democrat, saying
that the plan, should be speeded up
Last week, the Governor proposed universal coverage in Vermont beginnine
in 1995 — three years before M r Clinton's plan would cover all Americans.
Dr. John Chard, representing ihe
Vermont State Medical Society, said
this state s dociors supported "global
budgenng" — the idea that govern'
ment sets an overall l i m i t on how much
is spent for health care — as Jong a<
ihey were freed of antitrust rules that
keep them from bargaining collectively w u h government over what goes into
thai budget.
Dr Chard also said he favored in~cluding patients of both Medicare and
Medicaid — programs thai serve the
elderly and the poor, respectively —
within any national system. And ht
said future Federal aid should reward
. stales like Vermoni that already hold
costs down.
Senator Kennedy, an advocate of na
uonal health insurance since 1969
praised the stance" of Dr
Chard's
group. " You have real credibility on
these matters," he said. '•"This is never,
going to work unless we have the providers very much involved."
O O N O T FORGET T H E NEEDIEST!
THE
NEW
YORK
TIMES.
TUESDAY.
KOVEUBEF SO. 199:R
a
�But Lots of Skepticism From Workers in Quincy, 11
1.
I thing the country' needs,'' reasons James
Flone. a 50 vear-old roofer who is Leland
Lang s boss.' ' Bui it s like looking at a new
car. Looking doesn't necessarily mean
you're going to get thai car."
At the same time, they will be dismayed
if the confressional debate curdles into
raw partisanship or special-mterest power
plavs. They may not love politicians, but
they aren't wild about the current healthinsurance system either.
"I've seen how premiums go up afler
somebody's been sick." says 45-year-old
Susan Hummelsheim. who once handled
Blue Cross/Blue Shield claims for a pnvaie
group here. ' I've had to listen to people
say. My God. they're going up again^' "'
Heallh care is an issue that-touches
people personally. Most everyone either
has had a serious illness, knows a person
who has. or lives in fear of the financial
devastation that one might wreak. " I ll tell
you. I'm for anything like this."' declares
72-year-old Neola Brown. She lives on MS5
a month and womes that, despite Medicare, she is one prolonged illness away
from financial disaster. If the worst comes,
she says. "I've got this house and they can
just take it."
But what people keep coming back to.
again and again, is the cost of compassion.
Where do you draw the line^ How do you
draw the line? "Some people do need this, "
says Dawn Earley. an IS year-old student
ai the Quincy Beauty Academy. 'Bui
others u-ill take pdvantape of it."
Bill Hanley. 46. would limit coverage to
"the poo; and disabled. He is a man who
keeps an open Bible in his one-man autobody shop - his business sign outside,
quotes from John 3:16 - and helping the
helpless strikes him as the Christian thing
to do. But you cannot support every: body.' he emphasizes. .'Why should we
| take care of prostitutes who abuse their
bodies and ,get AIDS?" His bottom-line
instinct: "Anything the government gets
into, ii seems to get out of control."
Although instinctively cautious, people
hereabouts often display an altruism that
might surprise the partisan wamors of
Congress. Ms. Kuse. the small-business
woman, thinks the Climon plan would
probabh cost her beauty salon more. (The
salon already picks up part of the insur
ance premium for employees who need
insurance, i Just the same, she is ready to
pay that price.
"It would.make my employees (eel
more secure." she says." adding: "I keep
overhearing customers who just don't feel
well, but don't go to the doctor because
ihey don 1 have insurance. 1 think that's
pretty sad."
At bottom, says former Adams County
Democratic chairman Mel Koch, people
here aren't ideologues, they are pragmatists. and their instincts are rooted in an
earlier era in American politics. Democratic headquarters is called the Tmman
Social Club, and inside Mr. Clinton s pic
lure hangs on a side wall while Harry
Truman's gets center stage. Mr. Koch
searches for an adjective to describe area
voters and finds one: "hanl-headed."
So perhaps it is not surprising that Mrs.
Hummelsheim promptly pulls out a pocket
calculator when asked about the Clinton
plan. Mrs. Hummelsheim. who now helps
sell cooking utensils and gourmet coffee at
the Quincy Steamboat Co.. does some
quick figuring.
"Our family probably pays S800 a year
in insurance premiums right now. I can't
see that the Ginton plan would be much of
a hardship. People worn.' that the plan
would switch them into HMOs But companies are switching their employees into
HMOs anyway.
"This is one of those things you hope
will turn out all right.''
:
2\X
Clinton Wants to Allow U.S. Subsidies
For Firms That Hire Welfare Recipients
By pAi Lcm: THOMAS
Sic//
Rrporirr
o / T H E
W A L L
STHCrT
JOL-HNAL
WASHINGTON - The Clinton administrauon. as part of its plan to overhaul the
nation's welfare system, wants to allow
government subsidies for employers who
hire welfare recipients and to pul others
into community service work.
President Clinton listed welfare reform
among his campaign promises, and has
outlined a broad plan to require parents to
work after a two-year stint on the welfare
rolls. The president s advisers are considenng many options for ways to create
those jobs, they" say. An administration
welfare task force is to present options
• to the president next month, and plans to
have legislation on Capitol Hill early next
year.
Job subsidies, which were mentioned in
a New York Times article yesterday, maybe one relatively easy first step. Stales are
already permitted to subsidize employers
who hire welfare recipients, but one strict
stipulation applies: Subsidized jobs must
be newly created.
New legtslation would be required to
allow subsidies for employers who put
welfare recipients into existing jobs. Last
year's urban aid legislation would have
expanded the use of government subsidies
in just that way. but President Bush vetoed
the bill for other reasons.
The notion is to expose welfare parents
to the world of work, and give them some
experience to build upon. "It s just one
piece" of a broader plan, said Bruce Reed,
a senior domestic affairs adviser to President Clinton. "What's important to us is to
put a strong emphasis on connecting welfarerecipientsto the private sector."'
But it's highly unlikely, m'such a tepid
economy, that job subsidies alone would
suffice to put welfare recipients to work
after two years. There are now about 1.5
million people who have children over the
age of six and have been on welfare for
more than two years, according to congressional researchers. "There wm be .
some community service jobs that need to
be created, there's no question." said Mr.
Reed. Those sons of jobs have been med
with varying success in the past bv manv
states, but it has been difficult to create
real work because public employee unions
have fought off attempts to allow welfare j
recipients to do many government jobs.
Republicans on Capitol Hill have also
introduced their own plan to change welfare, which is similar in many ways. Ii
Please Turn to Page AS. Column i
Clinton Seeks Subsidy
For Employers Hiring
.Welfare Recipients^/
Continued From Page AS
calls for required work or training for
welfare recipients, arequirementto establish paternity for welfare children, and to
have substance abusers on welfare undergo rehabilitation programs and submit
to random drug tests.
The administration has already demonstrated its intent to reform welfare in some
ways, mainly by giving states more leeway
to experiment with their welfare loads.
Last month, in the most telling example,
the administration approved a Wisconsin
plan to conduct the most stringent experi
ment yet - limiting welfare payments to
two years, with no guarantee of a job
afterward. The expenment is limited lo
two counties. The Depanment of Health
and Human Services must approve individual state's welfare-reform plans.
THE WALL STRECT m n i K A l . MONDAY. NOVEMBER 29. 1993_
�i
i
;
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..JI . . . .
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Wathint^Baicau O M T .
• .•'f.{»»..;<fi;...\ . . .
. . . . . . . . .
'Mtonewta's b a h h care n u j t c i pro- .
S ^ n * ^ . M d n V f r a l : proof : l h » l . m a i t e l v . c a a
«H. ^.SviMV' .M.'hMh.fnialilv . al rrauwahle '.
' . V i i q t n s Ki(h q u l i l y >l m n a a b l e
i c o a ^ ' . ' s t l i Durenbenjn- ia.loutinB
; Hhe l i f e ' s heattli care. mar k n aa: a
I n o d d l D r Ihe nation. ..
:
,
mmm^ : •
,
EALTH
CARE:!
.
maJieri ( " T t n c r a t » l e i « T c l T ; d i b i l |
» l Iheir d i l l e m K n . T k a l i r i l l l c k a n n
-umiaht • a tl:: a ' t'S lti arr:^T rriib « h e //W'C t^ 0
umighi a a S l : T buhe ^ C !p
healtlv c a i r fonjirlj wkere^Durniberp a aad W d M o n e w i n b e j a n n f bi*
Jadilk Feder. a high-taalm>B.hcaltH
official i a • I he'; d u l l o o •adoiWntttf
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;We«uoiie ia not so iiptiHit. 'woniiia»
1 . i c S m « ' i dtsisil.
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• i l o n radi end
liebrbadcaal ia I B c n u r e t ^ D c L - . » ™ •
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my
• A B O U T F T . . i'.'.parti that raaay insurance coirtfiairy. W C T O . T \ . C h n d 4 : . v ^ ; ^ J * , ;
m - m a and
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I interfere.with doctor.... ,.........
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the h a e n d .
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'DuranbcittT'
: I t ' a ^ a m i u U e n i i o t h ^fer) m e i n t i e n l ^ l H : Miancaota heallii companiea t U t ^ ^ u m - j e n e m l y - a j m r n A ^
^ I ' r o f t e n • w e t j t o r n the same state t o be-on a Senate • .Dmenbciter admirea, are c i l r d . b y ' r a c n f i n n a l e m e a u l a d ' o e w a l R
n i h i ^ ' Uief oflen/csifceled
each
oamnKiee H«cthcr. But it's v m a a l l y , -Wellitone. as e u m p l e x of whai's
l e a n , but withoat raach lateractio^j'
WIICTV v ^ A i i T j O T . AJ«J on
no
'
.
j ' A ' r a r e s k i r m i i h occarred lasraieek ar.
i s m a n Oic^ furtlicT a p u l I h w «hn
U h n r C o m m i h c e Ittini<^!br("l6e/
insmaace i o d m r y W e l M o i e
his' q u e s t i o a i t i m e l o ' c r i l i c i T t B '•
•
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M
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iM-i-ai-r 'fi!
:
'-/sSW-i- • '»! •'
tll^bunion^compeaiauoa rpadogk.
:ractned by WiUtam MoGiiite, CEO
n r . M m n e s o M M s e d United^ Health
C m Catf., which owns and opentes
hcriltipbaaacmalliecominy.
'
J W ? •lAt'.MH.jfl .toi»w.«s-re"..Ki
T h i s high salary is one o f t h e t x s t m
and ' D a w W & i ' m s o o s why people, are beeomini h T B a r w i n d e b a f thohr t W l a K
wary o f where all o f this Inuaaeed
Pncca asi h a s l l h c a r s l o n l ^ L ^ j . .
! ctanpeulion] is e o i t i t " : Wellstone
He then chidesl W d h t o w e . saying r f t
is maeh easier to talk a b o u T S n
i«fcd. w i t h praise • m i l l i o n - and harder to .explaiiTiae
for the cmnpuiy's efTicicocy and convalue o f ianovationa t h a t - U p i w
. " T h i s salary " i f * Health Care h a i i n t r o d u e t d . sodl. ai
that there is 10 n n c h btoat m this "leport cards" t o help o o n n m e n a e . .
: system by which cons can beterhiccd leel Ihe best prb»iders.':'; . • ' . ; t y j ) ,
l l h j l t h o r i s aomehody out there who
.•.mo 1
can snake Hn tl much money by d n n m .
ti a
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�MOV.17 '93 e3:i5flH STAR TRIBUNE PHOTO
P.12
l
< Gare^he two^enators jiaye
visioKs of what Works and wh^
•
;
'
!
.
community :climci ind providinj "•in|le-p>yer hti the virtue of toundln| vet> limpie.
artforii:.
i
Wtllnoiic docin't put • ireit deal of
.
•
-:feith in th« idei. ayinr th«t in i n : , In Wuhiiijion, W.Ilitonc i ipproith ' Thn experience told ut 'we've foi to
be able to explain in (ood. limpie,
clearlinjune whet minijed eompelilion i i about, becaute people do not
chance of paaiaje. Bui il doei very want a complicated lyitem. We'll tr>
•well in jovemment coat-control rud- [tonithi] to deliver thai meiia(e
Fundamenully. the two men have a : iei and public opinion forumj.
;. clearly." r,--,---,
differenl viiion of health economict
and'poiential loluuoni lo problem Durenbeijer ! HifF wa« atunl recent- Al ihe same time, he said, Durenberly when a vcitiieni jury" atudyini ter want! to warn thai the Clinion
tn heallh care. Y .
heallh rafom went but of ill way to protram's reliance'on govemmeniFor veara in the Senaie, Durenberfer uv ii preferred Weliitone'i plan. Al- retulated price limits "are harmful to
hu been an advociie of nianated. ihbu(h the jury didn't formally tn- managed competitioa."
, , care and markei-baitd reformi, em- done it, thev rdected propoaali adcan: «n m. «:.-u.~».
: . bracing'many ideu developed by Dr. . vocated. by Durenberter and repre- TomihVs discussion will be' present:
' Paul EliWood. a Minnesota physician • sentatives of the "<"""< admimslra- cd.io a small audience in Minneapo—"<'"•" " ' Clinton administra..•who'encourajed healLh maimenance tion. Durenber»e.-'s staff hopes to ap- lis'made iip partly of citizens who
'•>- oraariiiations IHMOl) here in ihe ply lessons from that etpenence to- participated iii town forums on
ply lessons from that •«(
heallh reform: The Minnesou House
.,;iS.iPt^
.. n,th:^: , ' >
.J>
deleiaiion -will alsd panicipaie. Scg-'lVj^r.*beT»eri j»pu'iation is built on v - ^ ^ ^ i | e r ^ ; D « ^ e a l l y aur- . menu will be shown on Channel 4'i
10 p.m. news; the
diicusiion
ft an undentanditii bCthe intricaciei of prised by the jury;r.Baid Rick Evans, .be broadcast Dec. 9full 7 p.m. • will
°.«*:^ „r*h* tntn^i-jti of
at
heallh •system'and .the- concerns of
-'- - ' ^Mntinier't chief of itiff, because
v providers, manajed-care companies
'itn'd d6nors,!>Thls year, b« has joined
3f Rep. Jim .CooperV.EVTenn., to.offer
IS the;M»n«iea.Competiiion'Act,'-buili
-Taround • thebii? that Presidem Clin-.
Sf.toh embraced durina the presidential
^campeiin, ehd'one baeked by major
j .insurance interesu..Durenbener says
! ' that Miilnesbu'i experience-with
competitive- health plans shows tha!
•.ihfcpnvaie'aeftbr.can .deljver hi|hi,Valiiy'reariSit-. a: raaionable eon.
' Trhat uVo'thethlni ibveniment will
'Veftr do.VHfefM*; f'-'P," .'
.Cootinuid from ptgt IB
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^Weilitoni 6f,coursefieesiniieoiier.
v r / W i favors 'national health inaur-ianetShich.'would put privatt.bturv eni'Vouti!bf •tuiineav: Hr. has mtro;
- SlutM»l<iiiSatlon-based :)ir|ely.ion
VCknada's single-payer sysum that so
" diiwn the. most •iipponjof
v
L
BSHeSwelooioes rtht beil.of,ti>aBfied
Ifcare'dritb a sinilo-pawajTOmSBut
ISheTlbraki'' Mirmsaou'sriiadiuonVof
I"hdilUiSSe it3mWybnd HMOs.
He ptaises the atate's tradition of
,,
E
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�First
to
Visit^Atlanta; 'j
••-
i •;
-
M
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;lt wlllbe nrtanheimi care. \S*}
' ITAJT WRITBl - „ ..'.ji. -V ' -i .vin>o.,iaasembly at; Ooorgili;
;
••
] -Baptist also will be BvaUab^
' Hillary Rodhbm: CUntoii I4 -teleconftreticetodoctors In^Mtf-;.
•dtediilad to -yiili. Atlanta: on eon, lAnsuita,^ Cotanbui.'Savan-i
Mcmdny[to <lljcos«,the ad^ilnla, nah and Albanyi MAG said..' (..
Mrs. Olntoij. recenlli.^h<V
trallonV health" "' '
v'boen'trdvellng to dlfrerent psttj;
care •, (reform
, .of the'pouritry to build support:
plan,with every
,.' for Preeident ainton'splftn.. ' /,
attentive audi' . . Het 'Atknta appearance Wk}
ence: Georgia
' dlcates'.she carer what physl-;
doctors., '•
clans, r think," said P^sdUa.. Mra ainlon,
.<Davee, vfr' MAO- spakesvromaii^,
wlio. . led the.
^Thla Is a-very cbncillatory'ge^'-l
While I House
lure im her part."
.•.'.!
tapk'vfnrce' on
„ , Doctors,', groups In Atlanta:
tienl^h '(reform, |HI|lary , ,
' and thraughant the nation havb:
will apead" at Clinton
Geqrgl^^aptlat.Medlcal Center /.crtUched, parts of the admin*-;
; In i ; fonilTi>iapohaored by the t«Uoh'«ikan. : ''V' - . 'Vv.';
Paul Shanoir, MAO executive
' Medlcal' Aisoclatlon of Georgia,
which Tspi'esems 'more than 'director,' said Mra. Clinton W^tfts
7,000 doctora In the atale.
ito fthd "common giwrncR'-yiQi.
'i - . While the White House did ' doctbrs. - ' " • •
not glveldeialls pf her Itinerary In
Shanor'aald|tlie retorm plfai
Atlanta, MAG 'offlclals said a " "Is so niajjtve, people ire havlnp
mnlr. theme of UJB first lady's yls-. IrooWedlgeatlKft.'*
••'ByAndyMHerV-"-
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First lady to visit;Atlanta: i
for di^lbgue wii^ottbrs
;
:
By Andy Miter-
:
:
;lt.^' be'iiiMnt^ci*^,
- ..^ipw .iMBonibly at ; OBorgfli;
•
v/: . :vi: :
; -BfljHist also will be avillib^ ty
'-•'Hillary Rodhtai: atnton I4 -teJectaiiBreace to doctors ln:W;.
schediikid. to .visit. Atlanta: on oo'n, iAuguita, Cohanbus,' Savsri^ Mond ay ito-discuss,the adihlnis^ , nah and Albanyi MAG said,.' (..
Mrs. dlntoif. recenllr.^!
tratlon's' health
—:—:—;
.'been'trivellng to difrerent par^!
care , I reform
, .of the courilry to bufld support'
plan, with a very
,. for PresliJent CUnton's pisn. ' ;;
attentive audi. : Het'Atlanta appearance "Hh?
ence: Georgia
* dlcatea <she carer what phyai-;
doctors.; •
olans / think," said Prjscillft'
Mrs.'ainlon;
' Daves, MAO' ipakeswornaiLi
wlio, , led the.
^This Is a-veiy cbnciliatory'tafl-;
While I House
hire on her part " .•.':,'
tapk : force on
.,/>. Doctors.'^groups in Atlanta.
henl(h '|reform, iHlflary ,
' and throughom the nation havb
will speak at Clinton
Georgia Baptist.Medical Center crttlched, parts of tbe admlnto-;
; tn ij; forum»spohsored by the '•' twUoh^'ptohi'!'V-''V' - - 'Vv.';
'. Medical' Assoclatlon of Georgia,
Paul.Shanor, MAO exeoutlve
which rept'esems. 'more than . director; said MiiL Clinton vM>
7,000 doctors In the state.
• ; to find "commoo groontF,'>jll)i
, WhUe the White House did
not give details of her itinerary In
Atlanta, MAG 'ofBclals said a .. Shanoraaldjths reform pifai
mnin (home ofttjefirst lady's vls- "Is so nisssive, people are having
trouble dlgestiPB h."
•JTWWRITK;
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.'dociors -••-••:•* •
�ftWo-rJn
First
to VisitJMaiita; ;i
for dialdgue witfe^octors ^
By Andy MHer - :.
•STAITWWTR
V'
ii^;...-.:^:vi:-
;it wfll be irtsnlieahti care. % # J
j - ..„!!!» .'Maenibly: at; Oeorgik;.
: . 'Baptist also will be avallebtp
/ • 'HUUry Rodham:. Clinton l * -telecon&iwice to doctors In^Mit-;.
Scheduled. to ,visit . Atlanta: on cos, .Anguila, Cohanbus,' SavaiH MondayltO'dlscusj.thB ad^ilnls- nah and Albanyi MAG said... •'(..
tratlon's' health " "
Mrs: Olntoij. recenUi.[ hp'
care , I reform
V.beer:traveling to different psttp
plan, with a very
of the: country to buiM support
attentive audi, for President Clinton's plSn..- i ;
ence: Georgia
". Het"Atlanta appearance Till-' ,
doctors.;
'dlcates'.she carer what phyii-;
Mrs ainlon,
olans.,think," said Prjscilla.
who. , led . the,
- Daves, >>»; MAO - spokeswoman^,
White [ House
l^Thls is a-very coneillatory'ge^^
tapk'.. force on
hire on her part."
!
hcnljh' "Irefbrm,-,Hl|lary ,. . '
Doctors; ngroups In Atlanta:
will apeati at Clinton "
' and ttimughont tbe nation havb.
Georgia paptiat.Medlcal Center - crttlched, parts of the admlnto-;
; in forum>isponsored by the • traU6h's"irfBn.'!V''V- -Vv;;
' Medical AjBoclatlon of Georgia,
Paul Shanor, MAG exeoutlve
which -repyesentS! 'more than '• director,'said Mrs. Climon Warfts
7,000 doctors in the state.
• ito find "common groontf.'.-'»ftl}i
'•
• I'-t
: While the White House did .' doctbrj. '•
Stisnor'saldjUiB retbrni plfat
not glve'detalls pf her itinerary In
Atlanta, MAG 'offlclals said a ' "Is so massive, people ire having
. ' •,
mnih theme of 1^6firstlady's vls- . trooWe digestif h."
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^Jo^^-I
LtnSb^h*
�First lady toVisit^tlanta; !i
for dialoguewi&^oictbrs^
. : : I .; . , . ' . -'I
.,'..
:ltwfllbetn1»n"health csre-V^J
-: ..„!rho,ia«Bembly at; OeorgUi;
•n-^iMCTW;,,,,.-'!...--:- .
•
v-: . ' Baptist also will be avaUab^ ty
^'HUUry Rodham:. CUnton I4 -telecenlsretice tb doctors imM(f-;
scheduled to ,ylslt . Atlanta: on con, lAnguita; Cohmbus,, Savei>-<
Mondaylto Kllacuu/the adijilnia- nah and Albany! MAG said,.' >'•
tratlon'a' health '-^^—
'• Mrs. Olnto?. recenOi'^'
•V. been itrdvsllng to difrerent partfj
care , I reform
.• of the pourttry to biriW suppaff
plan, with a very
,.' for Presiiient Clinton's pisn. ;
attentive audi" ' . Hef 'Atlanta appeorance Vifa.';
ence: Georgia
' dlcates'>she cares- what phyit-'
doctors.; '. •'
. olans., think,'! skid . PrjaclUa'
.. Mrs. ainlotv
-Davee, v»; MAG' spokeswomah;,
who. , led the.
^Thla U a'very cbndllatory'fB^-,
While [ House
hire on her part ,"
.'.!
tapk'. force on
health Ireform, .Hillary,
. „ Doctors,' ^groups In Atlania;
wli: speak at Clinton
and throughom the nation have;
Georgia Baptlst.Medlcal Center ivcritiched. parts of the adralnik-;
; In 4; fonitn>;8t>ohsored by Uie tratlon's plan'." •
- •- •'. : ] ;
Medlcal' AsBoclallon of Georgia,
. Paul Shanor, MAG exeoutlve
which repifesents. more than ' director, said Mn. Clinton Wftfts
7,000 doctor In the state.
• J to find "common grotind.'..yBji
: While, the White House did , doctorj.'- : -•',• "•" \ ' i t
not give details pf her Itinerary In
• Shanor laid ,1)10 reform pith
Atlanta,' MAG 'offlclals said a " "Is so massive, people are having
mnlh theme of t^efirstlady's vls- . trouble dlgestlpc h."
..' v
• By Andy MWer
:.
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�First lady to visit;Adaiita; :;i
for^dialbgue wii^^(^tors^
:
• By Aixly MWer-*:.•
: :ltwnrta:^nilB^^M.i|4)
'UAITWRITHI':,... ' • I ! - • ;.-..^71>o-,>a<Bonibly: at.; OBorglh;..
v.lic-'.v.v
^^BapOst alMwUI.beavaUeb^ty
• 'HUlary Rodham:. Ointon Ifl -lelecosfsTeaee to doctors In^NW-;.
•cheduled to -yiili. Atlanta on co'svA^itiv Cohmbut; SavarnMondaylto^lacusi'.ihe.adifrilnln . nah and Albanyi MAG said,-'.[.<
tratlon's' health
"
Mrs. Cllntoij recontly.^.
care , Ireform
V boer traveling to (Hffersnt psttf!
plan, with a very
of tbe pourttry to build supptrft
attentive audi,.' for Prertilent Clinton's plin. •'
ence: Georgia
Het'-Atlanta appeorance rib-.',
doctors.;
- dlcatai'.she carer what phyil-;
, Mrs. ainlon,
olans. v think," said .PifscilUv
who, . led the.
DaTee,"*. MAO spokeswoman;,
While | House
^Tliis Is a-vaiy cdndllawygh^-,
tapk.' force on
hire on her part."
.•:'.!
health '|reform, |HI|lary -,
- .,/• Doctors,' ..groups In Atlanta:
will speak at Clinton
' and throughom the nation havb;
Georglq I)aptJst>Medlca] Center . critklied, parts of the admin*-;
in- i : fo'rum>ispphsored. by the^rtaUon'splan'.' '••
Medical ABsoclatlon of Georgia,
Paul.Shanor, MAG executive
which Tep/esenti! more thandirector,'said Mra. Clinton Waifts
7,000 doctors In the state.
•. I to find "common groand?,wtQ>
i. WhUe.the White House did. doctor*. '•
I'-'t:
not give details pfher itinerary In.
' Shanor'sald(tlu reform plrt
Atlanta, MAG'offlclals said a "Is so niaasive, people sre havinp
mnlnthomeofUJeflrstlady'svls- . tronWedlKesdp?it,"
:
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�First lady to visit'Atlanta:
for dialcigue wiih^^ors^
By Andy MUer :
;lt will be mWiiliMlfli CM*:.W,
-..,i7Tw,i»isembly at; Ooorgili;
-Baptist also will be avalleb|f> by;
. .
. v i : ..
' - 'Hillary Rodham: Clinton I4 -telecan&retice to doctors ItrMA-;
scheduled to .visit. Atlanta: on oo'n, lAnguita,- Cotanbus,' SavaiH
Mondaylto <llscuasithe atbhlnin nah and Albany! MAG said... J (.
Mrs. CUnto?. recently.
tratlon's' health"'-"^——
V been'triveJlng to difrerent pait}!
care , Ireform
/ .of the; pourttry to biiiM support:
plan, with a very
, for Presiiient dlnton'i pl»a •
attentive audience: Georgia
' . . Het 'Allanta appaorance Wh-":
doctors.,' -.
'dlcates'.she carer what phyri-;
, Mrs. Olnlon;
olans./think,': said .Pr^acHlawho. ./led the.
- Daree, v»; MAG spokeswoman^,
While I House,
^Thta Is rwry cbnciltatory'ie^;'
tapk' . force on
turebn her part."
.• .'.!
health '[reform, |HI|ljiry
. .//.Doctops,'^groups In Atlanta;
will speak at Clinton
' and throughom the nation have;
Georgia Baptlst.Medlcal Center crltlched, parts of the admlnlb-;
In ij'; fomlii^sppnaored by 'Uie tratlon's plan.'!•.
- . - "Vv';
Medical AsBoclallon of Georgia,
Paul Shanor, MAO executive
which repfesents: 'more than ' director, said Mrs. Clinton W^rtts
7,000 doctors in the state.
'.ito find "common grouuT.-tytQi
;.'•.: WMIe/Ihe White House did . ' doct'orp- •.-'. . ' ' •
"tr-*:
not glve'dqtalls pfher Itinerary In. .'Shsnor'saldjtliereformptfav
Atlanta, MAG offlclals said a "Is so iriassiw, people ire having
mnihlhemeofl^eflrstlsdy'svls- . IrooWedlgeeHpeIt."
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�First lady to visit^Atlanta;
for :di^lt)gue wffl^octors ^
, :
• .- ' • • ;
,
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Jtwnibeo^n'-healthcire. ;: ;
j -.. ^'nto .iaaaembly: at; Ooorgii;
-BajHlst also will be avaUabtp tjy;
Hillary Rbdh&m:. Otaton Iq -teleconlareace to docton \vr)t£-\.
•echeduled to .yiali. AUanta on con, i Anguata; Cohanbus,'Savan^
Mondayjto 'dlacusi,the adijilnla- nah and Albany; MAG said...' (.
Mrs. Olnto?.recentlyhfVtratlon'i' health"-^———
/been triveilng to (Ufferent psttfi
care Ireform
.of the^pouritry to biiiVl tuppoiff
plan, with a very
for Presiiient CUnton's pl»n. •
attentive audiHet'Atlanta appearance Vk^
ence: Qeorgla
-dlcstes '.she carer what phyi}-;
doctors.;
Mrs. ainlon,
clans./think," said .Pi^sciUa'
wlio. . led the.
> Dave*, va'MAO- spokeswoman;,
\yhlle' | House
^This Istfroryconcillatory'ge^'-I
tapk force on I
hire on her part."
health'"Ireform, |Hl|ljiry•,.\ . .„ Doctors,'.groups In Atlanb;
will apeak at Clinton
' and throughom the nation have;
Georgl^ Baptlst.Medlcal Center ;. crttlched, parts of tbe adminfc-;
; In .iVronim^sponsored by Uie trallon's plsn'.'l•: •';'" - i.
' Medical/Aisoclatlon of Georgia,
Paul Shanor, MAO eieoutlve
which fepi'esents. 'more than ' director; said Mrs. QInton >arits
7,000 doctora in the stale.
i to dhd "common groontf.'
. WhUe the While House did : doctorp. - " • •
•
not glve'detalls i)f her itinerary In
Shsnor'saldjtlureformpifai
Atlanta, MAG 'offlclals said a ' "Is so nisssive, people are having
mnih theme of Itye first lady's vla-. troobiedlgeedKlt.''
:•
By Andy MWer 'pmmrrB(-
.
1
�i\/nli3
^Adaiita: ;i
fcdoictbrs^
i •:
- , •..
First lady to
fordialdgue
1
•'
lit will be mfcariliealth care. \. V i
^ ..v.Tho .iaaaembly at; Ooorgili;
'Baptist also wlll be available ty
- ' IlUUry Rodhiim:. Clhiton I4 •teleconference to doctors In^Mtf-;.
•chedulad . to yiilt, AUanta: oo eon, 1 Angusta,- Cohsnbus, Savarn
Mordnyihxllscusaitho ediJilnUh . nah and Albany] MAG said...' I.Mrs. OlJitoif. recentli.';)!^.
tratlon's' health " " —
'.been'tiiveilng to dKfersnt pattfj
care , Ireform
of the^pourttry to btifld suppoift
plan, with a very
for Presiiient CUnton's pl»n. ;;
attentive audiHef 'Atlanta appearance nh.".
ence: Georgia
dlcates '.she carer what phys^
doctors.; '
olans 'think," said PrJadU*
Mrs. ainlon,
• Davee, «'».• MAO • spokeswoman;,
wlio. , led the,
^Thia is a^very cbncillatofy'geiv
While [ House
hire on her part"
.':'.
tapk" force - on
health '[reform, 1 Hillary 1. ,
,„ Doctored groups In Atlanti:
will speak at CDnton
and throughont the nation have;
Georgia IJaptlet.Medical Center •.: crttlched, parts of the admin*-;
.In ilfonim^aponsored by the trtUon's^sn.'IV 'V'- - . v;.':
. Medical' Association of Georgia,
Paul Shanor, MAO eieoutlve
which TepVesentSi 'more than ' director,' said Mra. Clinton Wtfta
! to And "common groontr,'..
7,000 doctors in the state.
•i While, the White House did,". doctorp. - ' • ' '•'•' •
• Shanor•saldithe retorm pifai
not glve'detalls pfher Itinerary In.
. Atlanta, MAG'officials said a " "is so masstve, people ire having
mnlh theme oftfje first lady's via- troobledlgeatiKlt.''
.
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By Andy MMIer •- :•
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�First lady to visit^anta! !|
fordialdgue withdtoors^
• By Andy MUer - :.
. .Itwfllto^rilMMcire.'.-':^
' m r v w
J;..^
.ijlw-.tatsembly: at; OeorBll>;.•' i v-:' ,
; ;
i.-BapOst aW wUl bB svaUBb^ty
Hillary Rodhtun:. Clinton Iq tBleamferenc*todoctors IrrM*-'
scheduled to .yfsit. Atlanta: oq con, 1 Anguita, Cohmbus,' Savon-'
Mondaylto ^llscuu.the. adijilnlth , nah and Albanyi MAG said... 'l.'.
tratlon's' healtti ^ ^ m ? B ^ m
Mrs. CUnlov recently 'r*^'
care , Ireform •••HI'V.bMnitriveilng to (Ufferent psnj!
plan, vith t very H S ^ x U o f the fourttry to btdld suppoft
attentive audi- ^ ^ H H f i H , for Presiiient Clinton's plea
ence: Georgia B B H B H W
Hef 'Atlanta appeattmce
doctors.,
H H K B i H I . dlcatea'.she cares- what phyil-'
Mrs. Qinlon, • B B B ^ Q olans.v think/: said Pr^adllW
who. . led the H B ^ H , Daves, va MAO spokeswoiViaC,
White H o u s e ^ ^ ^ ^ ^ H ^Thls Is a-vsry condliatory'gaa^
tapk ,fnrce on M ^ M H a i tore on her part."
henHh Ireform,,Hilary , ' , . . . , . Doctors; .groups In AtUnti;
will speak at Onton
' aiid throughout the nation havb
Georgia paptlat.Medlcal Center .•. critiched, parts of the adralniii-'
; in a; foriiiTiy>aponsored by 'the.-'- ttiUohi'ptah'.'V-'.\;' 'V ''
. Medical, Association of Georgia,': •... Paul.Shanor, MAG executive'
which Vepi'esents. more than V dlridor,'said Mii Cilitton ^arfts
7,000 doctors In the state
'ito find "common groond.'-wiQi
i - While the White House did;' doctbrv '-. " • • ^ ••-i'W
nbtglvedetallsi?f.herit!n8raryln. .. • Shanor laid, the ratonn plin
Atlanta, MAG offtelals said a " "is so nisssive, people are having
mnlhthemeofl^eflrstlady'svls- , troubledlfteetlp?h."
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�First lady to visit^Atlanta; ;i
for ^dial^gue \ ^ ^ o r t o r s ^
' By Andy MWer
- ^Tho .iMsembh' at; Oeorgik;
-BapOsl alfio will be ovallib^ by;
'•'Hillary Rodham:. CUnton Is •leleomference to docton In^Mjt;.
scheduled to .yisll. Atlanta on con, i Anguita,- Cohnnbuv Savenn
Mondaylto ^iscuse.tha ad^ilnla- nah and Albany! MAG laid. .. j t.i
Mn. cainto?. recently^KV'
tratlon's' health
— —•
/.been'traveling to difrerent paitp;
care , Ireform. .of the! pourttry to bu«d.«uppoift'
plan, with • very
i.forPrealclentCllntnn'iplia.' {•
attentive audi. Hef 'Atlanta appeorance
ence: Georgia
' dlcatea'.ihe carer what phyat-;
doctors.;'
oians .think," aald .Pi^dll*
Mrs. ainlon,:
. Da»ea,v»; MAa •pokeavromaoJ,
who, , led the.
^Thto Ii a^ery cbncfllatofygefl-,
Whitei I; House.;
ture on her part."
'
tajik '.force on
,,r .Doctors,'-groups Ift- Atlanta.'
henllh Ireform, |HI|hiry ,
' and throughont tbe nation havk:
will speak at CDnton
;
which repi'esents. more than ' director; said M i i atnton Wqifts
7,000 doctors In the state.
<.i to flnd "common groondV.'vfU}!
, While the While House did. doctors. '• ' •
"W:
nbtglve'deialls pfher itinerary In. ..' Shsnor valdjtlu reform piin
Atlanta, MAG 'offlclals said a " "Is so massive, people are having
mnlh theme oft^eflrst lady's vis- . trouble dlgeeap? It."
^.'-v
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
Contirtufd From Pngt Bl
just want good service.' '• he says.
Receni events in California seem lo
bear him out. The state has already set up
a health alliance much like those the
president envisions. But agents can still
sell policies offered by ihe purchasing
groups. Although businesses could save in
fees by buying directly from ihe alliance.
:9T, of Ihe 11 2 small companies enrolled
.9
in the alliance have chosen to buy from
Ms. Proctor. 3 years old. has about 1 0 agents. And they have done so even though
5
0
Ihey must first sign a form acknowledging
The answer led ner snaien. • Imaii mosfof it from commissions on policy
thai-Ihey pay more going through an
sumini; anyone as ooviouslv brilliant as renewals. Unlike life insurance, which - agent.
you could find someinmg else io markei.- provides agents with huge commissions m
.Insurance experts acknowledge that
the First Udy said.
ihe first year of a policy and low commis- agents provide services that someone
Hopmp to lame healin care cosis. ihe sions m later years, heallh insurance pays
would have to pick up. But ihey also say the
Clinton health plan tnes io inm adminis commissions that are fairly conslanl from currenl system adds an extra, cosdy layer
iranve fal oul ol the heallh care svsiem. year lo year.
of administration. Bui only one job would be lerislated oul of
On a receni morning. Ms. Procior met
"You re noi going to eliminate the cost
existence: heailh-msurance agems. There with a client to discuss coverage for his completely by eliminating agents." says
are aoout 150.000 Americans wno mane workers and agreed io sil down with an
Greg Herrtey. a consultant with Milliman
mosi ol iheir living selling heallh cover- employee of anotlier customer to explain & Robertson, an actuanal consulUng conage. .
•benefits. She also scrunntzed doctor bills
cern in Milwaukee. "Bui I can't believe you
Under ihe Clinton proposal, consumers of a aistomer who believed he was improp- can i do il tor less."
would buy health insurance Irom purchas- erly denied benefits, looking for mistakes
In addition, the savings Irom ellminaling cooperatives, known as heallh alliIf! don't keep these people iii my Rolodex mg agents are only part of Uie equaUon.
ances. Agents would be barred from selling happy, they'll fire tne." she says.
argues Paul Ellwood. a member ol the
the Insurance offered by the alliances.
Jackson Hole Group, sresearchorganiiaToledo advertising executive Roger
At first glance, the savings appear to be Raymor. one ot Ms. Proctor's customerj.
lion whose idess helped shape the atnton
huge. Insurance agents earn about $3.8 used to ihink insurance agents were noth- plan. He says the demise of agents is a
billion a year in commissions on heaim ing more ihan sales people. But then
byproduct of creating alliances, and he
coverage. Bui the services thev provide, he broke his arm in a motorcycle accident
believes that setting up the alliances is
such as explaining benefits and lighting in West Virginia. His insurance company
essential. By creating huge pools ot conwith insurance companies over denied refused lo pay his claim, and Die hospital
sumers who would share each others'
claims, would" have to be made up by charged him for services he says he never risks, the autances can providi affordsomeone - perhaps governmeni em- received. Ms. Proctor spent two years get- able insurance to everyone, hr lays. "In
ployees.
the come of other thing! the administrating the disputes untangled. "No normal
That scares some people. I don t see human being can possibly understand an
tion is doing, you don't need agents."
consumeq being v y_ welL servwl hv JOSUaaCt rnilirv " Mr R^ymn, „ ) .
Ultimately, the fate of hetltb-luuruce
mat. says Saul Spivack. a consultant wuh would hate to lose that representation."
agents could be decided less on the merits
Tillinghasl. an actuanal consulting firm.
The Better Business Bureau in Toledothan by poiiUa. Agentsrepresenta power
-It will be like dealing with the Depan- uses Ms. Proctor as a conduit to offer ful political group. The JOO.MUnember
menlof Motor Vehicles. Independent Insurance Agents of America
heaJtn insurance Io Its members. The head
But consumer advocates say anything of the bureau. Richard Eppstein. says his Is one of Washington i moat powerful
is better than the currem system, in which members don't mind paying lor an msap-lobbying groups, having donated B90.798
Ihe same people who give advice on insur- ance agent. "I talk to many business to federal campaigns over the past two
ance get commissions lied lo how much people who say. 'I don't care what it costs. years. The National Assoctatkn ol Health
I
insurance ihey sell. -| don l ihmk [he loss
Underwriters and other agent groups are
P/ense Ttini (o Pnje
CWumn I
also acUve.
Politically, this- Issue is Important
because every Congressman has agents in
their districts." Dr. Ellwood says.
Bv GREC STEi.NMrrz
siorf s o „ . „ . „ , r , „ » .,, i , „ .
j..,„,.
TOLEDO - M a nealin insurance
Jgenl. Ltin Proctor WMS njiurally curious
aoout now me-Clinton nealtn-care plan
would affeci ner joo.
So wnen sne visned ine wnne House
last monm as pan of a eroup of northern
Ohio business people, sne put me question
utwul ner fulure flirecllv lo Hillaiy- Rod
r
r T
oi aeems is someiliine consumer? will
m o u n t . - says Gail Shearer, a health care
r x p e n wuh Consumers Union, the publisher of Consumer Reports maRazine
Such talk ranldes Ms. Proctor, who
specializes in selling froup heallh policies
lo small employers, mcludinit plumbers, a
swimminif-pool conlractor and ihe police
depanment of nearby Pul in Bay. Ohio.
L
er
™
E
^
S
T
R
E
F
T
" ^ A L WEDNRsnev
,- , ,,,
�Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC SrF.iv.irrz
S f o f f R < e a * \ r ' o i T n , vv
, s r n . ry J . „ s .
A l
TOLEDO - AS a npdltn-insurance
Jgent. Lun Procior vvjs njiurallv curious
aoout how ihe Climon fiealin-care plan
would aflect her'job.
So wnen sne visited me White House
lasi montn as pari of a eroup ol nonhem
Ohio business people, sne pul ihe quesnon
aoout ner future directlv to Hillary Rod'milThe answer left ner snalien. Tm as=
suminir anyone as ooviouslv onlliant as
you could find someihmg else io markei "
ihe First Ladv said.
Hopmif lo tame health care costs, the
Clinton heallh plan Ines Io trim adminis
tranve fal oul ol the heallh-care syslem.
Bui only one job would be leeislaied oul of
existence: heailh-msurance agems. There
are aboul 150.000 Americans wno make
most ol iheir living selling heallh coverage.
Under the Clinton proposal, consumers
would buy health insurance from purchasing cooperatives, known as heallh alliances. Agents would be barred from selling
the insurance offered by the alliances.
Al firsi glance, the savings appear to be
huge. Insurance agents earn about S3.8
billion a year in commissions on heallh
coverage. Bui the services thev provide,
such as explaining benefits and fighting
with insurance companies over denied
claims, would have to be made up by
someone - perhaps governmeni employees.
That scares some people. I don t see
consumers being very well served hy
that." says Saul Spivack. a consullanlwilh
Tillinghasl. an actuarial consulting f i r m
It will be like dealing with the Department of Motor Vehicles."
Bui consumer advocates say anything
is better than the current system, in which
ihe same people who give advice on insurance gel commissions tied to how much
insurance ihey sell. I don'l think Ihe loss
Continued From 1Page Bl
just warn good service.' he says.
ill agents is something consumers will
m o u m . • says Gail Shearer, a heallh-care
r . p e n with Consumers Union, ihe publisher of Consumer. Reports magazine.
Such talk rankJes Ms. Procior. who
specializes in selling group heallh policies
lo small employers, including plumbers, a
swimming-pool conlractor and Ihe police
department of nearby Pul-m-Bay. Ohio.
Ms. Proctor. 35 years old. has about 100
Receni events in California seem lo
bear him out. The state has already set up
a heallh alliance much like those ihe
president envisions. But agents can still
sell policies offered by the purchasing
groups. Although businesses could save 5lt
fees by buying directly from the alliance.
79?r ol the 1.192 small companies enrolled
in ihe alliance have chosen to buy from
agents. And ihey have done so even though
. Ihey must lirst sign a form acknowledging
that they pay more going through an
agent.
mosr of i i from commissions on policy
renewals. Unlike life insurance, which
provides agents with huge commissions in
the firsi year of a policy and low commissions in laier years, health insurance pays
commissions lhat are fairly conslanl from
year to year.
Insurance experts acknowledge thai
agenis provide services -that someone
would have to pick up. Bui ihey also say the
current system adds an extra, costly layer
of administration.
"You're not going lo eliminate the cost
completely by eliminating agents." says
Greg Hen-ley. a consultant with Milliman
& Robertson, an actuanal consulting concern in Milwaukee. But I can't believe you
can't do it for less.'
. In addition. Uie savings from eliminating agents are only part of the equation,
argues Paul Ellwood. a member of the
Jackson Hole Croup, a research organization whose ideas helped shape the Clinton
plan. He says the demist of agents is a
byproduct of creating alliances, and he
believes that setting up the alliances is
essential. By creating huge pools of consumers who would share eacA others'
nska> the alliances can provide affocdable insurance to everyone, he say*. "In
the c o m e of other things the administration is doing, you don l need agents."
intimately, the fate o( healtb-lnauranc*
agents could be decided less on the ments
than by politics. Agents represent a powerful poUdcal group. The 300.OOfrmember
Independent Insurance Agents of America
is one of Washington"! most powerful
lobbying groups, having donated SS90.TS8
to federal campaigns over the past two
y e a n . The National AsaodaUoo of Health
Underwriters and other agenl groups are
also active.
"Politically, this Issue is Important
because every Congressman has agents in
their districts." Dr. Ellwood says.
On a recent morning. Ms. Proctor met
wilh a diem to discuss coverage for his
workers and agreed lo sil down wiih an
employee.of another customer to explain
benefits. She also scruiinued doctor bills
of a customer who believed he was improperly denied benefits, looking for mistakes.
. If I don't keep these people in my Rolodex
happy, they'll lire me." she says.
Toledo advertising executive Roger
Raymor. one of Ms. Proctor's customers
used to think insurance agents were nothing more than sales people. But then
he broke his arm in a motorcycle accident
m West Virginia. His insurance company
refused to pay his claim, and ihe hospital
charged him for services he says he never
received. Ms. Proctor spent [wo years getting Uie disputes untangled. "No normal
human being can possibly understand an
" nolirv." Mr Paymn,- . . y .
would hate to lose that representation."
The Better Business Bureau in Toledo
uses Ms. Proctor as a conduit lo offer
heallh Insurance to Its members. The head
of the bureau. Richard Eppstein. says his
members don't mind paying for an insui»
ance agent.
"I talk to many business
people who say. I don't care what it costs. I
Please Tint to Paqt B6. Column I
_ THE WALL STREFT
M
n
w
^
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC SrEiNMrrz
TOLEDO Ai a tieallh-insurance
affem. Lon Proctor K J S naturally curious
aboul now tne Clinton nealtn care plan
would affeci ner job.
So wnen sne visited the wnne House
last montn as pan of a uroup of nonnem
Ohio business people, sne put me Question
-aboul her future directlv to Hiliarv Rod-
ut agents is something consumers will
mourn.•• says Gail Shearer, a health care
rxpen wuh Consumers Union, ihe publisher of Consumer Reports magazine
Such lalk rankJes Ms. Procior. who
specializes in selling group heallh policies
lo small employers, including plumbers, a
swiniming pool contraclor and the police
depanment of nearby Put in-Bay. Ohio.
Ms. Procior. 35 years old. has about 100
".ua
• ABd-l
i-re
The answer led ner snalien. rm ay
mosr of it from
s on policy
summif anyone as ooviouslv. brilliant as
renewals. Unlike-life insurance: which
you could find someinm? else to marnet."
provides agents with huge commissions in
the First Udy said.
ihe first year of a policy and low commisHopin? to lame heallh-care costs, the
sions in laier years, health insurance pays
Clinton heallh plan ines to trim adminiscommissions lhal are fairly conslanl from
iranve (at oul ol ihe nealtn care system.
year lo year.
Bui only one job would be legislated oul of
On a recenfmoming. Ms. Procior met
existence: health-insurance aeems. There
with a client to discuss coverage for his
are aboul ISO.000 Americans who make
workers and agreed lo sil down with an
mosi of iheir living selling heallh coveremployee of another customer to explain
age.
benefits. She also scrutinized doctor bills
Under the ainlon proposal, consumers of a customer who believed he was impropwould buy heallh insurance from purchaserly denied benefits, looking for mistakes
ing cooperatives, known as heallh alli» I don t keep these people in my Rolodex
ances. Agents would be barred (rem selling happy, theyu lire me. • she sayi.
the Insurance offered by the alliances. "
Toledo advertising executive Roger
At first glance, the savings appear to be Raymor. one of Ms. Proctor s customen,
huge. Insurance agenis earn about S3.8
used to think insurance agents were nothbillion a year in commissions on health
ing more than sales people. But then
coverage. But the services mev provide.
he broke his arm in a motorcycle accident
. such as enpiainmg benelils and fighting in West Virginia. His insurance company
with insurance companies over denied
refused to pay his claim, and the hospital
claims, would have.io be made up by
charged him (or services he says he never
someone - perhaps governmeni emreceived. Ms. Proctor spent two years getployees.
ting the disputes untangled. "No normal
That scares some people. I don l see human being can possibly understand an
consumep.being very well servwi hv jastraace nolirv • Mr nay™™- . , ••[
lhat. says Saul Spivack. a consullant with would hate to lose thairepresentation."
Tillinghasl. an actuanal consulting firm.
The Better Business Bureau in Toledo
• Il will be like dealing wuh ihe Departuses Ms. Proctor as a conduit lo offer
ment of Motor Vehicles.'
health Insurance lo Its members. The head
But consumer advocates say anything otlhe bureau. Richard Eppstein. says his
is better than the current system, in which
members don't mind paying for an insurihe same people who give advice on insurance agent. "I talk to many business
ance get commissions ned to how much people who say. I don't care what il costs. I
insurance ihey sell. I doti'l mink me loss
P/euse Tm to Pagt 86. Column 1
r
: n , E WALL STREFT tnURNAL VVEDNESnAV
Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
Continued Frrm Page Bl
just want good service. " he says.
1
Receni events in California seem lo
bear him out. The slate has already sei up
a heallh alliance much like ihose ihe
presidem envisions But agents can still
sell policies offered by ihe purchasing
groups. Although businesses could save 51t
.fees by buying direclly from ihe alliance.
Wr'of the 1.192 small companies enrolled
in ihe alliance have chosen to buy from
agents. And they have done so even though
Ihey must first sign a form acknowledging
lhal they pay more going through an
agent.
Insurance experts acknowledge lhal
agents provide services lhal someone
would have lo pick up. But they also say Ihe
current system adds an extra, costly layer
of administrauon.
You re not going to eliminate ihe cost .
completely by eliminating agents.'' says
Greg Herrley. a consultant with Milliman
It Robertson, an actuanal consulUng concern ui Milwaukee. "But I can t believe you
can't do it for less."'
In addition, the savings from eliminating agents are only part of the equation,
argues Paul Ellwood. a memt>er:of ihe
Jackson Hole Group, a research organization whose ideas helped shape the ainlon
plan. He says the demise of agents is a
byproduct of creating alliances, and he
believes that setting up the alliances is
essential. By creating huge pools of consumers who would share each others'
risks, the aUlances can provtdt aflordable insurance to everyone, he says. "In
the course ol other things the adminlstntion is doing, you don't need agents."
UlUmately. the fate of health-limirance'
agents could be decided less on the merits
than by politics. Agentsrepresenta power '
ful political group. The 300.000-member
Independent Insurance Agents of America
Is one of Washington's most powerful
lobbying groups, having donated B90.798
to federal campaigns over the past two
years. The National Assoctatioa of Health
Underwriters and other agent groups are
also attlve.
"Politically, this Issue is Important
because every Congressman has agents In
their districts." Dr. Ellwood says.
..
,
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
ui agents is someihmg consumers will
mourn." says Gail Shearer, a heallh-care
expert with Consumers Union, ihe puMistier of Consumer Reports magazine.
Such talk rankJes Ms. Proctor, who
specializes in selling group heallh policies
lo small employers, including plumbers, a
swimming-pool con'iraclor and the police
depanment of nearby Put-in-Bay. Ohio.
Ms. Procior. 35 years old. has about 100
-On
The answer led her snalien. •Tm at.. masrof il from commissions-on-policy
summit anyone as obviously brilliant as
renewals. Unlike life insurance, which
you could find someihmg else io marKel." provides agenis with huge commissions in
ihe Firsi Udy said.
the first year of a policy and low commisHopine lo lame health care costs, the sions in later years, health insurance pays
Clinton heallh plan ines to trim adminis
commissions that are fairly constant from
iranve fal out of the health care system.
vear to year.
Bui only one job would be leeislaied out of
On a receni morning. Ms. Procior met
existence: health-insurance agenis. There
with a client to discuss coverage for his
are aboul 150.000 Americans who mane
workers and agreed to sit down wuh an
most of iheir living selling heallh coveremployee of another customer lo explain
age.
benefila. She also scrutinized doctor bills
of a customer wlio believed he was impropUnder the Clinion proposal, consumers
would buy health insurance from purchas- . erly denied benefits, looking for mistakes.
I f l dont keep these people in my Rolodex
ing cooperatives, known, as heallh alliances. Agents would be barred from selling happy, they'll fire me:" she says.
"the Insurance offered by the alliances.
Toledo advertising executive Roger
At first glance, the savings appear to be Raymor. one of Ms. Proctor s customen,
huge. Insurance agents earn aboul $3.8
used to think insurance agents were'nothbillion a year in commissions on health
ing more than sales people. But then
coverage. But Ihe services ihey provide,
he broke his arm in a motorcycle accident
such as explaining benefits and fighlmg
in West Virginia. His insurance company
with insurance companies over denied
refused io pay his claim, and the hospital
claims, would have io be made up by
charged him for services he says he never
someone - perhaps governmeni emreceived. Ms. Proctor spent two yean getployees.
ting the disputes untangled. "No normal
That scares some people. I don t see human being can possibly understand an
consumcrc being very well servwt hv iDSoaiice policy " Mr Raymnr says "1
mat." says Saul Spivack. a consullant with . would hate to lose that representation."
Tillinghasl. an actuanal consulting firm,
The Better Business Bureau in Toledo
ll will be like dealing with me Departuses Ms. Proctor as a conduit to offer
ment of Moior Vehicles."
healtti insurance to Its members. The head
But consumer advocates say anything of the bureau. Richard Eppstein. says his
is belter than the current syslem. in which members don't mind paying for an insur
ance agent, "f talk to many business
Ihe same people who give advice on insurance gel commissions ned lo how much people who say. 'I don't care what it costs. I
flense Turn tb Page Be. Colimx 1
insurance ihey sell. I don l mink ihe loss
By GREC MEINMETZ
S l o t ! R r p o ' t f OF T n ' w M , s i it. T T J ..i n s * L
TOLEDO a ntal'.h insurance
agenl. Lon Procior was naiurally curious
aoout now me L'linlon healin care plan
would ailed ner job.
So wnen sne visited me White House
last momh as part of a eroup of northern
Ohio business people, sne put tne question
aboul her fulure directlv to Hillary Rod-
Insurance Agents Are
Casualties of the Plan
To Alter Health Care
Continurd Prvm Page Bl
just want good service.' ' he saysReceni events in California seem lo
bear him out. The state has already set up
a health alliance much like those the
president envisions. But agents can still
sell policies offered by the purchasing
groups. Although businesses could save 5^
fees by buying directly from the alliance,
790 of the 1.192 small companies enrolled
in ihe alliance have chosen to buy from
agents. And they have done so even though
they must first sign a form acknowledging
mat they pay more going through an
agent. -•
Insurance experts acknowledge lhal
agents provide services that someone
would have to pick iip. But ihey also say Ihe
.currenl syslem adds an extra, costly layer
of administration.
You're not going to eliminate the cosl
completely by eliminating agents." says '
Greg Herrley, a consultant with Milliman
& Robertson, an actuanal consulUng concem in Milwaukee. "But lean t believe you
can't do it (or less."
In addition, the savings Irom eliminating agents are only part of the equaUon. '
argues Paul Ellwood. a member , ol the
Jackson Hole Group, a research organization whose ideas helped shape the atnton
plan. He says the demise of agents is a
byproduct of creating alliances, and he
believes that setting up the aUlances Is
essential. By creating huge pools of consumers who would share each others'
nskh the aUlances can provide aftortable insurance to everyone, he aayv "In
the course of other thlnp the admlnlstnnon Is doing, you don't need agents."
UlUmately, the fate of health-Insurance
agents couM be decided less on the merits
Ihan by politics. Agents represent a powerful pollUdl group. Tbe maw-member
Independent Insurance Agents of Amertcs
is one of Washington's mosi powerful
lobbying groups, having donated JS90.T98
to federal campaigns over the past two
years. The Nanonal Assodatkn of Health
Underwriters and other agenl groupe are
also active.
Politically, this Issue is Imporunt
because every Congressman has agents in
their districts.". Dr. Ellwood says.
THE WALL STREET JQLTRNAL WEDNESDAY, NOVEMBER ir
199
3
�Insurance Agents Are
Casualties of the Plan.
To Alter HealthCare
Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC STEI.NMETZ
SlOf/ R r p o r K r
n, T U P
W . M a r n t r T J. M • v .
t
Continued From Page Bl
JUSI warn good service." " he says
01 agenis is something consumers will
moum.•• says Gail Shearer: a heallh-care
r < p e n wuh Consumers Union. Ihe puohsher ol Consumer Reporls magazine
Such lalk rankles Ms. Procior. who
specializes in selling group heallh policies
lo small employers, including plumbers, a
swimming-pool contraclor and the police
depanment of nearby Pul in Bay. Ohio.
Ms. Proctor. 35 years old. has abcul 100
TOLEDO - As a nejtin insurance
JRem. Lon Proctor w,is nuluram curious
about now ihe Cimlon heallh-care plan
would alfecl her job
So wnen sne visited tne White House
last montn as pari of a group ol northern
Ohio business people, sne put me question
aboul her future directly to Hiliarv Rod"ifllaaThe answer left ner snalien. T m a t .
m o s r o f it from commissions on-policy
summg anyone as obviously bnllianl as
renewals. Unlike life insurance, which
you could (ind something else io market '
provides agents with huge commissions in
Ihe Firsi U d y said.
ihe first year of a policy and low commisHoping to tame healin care costs, the
sions in later years, heallh insurance pays
Climon heallh plan ines lo i n m aomims
commissions lhal are fairly conslanl from
native lai oul ol ihe healm-care svsiem.
S ear io year.
Bui only one job would be legislated oul of
- On a recent morning. Ms. Proctor met
existence: heailh-msurance agenis. There
with a client to discuss coverage for his
are aboul 150.000 Amencans wno make
workers and agreed lo sit down wuh an
most ol iheir living selling heallh coveremployee of another customer to explain
age.
benefits. She also scrutinized doctor bills
Under the Climon proposal, consumers
of a customer who" believed he was impropwould buy health insurance from purchaserly denied benefits, looking for mistakes
ing cooperatives, known as heallh alliIf I don t keep these people in my Rolodex
ances. Agenis would be barred from selling
happy, t h e y u fire m e . " she says.
the Insurance offered by the alliances.
Toledo advertising executive Roger
At first glance, ihe savings appear to be
Raymor. one of Ms. Proctor's customers,
huge. Insurance agenis earn about S3.8
used to think insurance agenis were nothbillion a year in commissions on heallh
ing more ihan sales people. But then
coverage. But ihe services mev provide
he broke his a r m in a motorcycle accident
such as explaining benefils and fighting
in Wesi Virginia. His insurance company
. wuh insurance companies over denied
refused io pay his claim, and the hospital
claims, would have to be made up by
charged him lor semees he says he never
someone - perhaps governmeni emreceived. Ms. Proctor spent two yeats getployees.
t i n g the disputes untangled. "No normal
That scares some people. "I don t see
human being can possibly understand an
consumeg bting very well servwi hv j a s u r a n c e ooiirv • M r p s p m , - . . y ,
m a t . " says Saul Spivack. a consuliam w u h
would hate to lose that
representation."
Tillinghasl. an aciuanal consulting f i r m
The Better Business Bureau in Toledo
" I t will be like dealing with the Departuses Ms. Proctor as a conduit to offer
ment of Motor Vehicles."
heallh insurance to its members. The head
Bui consumer advocates say anything
of Uie bureau. Richard Eppstein. says hia
is better than the current system, in which
members don't mind paying for an insur
me same people who give advice on insurance agent. "I talk Io many business
ance gel commissions ned lo how much
people whosay. I don't care what it costs. I
insurance ihey sell. -| don l ihtnk ihe loss
Pimse turn to Page B6. CWuroi 1
^ ^ H E j O ^ A L
WED.VESDAV
.
Receni events in California seem Io
bear him oul. The stale has already set up
a heallh alliance much hke ihose ihe
president envisions Bui agenis can still
sell policies offered by the purchasing
groups. Although businesses could save STc
fees by buying directly from ihe alliance.
ol the 1.192 small companies enrolled
in ihe alliance have chosen lo buy from
agents. And they have done so even though •
, they must firsi sign a form acknowledging
lhal they pay more going through an
agenl.
Insurance experts acknowledge thai
agents provide services that someone
would have to pick up. But they also say the
currenl syslem adds an extra, costly layer
of administration.
"You're not going lo ellminaie the cost
completely by eliminating agents." says
Greg Herrley. a"consultant with Milliman
& Robertson, an actuarial consulting concern in Milwaukee. " B u i lean t believe you
can't do it for less."
In addinon. the savings from eliminating agents are only part of the equation,
argues Paul Ellwood. a member of the
Jackson Hole Group, a research organization whose ideas helped shape the Clinton
plan. He says the demise of agents is a
byproduct of creating alliances, and he
believes that setting up the alliances Is
essential. By creating huge pools ol cons u m e " who would share each others'
risks, the alliances can provtdt affordable insurance to everyone, he says. " I n
the course of other thtags the administration is doing, you don't need agents."
Ultimately, the fate of health-lnsunnce
agents could be decided less on the merits
than by politics. Agents represent a powerful political group. The m o i x u n e m b e r
Independent Insurance Agents of America
is one of Washington's most powerful
lobbying groups, having donated 890.798
lo federal campaigns over the p u t two
years. The National AsaodaUoo of Health
Underwriters and other agenl groups are
also acUve.
Politically, this Issue is Important
because every Congressman has agents in
Iheir districts." Dr. Ellwood says.
n
v
^
^
^
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By G E C STEINMETZ
RT
TOLEDO - AS a nealm insurance
jgent. Lon Proctor u,is naiurallv curious
aoout no* the Clinton nealtn care' plan
would affect ner job.
So wnen sue visued me While House
lasi momh as part of a group ol northern
Ohio business people, sne pul the Question
about her future directlv to Hiliarv RodThe answer leit her sninen. 'feu a t .
summg anyone as obviously bnllianl as
you could find something else to markei."
the Firsi Lady said.
. '
Hoping to tame health care costs, the
Clinton heallh plan ines to trim adminisnative fat out ol the heallh care svsiem.
Bui only one job would be legislated out of
existence heallh insurance agenis. There
are about 150.000 Amencans who make
most of their living selling heallh coverage..
Under ihe Clinton proposal, consumers
would buy heallh insurance from purchasing cooperatives, known as heallh alliances. Agenis would be barred from selling
the Insurance offered by the alliances.
At first glance, the savings appear to be
huge. Insurance agents earn aboul S3.5
billion a year'in commissions on health
coverage. Bui the services ihey provide,
such as explaining benefits and fighting
with insurance companies over denied
claims, would have to be made up by
someone - perhaps governmeni employees.That scares some people. "I don t see
consumers being yery_ welL servwt hv
that." says Saul Spivack. a consullant with
Tillinghast. an aciuanal consulting firm.
Il will be like dealing with the Department of Motor Vehicles."
Bui consumer advocates say anything
is belter than the current system, in which
ihe same people who give advice on insurance get commissions ned io how much
insurance ihey sell. T don'i ihink me loss
oi agents is something consumers will
mourn." says Gail Shearer, a heallh-care
rvpen with Consumers Union, ihe-publisher of Consumer Reporls magazine.
Such lalk rankles Ms. Procior. who
• specializes in selling group heallh policies
lo small employers, including plumbers, a
swimming-pool contractor and the police
depanment of nearby Put-m-Bay. Ohio. "
Ms. Proctor. 35 years old. has abcul 100
an
I itiiOOO. I
mosr of il from commissions on policy
renewals. Unlike life insurance', which
provides agents with huge commissions in
ihe first year of a policy and low commissions m later years, heallh insurance pays
commissions thai are fairly constant from
> ear lo year.
On a recent morning. Ms. Procior met
with a client to discuss coverage for his
workers and agreed lo sil down with an
employee of another customer lo explain
benefits. She also scrutinized doctor bills
of a customer who believed he was improperly denied benefits, looking lor mistakes.
If I don't keep these people in my Rolodex
happy, Uiey'U fire me." she says.
Toledo advertising executive Roger
Raymor. one of Ms. Proctor's customen,
used to think insurance agents were nothing more than sales people. But then
he broke his arm in a motorcycle aeddent
in West Virginia. His insurance company
refused lo pay his claim, and Uie hospital
charged him lor services he says he never
received. Ms. Proctor spent two years getting the disputes untangled. "No normal
human being can possibly understand an
jflSiraace polia'" Mr Raymnr n y i " I
would hate to lose that representation."
The Better Business Bureau in Toledo
uses Ms. Proctor as a conduit to offer
health insurance to Its members. The head
of Uie bureau. Richard Eppstein. says his
members don't mind paying lor an injur
ance agent. "I talk to many business
people who say. 'I don't care what it costs. I
Pfeose TurntoPaqt B6. Column 1
Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
Continued Frxm Page Bl
just warn good service. " he says.
Recent evems in California seem lo
bear him out. The slate has already set up
a health alliance much like those the
president envisions. But agenis can sun
sell policies ottered by Ihe purchasing
groups. Although businesses could save 5%
lees by buying directly from the alliance,
790 of the 1,192 small companies enrolled
in the alliance have chosen to buy from
agents. And they have done so even though
they must firsi sign a form acknowledging
that they pay more going through an
agent.
Insurance experts acknowledge that
agents provide services that someone
would have to pick up. But they also say the'
current, system adds an extra, costly layer
of administration.
"You're not going to eliminate the cost
completely by eliminating agents." says
Greg Herrley. a consultant with Milliman
k Robertson, an actuanal consulting concern in Milwaukee. "But I can t believe you
can't do it for less."
In addition, the savings from ellmihaiing agents are only part of the equation,
argues Paul Ellwood. a member ol (he
Jackson Hole Group, a research organization whose ideas helped shape the Clinton
plan. He says the demise of agents is a
byproduct of creating aUlances. and he
believes that setting up the alliances is
essentisl. By creating huge pools of consumers who would share each others'
risks, the aUlances can provtdt affortable insurance to everyone, he says. "In
the course of other thtngs the administration Is doing, you don't need agents."
Ultimately, the (ate of healtb-lnsurance
agents could be decided less on the merits
than by pollncs. Agents represent a powerful political group. The SOO.OOO-member
Independent Insurance Agents of America
is one o< Washington's most powerful
lobbying groupe, having donated 090,738
to federal campaigns over the past two
yean. The Nabonal Association of Health
Underwrtten and other agent groups are
also active.
"PollUcaUy. this Issue Is Important
because every Congressman has agents in
their districts." Dr. Ellwood says.
THE WALL STREET JOURNAL WEDNESDAy. NOVEMBER 17 ,o..
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC STEIVMETZ
TOLEDO - As a neaun-msurance
agent. Lon Proctor was njiurailv curious
_aDou[ now tne Clinton nealtn care plan
•would affeci ner job.
So wnen sne visued me While House
lasi momh as pan of a eroup ol northern
Ohio business people, sne put the question
about her future directly to Hillary Rod
.'JI agents is something consumers will
mourn." says Gail Shearer, a health care
<-*pen with Consumers Union, the publisher ol Consumer Reporls magazine.
Such lalk rankles Ms. Procior. who
specializes in selling group health policies
10 small employers, including plumbers, a
swimming-pool contraclor and the police
depanment ol nearby Put-m-Bay. Ohio.
Ms. Proctor. 35 years old. has aboul 100
The answer left her snalcen. Tiu a t
most of il from commissions on-policy
suming anyone as obviously brilliant as
renewals. Unlike life insurance, which
you could find someimng else to markei."
provides agenis with huge commissions in
ihe Firsi Lady said.
ihe firsi year ol a policy and low commisHoping to lame heallh-care costs, the
sions in later years, health insurance pays
Clinton health plan ines to trim adminis'
commissions lhat are fairly conslanl from
native fat oul ol the health care system.
year lo year.
But only one job would be leeislaied out of
On a receni morning, Ms. Proctor met
existence: heailh-msurance agents. There
with a client to discuss coverage lor his
are about 150.000 Amencans wno make
workers and agreed lo sit down with an
most of meir living selling health coveremployee of another customer to explain
age.
benefits. She also scrutinised doctor bills
of a customer who believed he was impropUnder the Clinton proposal, consumers
eriy denied benefits, looking lor mistakes.
would buy heallh insurance from purchasIf I don't keep these people in my Rolodex
ing cooperauves. known as heallh alliances. Agenis would be barred from selling happy, theyu fire me." she says.
the insurance offered by the alliances.
Toledo advertising executive Roger
At first glance, the savings appear to be Raymor. one of Ms. Proctor's customen,
huge. Insurance agents earn about S3.8
used io think insurance agents were nothbillion a year in commissions on health
ing more than sales people. But then
coverage. But the services ihey provide,
he broke his arm in a motorcycle accident
such as explaining benefits and fighting
in West Virginia."His insurance company
with insurance companies over denied
refused io pay his claim, and the hospital
claims, would have to be made up by
charged him lor services he says he never
someone - perhaps government emreceived. Ms. Proctor spent two yean getployees.
ting the disputes untangled. "No normal
• That scares some people. "I don't see human being can possibly understand an
consume^ being very well servwi hv J o s n n c e polity " Mr Raymnr nys "I
ihat,'' says Saul Spivack. a consullant with would hate to lose that representation."
Tillinghast. an actuanal consulting firm.
The Better Business Bureau in Toledo
It will be like dealing with ihe Depanuses Ms. Proctor as a conduit to offer
ment of Moior Vehicles. "
health Insurance lo Its members. The head
But consumer advocates say anything of the bureau. Richard Eppstein. says his
is belter thin the current system, in which memben don't mind paying (or an insurance agent. " I talk to many business
ihe same people who give advice on insurance get commissions lied io how much people whosay. '[don't carewhat it costs. I
Please Tint to /tye SS. Cblima /
insurance ihey sell. "I don'i mink me loss
Insurance Agents Are
Casualties of the Plan
To Alter Health Care
Continued From Page Bl
just want good service." " he says.
Receni events in California seem to
bear him out. The stale has already set up
a heallh alliance much hke those ihe
president envisions. But agenis can still
sell policies oKered by the purchasing
groups. Although businesses could save 5%
(ees by buying directly (rom the alliance;
790 o( the 1.192 small companies enrolled
in ihe alliance have chosen lo buy from
agenis. And they have done so even though
Ihey must (irsl sign a form acknowledging
lhal they pay more going through an
agent. •
- Insurance experts acknowledge that
agents provide services that someone
would have to pick up. But they also say the current system adds an extra, costly layer
of administration.
•You're not going lo eliminate ihe cost
completely t>y eliminating agenis." says
Greg Herrley. a consultant, with Milliman
St Robertson, an actuanal consulting con*
cem in Milwaukee. "But ('can't believe you
can t do it (or less."
In addition, the savings (rom eliminating agents sre only part of the equation,
argues Paul Ellwood. a member of the
Jackson Hole Group, a research organization whose ideas helped shape the Clinton
plan. He says the demise ol agents is a
byproduct of creating alliances, and he
believes thai setting up the aUlances is
essential. By creating huge pools of consumers who would share each others'
risk*, the aUlances can provtdt affortable insurance to everyone, he says. "In
the course of other thtngs the administration is doing, you don't need agents."
Ultimately, the fate of healtb-lnsurance
agents could be decided less on the ments
than by politics. Agents represent a powerful poildcal group. The MO.OOtwnember
Independent Insurance Agents of America
is one of Washington's moat powerful
lobbying groups, having donated 1590.798
to federal campaigns over the past two
yean. The National AssodaUoo of Health
Underwriters and other agent groupt art
also active.
"Politically, this Issue Is important
becaiae every Congressman has agents in
their districts." Dr. Ellwood says.
THE WALL STREET JOURNAL WEDNESDAY. NOVEMBER ,7 ,oo.
�Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC SCEINVIFTZ
Continued From Page fit
jusi want good service." he says.
ot agenis is someihmg consumers will
mourn." says Gail Shearer, a heallh-care
experi wuh Consumers Union, ihe publisher ol Consumer Reports magazine
Such lalk rankles Ms. Proctor, who
specializes in selling group health policies
lo small employers, including plumbers a
swimming-pool conlractor and me police
depanment of nearby Put-m-Bay. Ohio.
^ Ms. Proctor. 35 years old. has aboul 100
TOLEDO - As a neaUn-msurance
jRent. Lon Proctor was naiurallv curious
aboul how ihe Cimlon nealm care plan
would affeci her fob.
So when she .visited tne While House
last momh as pan of a group of northeni
Ohio business people, sne pul me question
about ner future directlv in Hiliarv RodVim Mininn
The answer lell ner snaten. Tm a t
mosr-of it from commissions-on policy
suming anyone as obviously brilliant as
renewals. Unlike life insurance, which
you could find someihmg else io markei."
provides agents wuh huge commissions in
ihe First Udy said.
ihe firsi year ol a policy and'low commisHoping to tame health care costs, the sions in laier years, heallh insurance pays
Climon health plan ines to mm adminis
commissions thai are fairly conslanl from
iranve fal oul ol ihe healm-care svsiem. ' v ear to year.
Bui only one job would be leeislaied oul of
On a receni morning. Ms. Procior met
existence: health msurance agents. There
are aboul 150.000 Amencans who make with a clieni to discuss coverage (or his
workers and agreed to sit down wiih an
most, of their living selling heallh coveremployee o( another customer to explain
age.
benefits. She also scrutinized doctor bills
Under ihe Clinton proposal, consumers
of a customer who believed he was impropwould buy health insurance from purchaserly denied benefits, looking for mistakes.
ing cooperatives, known as heallh alliIf I don't keep these people in my Rolodex
ances: Agenis would be barred from selling happy, theyu fire me. "she says.
the Insurance offered by the alliances.
Toledo advertising executive Roger
At fitst glance, ihe savings appear to be Raymor. one of Ms. Proctor s customera.
huge. Insurance agents earn aboul S3.8 used to think insurance agents were nothbillion a year in commissions on health
ing more than sales people. But then
coverage. Bui the services thev provide,
he broke his arm in a motorcycle accident
such as explaining benefits and fignnng
in West Virginia. His insurance company
with insurance companies over denied
refused lo pay his claim, and the hospital
claims, would have io be made up by charged him for services he says he never
someone - perhaps governmeni emreceived. Ms. Proctor spent two years get- '
ployees.
ling the disputes untangled. "No normal
That scares some people. " I don t see human being can possibly understand an
Tonsymefl being vyy welL served hv -USiraoce noiicv." Mr H n ^ r ^ . y .
mat." says Saul Spivack. a consullant wuh would hate to lose that representation."
Tillinghasl. an actuanal consulUng firm
The Better Business Bureau in Toledo
It will be like dealing wuh [he Depart- uses Ms. Proctor as a conduit to offer.
ment of Motor Vehicles."
health insurance lo Its members. The head
But consumer advocates say anything of the bureau. Richard Eppstein. says his
is belter than the current syslem. in which
members don't mind paying for an insur
me same people who give advice on insurance agent. "I talk lo many business
ance get commissions ned to how much
people who say. I don't care what it costs. I
insurance they sell. "I don l ihmk me loss
Please Tun to Page 86. Column I
_THE WALL STREFT t
n
^
m
Receni events in California seem to
bear him oul. The slate has already set up
a health alliance much like (hose the
presidem envisions. But agents can still
sell policies offered by the purchasing
groups. Although businesses could save sit
fees by buying direclly from Ihe alliance
790 of ihe 1.192 small companies enrolled
in me alliance have chosen to buy from
agents. And Ihey have done so even though
ihey musi first sign a forni acknowledging
thai they pay more going through an
agenl.
Insurance experts acknowledge that
agents provide services that someone
would have to pick up. But Ihey also say the
current syslem adds an extra, costly layer
of administration.
"You re not going to eliminate the cost
completely by eliminating agenis." says
Greg Herrley. a consultant with Milliman
4 Robertson, an actuarial consulting concern in Milwaukee. "But I can t believe you
can I do it for less."
In addition, the savings (rom eliminating agents are only part of the equation,
argues Paul Ellwood. a member of the
Jackson Hole Group, a research organization whose ideu helped shape the Clinton
plan. He says the demise of agents is a
byproduct of creating alliances, and tie
believes that setting up the aUlances is
essential. By. creating huge pools of consumers who would share each others'
risks, the aUlances can provtdt afford-,
able insurance to everyone, he lays. "In
the course of other thlnp the administration is doing, you don't need agents."
UlUmately, the fate of healtb-lnsurance
agents could be decided less on the merits
than by politics. Agents represent a power
ful poUUctl group. Tbe JOO.OOtHrtember
Independent Insurance Agents of America
Is one of Washington's most powerful
lobbying groups, having donated 090.738
to federal campaigns over the p u t two
yean. The National Associatloo of Health
Underwrtten and other agent groups are
also active.
"Politically. Ibis Issue is Important
because every Congressman h u agents in
their districts." Dr. Ellwood says.
_
^
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
Insurance Agents Are
Casualties of the Plan
To Alter Health Care
Continued From Page Bl
just warn good service.' " he says.
•Recent events in California seem to
S t a l l f t m o n e r ot T m
W i i i . 3 r n f r T J . . i R N * L
bear him out. The state has already set up
TOLEDO - A a healin insurance
S
a health alliance much like those the
agent. Lon Procior was naluraily curious
president envisions. But agents can still
atwut now.ihe Climon heallh-care plan
sell policies offered by the purchasing
would affect her job.
groups. Although businesses could save 57
So wnen sne visued the White House
fees by buying directly Irom the alliance.
last month as part of a group ol northern
790 of the 1.195 small companies enrolled
Ohio business people, sne put tne question
in the alliance have chosen lo buy (rom
aboul her future directlv to Hiliarv Rodagents. And they have done so even though
'Mm
. ihey musi first sign a fonn acknowledging
The answer left her snanen-• rm. at.. mosi of il from commissions, on-policy
that ihey pay more going ihrough an
suming anyone as obviously brilliant as
agenl.
renewals. Unlike life insurance, which
you could find something else lo marKel."
provides agenis wuh huge commissions in
Insurance experts acknowledge lhal
the Firsi Lady said.
ihe first year of a policy and low commisagents provide services thai someone
Hoping 1 tame health care costs, ihe sions in laier years, health insurance pays
0
would have to pick up. But they also say the
Clinton health plan'tnes to trim adminiscommissions that are fairly conslanl from
currenl system adds an extra, costly layer
trative fat oul ol ihe health care syslem. v ear to year, v
of administration.
But only one job would be legislated oul of.
On a recent morning. Ms. Procior met
' Yourenot going to eliminate ihe cost
existence: heailh-msurance agenis There
with a client to discuss coverage for his completely by eliminating agents." says
are aboul 150.000 Americans who make
workers and agreed lo sit down wuh an
Greg Herrley. a consullant with Milliman
most of iheir living selling heallh coveremployee of another customer to explain
& Robertson, an actuanal consulting conage.
benefits. She also scruunixed doctor bills
cern in Milwaukee. "But I can't believe you
Under the Clinton proposal, consumers of a customer who believed he was improp- can t do it for less."
would buy heallh Insurance from purchaserly denied benefits, looking for mistakes
In addidon. the savings from ellminat-'
ing cooperauves. known as heallh alliIf I don't keep these peopie in my Rolodex
mg agenu are only part of the equation,
ances. Agents would be barred from selling happy, they'U fire me." she says.
argues Paul Ellwood. a member ol the
the Insurance offered by the alliances.
Jackson Hole Group, aresearchorganizaToledo advertising execunve Roger
At first glance, the savings appear to be Raymor. one of Ms. Proctor's customen.
tion whose ideas helped shape the Clinton
huge. Insurance agenis earn, about 13.8
plan. He says the demise of agents is 'a
used to think insurance agents were nothbillion a year in commissions on heallh
byproduct of creating alliances, and he
ing more than sales people'. Bui then
coverage. Bui ihe services ihey provide
believes that setting up the alliances is
he broke his arm in a motorcycle accident
such as explaining benefits and fighung in West Virginia. His insurance company
essential. By creating huge pools of conwith insurance companies over denied
sumers who would share each others'
refused lo pay his claim, and the hospital
claims, would have io be made up by charged him for services he says tie never
nsks. the aUlances can provMt affordsomeone - perhaps governmeni emable insurance to everyone, he says. "In
received. Ms. Proctor spent two yean getployees.
the course of other thlnp tbe admintstrating the disputes untangled. "No normal
tion is doing, you don't need agents."
That scares some people. 1 don t see human being can possibly underatand an
consumeQ_being -v e j^ w e lnL s e a o[t JUL. J f l S r a i C e MliCV " M r P a y m n , . a y .
UlUmately, the fate of health-Insurance
II
vi
we
an vn
i^y
hat
M V t
.
agents could be decided less on the merits
lhat. " says C a u l CSpivack.-a consultant with would hate lo lose that representation."
Saul n l u q ^ l .
Tillinghasl. an aciuanal consulting firm.
The Better Business Bureau in Toledo than by poiiucs. Agentsrepresenta power
(ul polincal group. The 300.000-member
"It will be like dealing with ihe Departuses Ms. Procior as a conduit to offer
ment of Motor Vehicles."
health insurance to its memben. The head Independent Insurance Agents of America
But consumer advocates say anything of the bureau. Richard Eppstein. says his is one of Washington's most powerful
lobbying groups, having donated 1590.798
is better than the current system, in which memben don't mind paying (or an insur
to fledenl campaigns over the past two
the same people who give advice on insurance agent. "I talk to many business
ance get commissions ned to how much people who say. I don 't care what it costs. I yean. The National AssodaUoo of Health
Underwrtten and other agent groups are
insurance they sell. "I don'i think Ihe loss
Please Tiint to Page B6. Column I
also active.
"PollUcaUy. this Issue Is Important
became every Congressman has agents in
their districts." Dr. Elwood says.
By GREC STEIVMETZ
oi agents is someihmg consumers will
moum." says Gail Shearer, a heallh-care
expert wuh Consumers Union, the pu
blisher of Consumer Reports magazine
Such talk rankles Ms. Proctor, who
specializes in selling group health policies
lo small employers, including plumbers, a
swimming-pool contractor and the police
depanment of nearby Put-m-Bay. Ohio.
Ms. Proctor. 35 years old. has about 100
_JHE WAU. STREET JOURNAL WEDNESDAY M W . ^ ^ ^ ^
c
�Clinton Health-Plan Casualty:
The Health-Insurance Agent ^
By GREC STEIVMETZ
S i a l t R r p o n r r < Tup w i s r R. F T j m ^ » "
0
M
K
L
oi agents is something consumers will
mourn, says Gail Shearer, a heallh-care
expert with Consumers Union, ihe publisher ol Consumer Reports magazine
Such talk rankles Ms. Proctor, who
specializes in selling group heallh policies
10 small employers, including plumbers, a
swimming-pool contractor and the police
department of nearby Put-in Bay. Ohio
Ms. Proctor. 35 years old. has aboul IM
TOLEDO - AS a nealtn insurance
ugeru. Lon Proctor was naiurallv curious
aboul now ihe Cimlon healin care plan
would affeci her job.
So when she visued ihe While House
lasi monlh as pan ol a group of nonhem
Ohio business people, sne pul me question
aboul her future direcilv io Hillary Rod'•imnminn
The answer lell ner shaken, •nn.afc. mosi of it from commissions on-policy
suming anyone as obviously bnllianl as
renewals. Unlike life insurance, which
you could find someimng else to market "
provides agents with huge commissions in
ihe Firsi Lady said.
the lirsi year of a policy and low commisHoping lo lame heallh-care costs, the
sions m later years, heallh insurance pays
Clinton health plan ines lo trim adminiscommissions ihai are fairly constant from
Iranve fal oul ol ihe heallh care svsiem.
year lo year.
But only one job would be legislated oul of
On a recent morning. Ms. Proctor met
existence, health-insurance agents. There
with a clieni to discuss coverage for his
are aboul 150.000 Amencans wno make
workers and agreed to sit down with an
most ol iheir living selling heallh coveremployee of another customer to explain
age.
benefits. She also scrutinized doctor bills
Under ihe Clinton proposal, consumers
of a customer who believed he was impropwould buy health Insurance from purchaserly denied benefits, looking for mistakes
ing cooperatives, known as heallh alli- • If.I don l keep these people in my Rolodex
ances. Agenis would be barred from selling happy, they'll fire me." she says.
the insurance offered by the alliances.
Toledo advertising executive Roger
At first glance, the savings appear to be Raymor. one of Ms. Proctor's customers,
huge. Insurance agenu earn about U.8
used to think insurance agents were nothbillion a year in commissions on heallh ' ing more than sales people. But then
coverage. Bui the services ihev provide.
he broke his arm in a motorcycle accident
. such as enplaining benefils and fighung in West Virginia. His insurance company
wuh insurance companies over denied
relused to pay his claim, and the hospital
claims, would have lo be made up by
charged him for services he says he never
someone - perhaps governmeni emreceived. Ms. Proctor spent two years getployees.
ting the disputes untangled. "No normal
That scares some people. I don't see
human being can possibly understand an
consumen_b}ing very well served hv J U S i r a a C t n o l i r v " M r B a p ^ r
ihat.'' says Saul Spivack. a consultant with would hate to lose that representation."
Tillinghasl. an aciuanal consulting (inn.
The Better Business Bureau in Toledo
' It will be like dealing with ihe Depart- uses Ms. Proctor as a conduit to offer
ment of Motor Vehicles.
'
health Insurance to Its memben. The head
But consumer advocates say anything of the bureau, Richard Eppstein. says his
is better than the current system, in which members don't mind paying for an insur
ihe same people wno give advice on insurance agent. "I talk to many business
ance get commissions tied io how much people who say. I don't care what it costs. I
insurance ihey sell. -| don't think me loss
Please Tm to Poje SS. CWumii (
_THE WALL STREFT iQURflAL WEDNRSnav ^
Insurance Agents Are
Casualties of the Plan
To Alter HealthCare
C m t i i u t i Fmm Page Bl
just want good service.' " he says.
Recent events in California seem to
bear him out. The stale has already set up
a health alliance much like those the
president envisions. But agents can still
sell policies offered by the purchasing
groups. Although businesses could save 5%fees by buying direclly from ihe alliance.
79* of the 1.192 small companies enrolled
in the alliance have chosen lo buy from
agents. And they have done so even though
they must first sign a form acknowledging
that they pay more going through an
agenL
Insurance experts acknowledge ihat
agents provide services thai someone
would have lo pick up. But they also say the
current system adds an extra, costly layer
of administration.
"You're m l going to eliminate the cost
completely by eliminating agents," says
Greg Herrley. a consultant with Milliman
& Robertson, an actuarial consulting concern in Milwaukee. "Bui I can t believe you
can't do It for less."
In addition, the savings from eliminating agents are only part of the equation,
argues Paul Ellwood. a member of the
Jackson Hole Group, aresearchorganization whose ideas helped shape the Clinton
plan. He says the demise of agents is a
byproduct of creating alliances, and he
believes thai setting up the aUlances is
essentisl. By creating huge pools of consiunen who would share each others'
risks, the alliances can provide affordable insurance to everyone, he says. "In
the course of other thtngs the administrauon is doing, you don't need agents."
UlUmately. the fate of healtb-lnsurance
agents could be decided less on the merits
than by politics. Agentsrepresenta power
ful political group. The 300.000-member
Independent Insurance Agents of America
Is one at Washington's most powerful
lobbying groups, having donated 090,738
to federal campaigns over the past two
years. The Nanonal Assodatkn of Heallh
Underwriters and other agent groups are
also active.
"Politically, this Issue is important
because every Congressman has agenu In
iheir districts." Dr. Ellwood says.
,
| |
�-•' • ilA'i ' • • i ^ i . V t l i i t i ' ^ ' S f c - rMiiiiieioti'theiKh care nuttrt pro- . raikcn tort nerd eiiteiniTdy:d£l»l+ |
it.^.iyideiVrealiproof
. . ^ J M S L ^ i T S u - - , » •f3i.Wv.i»i*i;-.retl:pn>of that n u r t m . d i i . nt ibcir diffciman. Thai will chann nuitet«..ci». «t ikot dinnencn. Tkal wil! cluniK,
fji|i>*ii*V'di'lii«h:.qMliiy ->i. mineable :. nonighl alia 'Star Tribune/^cra ;
I l l :i ct»B,'i.ij»y5 IXnmbcipT in.touting: heatlh:Mir foninC wWiDDrenber- .
_ - . - " r r • Bbe U«le> hralth ore ratket u • (Er and WdhMne will heloinerf W ]
At if by • «i>liGM.tcKiilnt't daige.
ifllillK'Sr,
HluMtoitKMim.:
'
Jedilli F r i r r . a biglMa.lrini.healtH
MmBooUi.iaaariMtonndi end
t W f t n C a ^ k i f ^ i - . ^ . . v - i ' w r > i - 4 . ' 'Official' i«.-.*e"CItaloo"«d«hbli*,i
: j f ; ihe§S8Wft|iS«VCbfflniitiee"i
I F T ' Q T'AI'k>:.;WHtao«bnoi »iipb<iiit..w>ri^iig. tm. Both raen hiVe'bOT prepdnA ,
' boneaHdcTiiiripfcP^lei! "Democrat
. • L t - i S d ^ A - .'rebel*' . r i « ~ r d W . S r . l i o . ' V o l ' fa, the Bicouoter.-SHlid. •witlXbt ,.
'ttul WejitteeiSgiiyUie k n end.
L v A B O U T T T r i .wwrm and ktnpital groom and i ^ broatoal ia J u enl»t»r D « y 9,.
JlicpoblM«-Siirra*t 'Durenberter
i .porn Ibat many insunnK comply WCOO-TV.CbaeneK.v
ihe.iijRWSMplijKdoaVoAen meet
,. buiaucratl inlerfaT with doctnr-p..
in.Ae
'
» *'-,'?
'"."^jlieet jeIatioil»biiB..lndiw),.iome of ' .Until,ioeiglift'd
nUimoagJi ;for)
Bmoaiy . l io abortiaa < irr''amninl?nMmgii' —. meerterelJllK Mnraoia .heaMi coniptnia tliit^/1ia»t- .
.
.
^ ..„ ..-^.i
Senile * • Dumfantr tdmim tre citrd "by 'Blenrm slalemeiils nLid news1h(
menrm italcnw
'
'- '
siniC stile
etch ; fttMl thetine Mile to be-on l :
lea
. oomnitlee tosethcr. But it's vinnlly ,. AWdldonc aa eiampla of what's leases, but withoat ratch interactk .
S ^ S a ^ i n n o
c
' / . ' / . / Araieifcirtnish occtrred last'week nl'.
l
' c are O^fBiiba •pin than ihn nhetid of in mcli a nsefor.than to* .wnwf; fii; .•'1 '•••:'-;:.'.',:
..
^,
te. about ihe.iiiutioe^ >.. .i •«;».»'..• / • . „ . J . >i-;>. _ Labor Commihee WamiirfHA^fc.'
'
• I
Despite .tbdr* shared' coomittee v* . hetlili insuiaiice indBtiy. WeUtto^el
: >i|. •;, it v i ..•'.•SU.;; i ' ; •. .'...Hpimeni. .the. two .Minnesota law- ned his question i time to criiiciTt.n '
•
'•• -'" ' a V t ' . - ' i " . . l o w
... ..• '..• .'l-' • •'•
••'.'.
• '.'.^V.',;.!;'^i^-.'
f^T*mlhalnT«(i,.,l
. Wartinl^BumuCNtf. - - ;
:
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("vj.ti 'fii-'.atf- •••,/«!«•:•:•• •
1l2^bun»nicompe«tiiioe »picki»t
'recrirrd by WiUiMn McOiiire. CEO
»r;Mimesot>4>tsed United. Htaltk
C m Cap., wtiicb owns and apaatcs
hcdlhpbM across Ore coontiy. :r:>
I'KW.-SKAiMH.M .SBJWJ.te.rt'.iri.
T i m hi** tHary is one ofthe bioEst
'letsons wby people tie becominj.
wwy of where all of Ikis Inunged
•mnpewionr ii (Diet-. Wellstone
nd.
,••> •'"
' •
Diuiuiliuiu ' respCTMfcd Wilk praise
rortbecompuy'scflkiencyandcoT^
lamer awareness. "This stltry ays
that there is so mod) bto«t m Ihn
•sjswm by whit* cosis can belrtkicrd
': that tine it snmbody nit there who
e n mike that much mooey try "
ihiici difftrtrntly"Dorerbener said. •
: -v? .
i. ••" •ii.(.
wtixxm an nownn CBTW wxTym.'.,..J ' - - " ' - ef/.-; ' ' ' T i
Hf lhmcliirtci)Weilttrwpe.J»TH 7
is marii etsier to oik ibout' Si:
mill km- md harder to ewtnine
value of itnoviliom Ihtt'Ujitlci
Health Care.has introduetd.
'irpon cards" to help consnmepjY •
led Ihe best providers.'. '
;'t j'.^h'
1
J
.-
j
.. .
:
Ore cominaed oitW
1
.•,•.•.":': '. .'.ingl
2B >";'.
: . • V •':'•', '\r . •.-' :••»
2-
�I t t t L I 1 1 : ' cmB.'"'^!!! Durenbercr-iii.loining hcallli cair'fbhin^ wbere'DweDbef- •»
_ ~ "
_ Vrr? : . iilie ilae't brdih a r c . mifkn a t j a .nd Wdhtone will be^MiwT bit ]
•
Jeditli Feder. • k i n h ^ i k ^ . t p h i j
P A D C * ^ i . lmoddfiH Ihe nation ::
official ia •Ibr C^ltw athniifalitf )
w T O l f c « | j k ; - * | ! T ' •'r^fi—.'•fi-.v'-jtrr.vvi-.-.ft
' I F T ' ^ i T A l ' k ; W e t « o « h not so apbeal.' wonyiaj. tion.'iBolh Dten hAVe 'bcnt peeiienH i
- ' • . W ^ V V ^ T ^ " • ' » • » > > • ri"™«»> ^nccmralio.". of Sic the.: iw»Mler.<S»ttc«^iwfllIbt „
.•. A B O U T l l i i > • .imeten ami kotpital STOUIB and reponi lint maey insurituc
e.comdaiiy : WCCO-TV, Chiaiid<... I'Ji i'J'Jff
interfcrewitli donor«a. : ' : J - •': .' • •..•.•.•'l >-?;.*»»-l i
•• '.
• .1
i.
of. Until. toaighfi'diOTiiony.tlKtTwij• i » ' ; • ;. .i.
"^'.lierl jetalioBsliilB. liHted. some irf/,Unrtl,te»ighfVdtsceBioo;
panics thil^^UTC- jcreraMy extra^'^duiiihit*i^moogh ^mvnieintiorsl^be Mianooia health conipanieitliii\^iaTe- jcreraMy' expreiwd''
to short ma i : HV anusual
: citrd bv "faeorie italemeafs •'•^»d^new^1tt-.'..
ieyjUlWb/ca])celed (Mil cacti \ from the seme stile lo be-on it Scnstc •'l)aiuibtnu admires ire citrd by
lally
lea
„
mher-i irt'ff^il'ytiri-.Aiid on no j eomniuee le«eUier. But it's vmaally V iWdlttmc as eaaniples of what's leases, but wnhool faarii iateractib^L^
'A 'rare ikrrmhh oocarrad last'Week at .
• of in sarb a rase for .them
nto« wnat. tV I." '• • ''..•' ^ • . l/.'.V"*'
issue an die^-rertlKr apart than this
rite about
i » a " ' . . V ' . >:.• '" . " J ."• »:••'» Ubor Committee hesriii^wlltjc •
yorXkotttstcomritlet topic.heahh
, Despile 'their' shared committee as- htallh insmanee indmtry: WelWo+el
back home;
' • ^ ' ' ..iigameilt.. a k * .two. U inntaola
•
H
»
1 I 1w« n t K ^
his qiMtic»itmie'lo'eritienx!a''the.
M .
-•. ..^
.:f|.';r -ii'Uj.iiJ.'.^'.u.i r^i':..' ':.::,sifa
• "' .' " I
-»>•"•'>''?•-..•
— l ^ S i V - ' ; " • tVl't'-i-.v
. to if by tippliWI.IcftiiHft desimi,
Htwaaao i i a k t t n nl on n d i end ,
liB*('Gomniiltrt l
J j y i t i : "Dcmocral
" iVihekflnKl.
tDui
i l 'often meel i
;
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ij —... ;
^
,1
'• •' ' '.• 4'
v- . i l : • ..'i.il'f:
il2-minion compeMMioa
(mxhed by WiUUm MoGmre. CEO
nfiMinnnota^iased United. Ilalth
Caie Corp.; which owns and operates
hedlhplaas across the cotmtiy. :«>•'
!'«ffl'ill'*.rMH.'i3.io>»s«.tec^e:.'r'!
T b i t kitli sataiy is one of Ihe URCSI P ^ ' . ^ t i l u n . •wl'.D^e b ^ 'itasoot wby: people lie beoommt bergar will d e b a f theb dXerf
wiry nf where all of this lmaea(ed fencM on hodTti csre ^^V'^'jit/j^' •
compniUon) ii • goiat" Wellslone
i « then ckided Wdl'tto^ sayiajf f i t
is mack 'easier .lo' talk about'' $12 .
Damilmtu responded witk p n i r millKai- and harder to aplulQW
for ike compajiy's elTicicncy and con- value of iaaovations thai • UjtiWd
. "Tbts talafy ays Health Cue has immdmd. suclt. ai
Hut there ii so mnch Hoat m this "npuit cards" m help oonsumeraae. ,
.t
tystem by which costs can be'reduced lect the best providers.':!','
'! that Ikioe ii tomebody out there who
' j .-• •• •
•. .:'
'. •• r
can make lliat much mooey by dotm
thiaei diffcrintly,''. Dorenbener said. ' Cue oominaedbif piae 211 > "•"iirtitj !
.
riiT
:
:
. -f^-:-:- ••• -y -f"
. i
I
,0>
2-
�NOV 17 '93 03:l5an STAR TRIBUNE PHOTO
Gare^he t wo^enatorstiave differing ^
visions of what vvorks and what doesn't
• commuhily .'clinici and providing "iin»le-payer bat the virtue of toundin| very simple. ...
cart for ill.
..Wellstone 'doesn't pul i ftreii deai of
•: faith in the idet. ia>-in|-that in' an:". In Wa*hin$tdn, WelUtone'i approitb ; "That eiperience told ut we've jot to
environment of. lirje health insur-" —•in which the fovemmeni would .•be able to explain in good, timple,
ance bureaucrarievreport card* can*.' :lakt over,the role of insurance com-., clearlanguage. wbai mansged compenot really jive eoniumen much lev- " paniei —.is "not-given much of i ' lition is about, because people do not
.
chance of pauage. But it dbei veo' want s complicated tyttem. We-'|| try
erage '
well in fovemment ccst<contr6l ftud- [tonighi] to. deliver that menage
. clearly." .T' - i
- Fundamenullyrthe two men hive • '. fei and public opinion forums.
different'vision of health economics
and potential wlutioni lo proble.xs Durenberger's itiff was ituni recent- Al the"tame time, he said, Durenberly when a ."ciiijeni'jury" rtudying , ger wants-tc warn that the Qimon
In heallh care.
health refbrm went "out of iu way to program'i reliance oh- govtrnment: For van in the Semic, Durenberger uv it preferred Welliione'i plan. Al- reiulattd price limitt "are harmful to
hu been an advociie. ef roanaced though the jury didn'l formally .Un- managed compeiiiion."
cart and Imarkei-baiedreformi,em- done it, they injected proposals ad• bracing many ideu developed b> Dr. vocated, by Durenberger and.pepre- Tonight't ditcuttion will be prttent;
Paul Ellwood.'a.Minnesota phytician •entitivei of the Ginton admin in ra- ed.to t imall audience in Minneapowho encouraged hulth maintenance tion. Durenberger'i itaff hopes to ap- lis made iip.partly of citiaens who
7- o^ariiutiorii (HMOi) here in ihe • ply hswai from that Mperience to- participated in town forums on
health reform. The Minnetoti House
niiM
;
delegation will sltd panicipaie. Seg. .-"Durenberter -WM * not •.' really. aiir- ments will be thow'n on Channel 4'i
Dufeiiberier'i irpijUiion i i built on
an undentan'ditii otthc imhciciei of • : prised by .the jury;'', laid "Rick fevani, 10 p.m. news; the full ditcuttion will
Xheilth'i)iteiti?:and .the concemi of. r Durcnbcrger'i chief of 'itiff, because be brosdear Dec. 9st7p.m. .
i-^providcri, thanijed-care companies
-^and dbctors,<ThIi year, he hat joined
Rep. .Jim Coopef/.D-Tenn.; to.offer
the Maiisjed Competitioii'Acv built
^•roiihd i theoiV.ihii Ptetident Qin-'.
•jrion embraced durina the prtsidtntiil
" ampaifn, aiid "one'bicked b>' nuior
•'. insurance ititeretu. Dtitenberjer tayi
' that Mirlnesou'i eipcriencc - with
competitive-health plant shows that
'.r.th^:ppvate ieftor-cah .deliver hifhSmSOaa^al^tt. ••'reasonable eon.
> •••tThat is^sortiethlna tdventment will
"
''^•toXMh***?**^
.jr.
V:i.VS«fp|itV?%^rV« X*
WtUlton^ 6f courie. aees il the otjier.
Hiy.'He favors national beilUi io'siir-^«ifiee,iwhich would put private lasu'r-.
> ers'yoSt'?of.'buiiness,-. He ;has intfO:
•-^"^^leiiilitlon' batied: lariely .Von
I'I iin»le-payer"iirittm thario'
iCdrawn the mon tuppon -of
^WHoHS-fct'
.CootinutJ frcn p»B» IB
1?®}
. -1^.^
t
v
L
"
ibi
SHiSVclmion ."lie bett'or^sapaed
ircare'Wntb a tinglo-piiycr tysumjiui
W ~ IbrnJu^Miimesou'l-tnidition' of
hiallhSf'gci»Ty«ll1eybnd HMOs.
He praitet tht state's' tiidition of
"'-
• '
�M V 17 ' 9 3 03:1501-1 STBR TRIBUNE PHOTO
O
P. 12
(5)
-.»iV.i-..- .i, •. , - ,
!
/<JJhe two^enators "^ffiring
visions of what works andwhait doesn't
community .clinics and providinii
care for all.
.Coaitnutd from p«gt IB
"single-payer bai the virtue of sounding very limpie. ;., . ..... .. .
'
WelJitone doein'i put * greti ded of
-faith in the idea,"nyinf that in" an:, Iii Washin»idn, Welliione'i spproatb ' "Thai esperience told ui we've got to
'environment of larie heallh imur-' .— •in. which the fovemment would be able to explain in good, simple,
ahce bureaucraciM, repon card« can-. take over .the role of insurance com. clear.langusge. what managed compenot really jive eoniumen much lev- • paniei'—.ii'nbt: given much of s • tition is sboui, because people do not
chance of pasuge. Bui ii does 'very want t complicated system. We'll try
eraie.
we!) in governmeni cost-control flud- Itonighl] 10 deljver lhal mesiage
. clearly." < .•
Fundamenullyi the two men have 1 ieund public opinion forums:
different viiion of health.economics
and potential aoliitioni to problemi Durtnberger'i siiff wu itunj recent- . At the lime time, he laid, Durtnbertn heallh care.
ly when s .Vcitiieni jury" studying . gtr winti 10 warn that the Clinion
health reform went but of ill way* to program'i reliance oh govemmeni-•. For years in ihe^Senaie; Durenberger iay it preferred Weliitone'i plan. Al- •reiulsted price limiti "are hsntiful to
though the ju'ty didn't formally tn- mansged compeiiiion."
•-. has been an .advocate of manated
t f care and; markei -based reformi, em- .dorse it, ihev rejected propoials ad'- :bracing many ideu developed by Dr..- vocated by burenberger snd. repre- Tonight'i diicussion will be present' -." Paul Ell wood,'a Minnesota physician semativei of the Ginton administra- ed.to s imall audience in Minneapo' / who encouraged healih maintenance tion. Durenbergc-'i iielT hopes to ap- lis made up partly of ciiuens who
V- orjaiiizatioris (HMOs) here in the ply lesioni from that esperience to- psnicipited in iov.'n fommi on
night.: v, ;
: :.; ':ir,?. .-.-,:
tiealih reform. The Minnesota Houte
delegation-will slid pantcipite. Seg.''DurenbeigCT--wai'not*.'reaJly. siir- . menu will be ihow'n on Channel 4'i
;
&Duhntie^<ri ftpuUtion i i built on . prised by .the jury;r..uid Kick Evans, 10 p.m.'news; the full ditcuiiion will
a «n lindenun'diiii otthe tmricsciei of '. Durenberger'i chief of itaff,-bccauie .be bfosdcajt Dee. 9 at 7 p.m. . •
?! hulih'iynctn^iid .tlie conami of;
iOprovidcn.' mtnised-ure comptniet
i»nd dono™,*ni(i ye«r, tu bal joined
2-Rep "Jim Ci5oper7,D-Tenn.', to offer
T the-Mahagea.Competition'Aet.-built
B
Ja-rbund 1 theon? that Pttaiiehl Om-.
JT.toh embraeied durina the prtiidentiil
• cimpaiin. arid'one'btelred by.m^jor
insurance interests. Durenberter lays
that^ Mitinesbta's experience • with
:
;
:my.^..:. v,:;v.-
;
:
:
Welisione, 6f course, tea it the
wiy.' He favors national health iinur-.
;iijrice,i*bich would put private tesuV-.
t ers'Votii?bf:businesV; »e. hw.'intro:
yduoidliegiilstloti'' based.:' larply-Von
^Cknida'i •inglo.payer'ffystem thario'
—^.dnvm-the most.suppbn'/of- 1
joii.no: j&itettwu.- b t
u„_re'*!ihto'sringle-payersySemSBui
Jheribaki'LMin^tt's.-iailiuoiVtjr
h^tbW'iwIvall'beybnd HMOi:
He praiies the stafeV Uaditioo'of
;
�M V 17 '93 03:ISAM STAR TRIBUNE PHOTO
O
P. IS
(5)
GareSiFhetwG^r^rs^
visions of what works andwhat dbesn't
communily dinici end providing
cert for Bll.''.
"
tCoalinutd from ptgt IB . -
"single-payer bat the virtue of funding vety simple. -,
'
Wellitone doesn't put a great deal of
•i"faith in the idea,"nyinf that in'an: In WMhin»tdn. WelHione's »pi)ro«eh ; "That esperience told ui >e'vt got to
- environment of large .healthJinjur- v.—•in which- the fovenuncM would -be able to explain in good, limpie,
ance' bureaucracies, repon cards can- •.teke over'.the role of intunnce com-.. clearlanguige.whai managed eompenoi really pve eoniumen much lev- pinies- —.ii'n'bl. jiven much of. a . lition is about, because people do not
'chance""of passage. But it does very want s complicated tyitem. We'll try
eraie.
well in government cost-conuol nud- [tooight] lo deliver that menage
clearly." .-r
--j
"Fundamentally; the two men have a ; iei and public opinion forums.
differrni vision of health economics
Durenberger's itifT was ttunf receni. At ihe 'lime time, he uid, Durenber-.
and potential solutions to problems •
ly when a "citiieni jury" studying ger wanti to wa^n'that the QimonIn health care. :-•
health reform went but of in way to program'i reliance on govemment> For yean in the Senate, Durenberger lay it prefentd Weliitone'i plan. Al- -tefulated price limiu "an hirmful to
,
has been an advocate "of managed though the: jury didn't formally en- msnsged competition."
: care and market-based reforms, em- dorse it, thev rejected proposals advocated, by Durenberger and.repre- Tonighili discuuion will be presentbradng'many ideu developed by Dr..-:
. Paul Ellwood, a Minnesota physician tcmalivei of the Ointon administra- ed;io a small audience in Minneapo.'.""who encouraged health majntenance • tion. Duranbetge.-'i itaff hopes io ap- lis made tip partly of citiiens who
i
,1,.^.,
he
eiperience
>-organizations (HMOi) here in thi ply lesioni from, that 'it:,'. .-•, .to- anicipsted in town fdnimi on
night.'.V;^ '£
ealth reform. The Minneiota House
:
delegaiioh will altd participate. Seg"Dunabetter .-vu '.botJreaJly iiir- menu will be shown on Channel 4 i
prised by the jury.T-iaid Ttick Evsns, 10 p.m.'news; the full diicuiiion will
£.Du/rnt)crfer'i jrepiilition.ii built on ^ Duntnbergi '«
ef itiff, becauie be brosdcast Dec. 9 st 7 p.m. .
R.Bn lindenundifig ottbe imricacici of .t:
'V'heilth'fvftcm^pn'd .the concerns of;"
^'providers. iii»n«|'ed<ire comptniej
'i/trii doaon.-Thli ye»r, ht hsi joined
*Rep.;Jim :Oxipcr -.D-Tefln.;- to.offer
' the.Mshsjeil.Conipetition'Act,-built
:
i:
f
t
i'm:^ -
••
T
r
!
p
I
imurance ititerens. Dufenbeiger layi
•that MiHnesbu'i esperience with
com^itive'health plans shows ihst
;thCPtivate sefibr'Csn '.detJvcr' high,
s quality'j^riSat . •.' raaionable eon.
v
v
:
Wiy'.He favors national health iosiir-.
•ttee.iwbich would put private lasu'ritfbf.'businen.' H r hairintrt^:
llegiilatloii' based: largely Von
la's lingle-payer'sysiem thafio'
"drawn the most support jof
jBTlngtittNi' Hensf-AiO.
. i t ,
—
—
J
-
T
-
*
^
-
�NOV 17 'S3
0 3 : i 5 f l n STAR T R I B L f i PHOTO
P. 12
(5)
visions of what Works arid what doesn't
. cbmmuiiily .elinici and providini •single-payer hai the virtue of toundcart fora'.l
.
.
. Ing vety limplt.
.Wellstone 'doesn't pul i great deal of
-'faith in 'the'idea, sayinf that in an
:..'In Wuhinttdn, WiHstone'i approacb .: "That esperience told uiwe'vt got to
' environment of. large health insur- *;: — ' i n which the fovemment would be able to explain in good, timple,
ance bureaucracieii report cards can- take over the role of imurance com- clear language.what msnsged compenot realty give eoniumen much Itv-' V paniei — . i l not. given much of. a ' tition is about, bccauie people do noi
. erafe. ;
'chance of passage. But it don very want a complicated tyttem. We'll try
.- well in government cosKontrol itud- [tonighi] to. deliver thai menage
'Fundamentally/ihe two men have a .' iei and public opinion forums. ••
. clearly." -V '•.- • -i
different vision of health economics
and potential lolutiom to problerr.s . Durenberger*! i t i f f was .nunl recent, . Al ihe isme time! he taid, DurenberIn health care. Y "
ly when i ."cilizeni jury" studying ger wsnti lo wacn'lhat ihe,Clinton
' health reform went bui of i l l way to program'i reliance on gbvemmemFor yean in the Senate, Durenberger iay it preferred Weliitone'i plan. Al- reiuiated price limiti "are hirmful to
: has been an advocate of managed, . though the juty didn't formally en- managed competition." '
f ; care and imarltei-based reformi, em-' dorse it. ihev ryected propoiali sd- -;bracing many ideas developed b) Dr.. . vocated.by burenberger and.repre. TonighVi ditcuttion will be presentPaul Eliwpod, a Minneiota physician '. sentalivei of the Ginton adminiitra- ed.io a imall audience in Minneapo/."•who enccuraged healLh maimenance - tion. DuTenberger't staff hopes to ap- lis made up.parity of ciiuens who
'/•• orgariizatioris (HMOs) here in the ply lesioni from that «»perienoe to- pinicipated in town f o m m i on
health" reform. The Minneiou House
• right ••'. [.- - b i .;•
•'
delegation will alid pmicipate. Seg^
.DufGn£cTvrt'"jTpLiUiion.U buill on .:"Durenl)ereer.-w-nmVreally siir- menu will be ihown on Channel 4'i
en undenunditig otllie imricacici of *: prised by the jury.T said Hick Evans, 10 p.m. news; the full ditcuiiion will
heilili'iyiietn^arid .Uie concemi of burenberger'i chief of itaff, becauie .be broadesn Dec. 9 at 7 p.m. . .
v V o v M e n , ' miniied-care companies
v,»nd docton/Thli year, ha, has joined
Rep:Jim .Cooper, .D-Tenn.,- to,offer
the.-ManBged.'Competition'Act,- built
^ irbiind atheoii? that Preiident C1in
^ t o h embrabed ourint the presidehtislcampaifn, and 'one'backed by major
j i : insurance interests. Dutenberier laysf ' that Mitin'esbta'i' esperience with
compjnilive health plans Ihowi that
•th£ptfviiie'tcTibr;Cen deliver hi|h>CoDlinii»d from pig* JB
:
:
.
t
!
:
v
;.s qualityr^ear^at .a.'.raaionable
OOIL
:
" vky: He favori.'iiational health insur-;
- sifiee,i)i(ti|ch would put pnvate_lnsu'i:-;
v eis'>oiit*bf.'b™i'>e»v'- H r ' h a i ' i n i r i .
ydutzd^legt'ilitlon' based: largely Von
-,'CaniiJa'i lingl^paytr'iystem thario'
drawn the most tupponjof*-- " - - - ' - n s o ^ i i B l h e .
Hz-
�NOV 17 'S3
03:15C1M STBR TRIBUNE PHOTO
P. 12
•JT • ••"•• •f-
visions of what works arid w
community-elinici and providini "single-payer hai the virtue of louhding vety limpie. :
cart for ail
Wellstone 'doesn't put l great deal of
- faith in the'idts,'uyinf that in an! ,' Iii Waihiriiton', Welliione'i approacb ; "That eiperience told ui we've goi to
-environment of.large health insur.'-.-—•in which'the fovemment would . be able to eiplatn in good, timple,
anct bureaucracies, report cardi can-.. • •take bver^the role of imurance com-.: clearlanguage.whai managed compenot really give eomumers much lev- ;: paniei — . i i hot »ivtn much of. a iiiion is about, becsute people do noi
' chance of paiujt. Bui il does very want a complicated tystem. We'll try
ersge. '
• well in fovemment cost-control rud- [tooight] to deliver that menage
Fundamentally, the two men have a : : iei and public opinion forums. •
.Cootinutd from paft IB •
J
:
different viiion of health economics
1
and potential ulutioni to problem! • Durenberf er ! staff wu itun| recent,
ly when t "citiieni jury" studyinj
In health cire. ':••heallh reform went out of in way to
.., For yean in the Senile, Durenberger iay it preferred Weliitone'i plan. Alv hu been an advociie of mansged. 'though the'juty didn't formally eni i care and ^markel-baied'reformi, em- dorse it, they rejected propoials ad*
• .-.bndng many ideu developed by Dr. . vocated.by Dutenberfcr and.repte-' • Paul Ellwood, 'a'Minneiota physician '. Kniativei of the Ointon administra'..' who encouraged health maimenance tion. Durenberier'i itaffhopei to ap.:
:.
i \ 3 i t r \ . \
. i
"r- o.-aanieiiioiii (HMOi) here in the ply lesioni fmm that eaperienoe to-
. At the tame time, he taid, Durenber. ger wanti to warn that the Ointon
program'i reliance on government.refulaied price limiu "are hamful to
'managed compeiiiion."
Tonight'i discussion wilt be presented.io i imall audience in Minneapblii made up .pahly of.eiiiietu who
participated in town forumt on
neaith reform. The Minneiou House
delegation-will altd panicipaie. Seg' ' ' ' — ' - - jtpulaiion.is
—
SiDuiehbeigir'i - ' - - ' - ' ' - buill on "Durtnbelier.^was.notJreally sur- menu will be ihow'n on Channel 4't
ft an undentan'ditig otthe tntricaciei of priied by the jury;'; said Hick Evsns, 10 p.m. news; the full ditcuttion will
''-health'iyiteni?:and .the ooneemi of Durenberger'i chief of iliff, bccsuie .be brosdcait Dec. 9 st 7 p:m. .
i^provideii,' mshiged-eart companiei
^-an'd d6cton,f>ThIi year, ha.hai joined
3 Rep..Jim OjoperV-.D-Tenh:; to.offer
\the Mehigea.'Compeiition'Aevbuilt
rarbiind I theori? that President Clin-',
^r.toh embraced ouring the prtsidehiial
?'campaign, ind ;one'Oaeked by m^ior
. imurance ititereits. Durenbeiger layi
thai Miiihesbu'i esperience with
eomp^itive' heallh plant showt thai
^thfcpnyate'seftbr-can [deliver h/gbi^ ouilny'^car^at'-.a'naio'nable cost.
" ••tThat ii so'rhethlng fovemment will
neJer'do.S^Bfe^i";'*^^'^' ••• Ji'
j r
r
i
s
Welisione, 6f course, sees il the over
wily.'He favors .'national health insiir^uice.iwbieh.woiild put private Insur-.
1 en'iotS^bfJbiisihetV' Hr; hai'intfO:'
-yducid7lefiilstloti"bated:largely Von
i . Cknida'i single-peyer'aystem thario'
'•--"drawn the most support ,of
. .-.i raw w^jjjjjjj. Hquii;- but'
'"''SjuSlie,
2-
•/2_
�NOV 17 'S3 03:l5«n STAR TRIBUNE PHOTO
P. 12
! • CaregThe two^enators^ayedif fering
visions of what works arid whait doesn't
commu'niiy elinici ind providing "lingle-payer hai the virtue of iounding very limpie. ,
art for i l l . ' .
• ;.r.
Weinrorie 'dotju'i pul igreii oe»i of
t greti i a l oi
Wdliione dacsn-t
.:•
•. .-^
• - ^ v i "That experienoe told
0
- faith in the'idei, i i j i n r that in an:., In Wa»hin»ion, Willitont i ipproatb ' be able 10 explain in ui we've goi 1
good,
• environratm of.litte heilth iniur- r —-in which the fovtrnmem would clearlanguagewhat managed timple,
compeance buretuenciw; repon cardt can- -take over .the role of imurance com-, • tition 11 about, becauie people do not
not rtallv five eoniumen much lev- V ppiniei —. .11 not. given much .01. •
really give
^ imt,
We'll try
erage.
' chance of puuge. But it doei very want 1 complicated lyitem. menage
- well in government coit-conuol rud- . [tonight] to deliver lhal
clearly." V
Fundtmenully; Ihe two men hive • ; iei and public opinion forumi. •
different viiion of heilil". economici
Ai
and potential lolutiom to problexj Durenberger'i itaff wet ituni recent- . ger ihe Mmc time, he laid. Durenberwanti to warn lhat the Qimon
ly when 1 "citiieni jury" ttudying
In health cire. v
heallh reform went bui of in way to prognm'i reliance oh govtmmeniprice limiti "are
Al., For yean in the Senate, Durenberger . uv it prefeired Weliitone'i plan. tn- .regulated compeiiiion." hirmful 10
though
fomally
• hu been an advocate of managed done it,the jury didn't propoiali ld- minaged
Ihey rejected
cart >nd mtrkei-biiedreformi,em- . vocated.by Durenberger and.repre- Tonight'i diicuuion will be preieni• •• bnang many ideal developed by Dr.- - ! * :—..... > l ^ . r* "i I A a M M * / 4.a n < m a l
..
^
f
&
0
•' Paul EllWood. a Minneiota phyncian . icnulivei^ of the Climon adroininra- ed 1 1 imair.iudience in Minneapoi- who encouraged heallh maintenince tion Durenberger 1 itaff ^opei to ip- lii'made up partly of .ciiiienj who
1
pinicipated in town forumi on
/ orgihiiatiorii (HMOi) here in she ply leiioni from lhat experienoe to- healthrefbrm.The Minneiou Houie
' 19701 ''
''• '
" • • " ' . ' nigh: •., . •'
:.' •
delegation will alid panicipate. Sec•V.'.^.V /'V-.:;-.. • "
•-•
' ' ••' ••'-«'"
. menu will be ihown on Channel 41
10 p.m. newi; the full disunion will
be broidcact Dec. 9 it 7 p.m .
irVoviden,' mahiged-eare compiniei ! •
^and doieton/Thli yeir, he.hii joined
J.Rep. Jim .Cooper?,D-Tenn., to.offer
* the Mahaged.Competiiion Act,-buill
tirbiind 1 theoiy thit Preiideni Clin^tohembraced during the prtiideniiil
? campeign, and'one backed by.maior
. imurance iiiliireiU. Durenberger layi
' that Mitineabta'i experience with
competitive' health plant ihowi ihn
jthfcprivate-ie^ibr.can deliver high.<» quUity^reariSat"- a: riaibnable eon.
"'i^Tliit irVomethlng gdyemment wtU
.CominuKi (ram p>|t IB
:
:
:
:
:
.. WeUnone, 6f ooune. »ee» it the.01.
way' He favon'iiational heallh iniur-.
:
i CaM4a ^tiniipe^r"IylUin^^io
"--'---"drawn the molt tuppon,of
f
,
l^™M^^u^vfetiOT .br
I
I
h^th'ire g w W l Vybid HMOt
He praiiet the atate'i tradition of
�NOV 1? 'S3 03:i5GM STAR TRIBUNE~PHOTO
P 12
.
' eare^he twoiSenators;ha\^ differing'
visions of what works and what doesn't
• communily .elinici and .providing "linfle-paycr has ihe vinuc cftcundin| very timple. . , .
care for all.; -. .Wellstone 'doesn't put a greai deal of
--'faith in the'idea,'saying*thai in'an:.," In Washii^idn^ Wellstone's.approatb ; "That experience told uVwe've |oi to
- environrnent of. large health insur-"r — •in which-the governmeni would be able io explain in good, timple,
ance'bureaucracies^ report cards can-. '. take over,the role of insurance com-, . clear language .what managed compenot really give consumen much lev- paniei ".—.is hoi. given much of. a - lition is about, because people do not
chance of passage. But it does very want a complicated system. We'll try
erage
well in government cost-control »tud- [tonight] to deliver ihat message
. elearly." .-v
.- -J
Fundamenullyi the two men have a :' iei and public opinion forums. •
difTerent'vision of health economics '
and potential solutions to problems .• Durenberger*! staff was stun! reemt- . At the same time, he said, DurenberIn health care. :••
ly when a Vcitiieni jury*"ttudying, ger wants to wap? that the Qimon
heaJih'raform went out of in way w program'i reliance "on govemmeni, For years in the Senate, Durenberger iay it preferred WeIlilone i plan. Al- .regulated price limiu "are harmful to
:• has been ah advocate of managed. though the" jury didn't formally tn- managed compeiiiion."
; care and :'markei-based reformi, erri-' dorse it, thev nyected propoiali ad;:bracing'many ideas developed by Dr..'. vocated, by Durenberger and.reprr- Tonight's discuuion will be present.»Paul Ellwood, a Minnesota physician '. sentativei of the Ginton administra- ed.io a small audience in Minneapo'/'who'encouraged healuh maimenance tion. Durenberger'i naff hopes to ap- lis made iip.panly of .ciiuens" who
orgaiiizarioiis (HMOs) here in the 'ply lessons"from 'iKat esperience,to- participated in town forums on
health reform. The Minnesou House
delegation-will alsd participate. SegItDufenberger'i >TpiiUtion is built on /"DurenberKer .-rwu«nott-nilly. stir- menu will be shown on Channel 4'!
•-•"••-*-«- imricacici -* "prised by the jiiry^iaid Kick Evani, 10 p.m.-news; the full discussion will
— ' — - of ;
*\ tn undenun'ding otthe
^'health'iystem^and-.the concent's of- Dunfinberger'i chief of itaff, because .be broadcast Dec. 9 at 7 p.m. .
i-jjroviders.' managed-care companies
-^ and dociors^Thfs year, he hai joined
a.Rep. .Jim .Cooper?-D-Tenn.; to offer
a the-Managed Competition 'Act,- built
- f around a theorV that Preatdetit Clin-.
ton embraced durina the presidential
* camptifn, arid "one'backed by.maior
-.insurance intereiu. Durenberger says
' that Miriiiesota'i experience-with
compfjitiyf'health plans thowi that
^h&pgvate'iefrorjcan'.deUvef htgb,quality^r^atX a:reasonableeon.
" ycThat irfcoihethlng government wili
XoDtinutd from page )B
J
-
:
,
1
:
;
WtUiione i>f course, sees it the 64 .,
' ' way.'He favoririationalhealth ibaur-.
..-^ahce;^ich.w6uld put private tofur-.
\ cnVmitfbfibuiiMai,-? H r Kaa'intro:.
Vdudtf^lefiilatioti" baaed:' largely 'ion
i , Ganada's ainglo-payer'ayiUm lharao'
- * ""\drawn-ihe rooal tuppon of
T
faf
h
2-/
•/2_
�NOV 17 '53. 03:15AM STAR TRIBUNE PHOTO
P. 12
* eare^he two^enators ^ differing/
visions of what vvorks what doesn't
communily :clinici and providing
care for ail
•.-
'vCoalinufd fnm ptgt IB . - .
"tingle-payer hai the vinuc of tounding very limpie. , ;
'
:
-
W«ll>t"orie docin ! pul • gren i a l of
"That eiperience told
-;&ith in Uie idei, ayint tint in »n ,' In Washington, Welliione'i approach. .; be able to explain in uiVe've goi lo
good,
- environmeni of large health insur-'-;:— in which-the government would clear.language.what minaged timple,
compe• ance burtaucrades;reponcards can-. -itake over jthe role of insurance com-. tition is about, becauie people do not
• ptniei —. i i hot given much of. a
noi really give consumers much lev-''.:
want a complicated lyitem. W'c'll iry
chance of pasuge. But it doei very
erafe.
• well in governmeni eosi-comrol nud- [tonighi) to deliver lhal menage
. clearly." -.V '•.• '"'
' "Fundamenullyi the two men have a iei and public opinion forums.
differenl viiion of health economics
• Durenberger'i itiff wei'ituni recent- At the lame time, he laid, Durenberand poieniial lolutiom to problemi
ly when a "citiieni jury" nudymg ger wanti to warn thai ihe Clinion
' - In health care, v
heallh reform went out of iti way to program'i reliance on governmeniregulated price limiu "are harmful to
., for. vears in the Senate, Durenberger . iav it preferred Weliitone'i plan. Al- managed competition."
though the'jury didn't formally in' hu been an.advocite of managed
, . care and msrliel-battd reformi, em- dorse it, ihev rejected proposali ad- Tonight'i diicuuion will be present'• :•• bracing'many ideu developed by Dr... vocated by Durenbeiger and .repre- ed to a imall audience in Mmneapo..• Paul EllWood. 'a Minneiota physician sentativei of the Clinton admininra.'." who encouraged health maimenance tion. Durenberger'i iiaff hopes to ap- lii'made up .pahly of ciiuens who
•f- oqanuatioiit (HMOi) here in ihe ply lesioni from itiat esperience to- pinicipated in lown forumi on
heallhreform.The Minneiou Houte
nighi.;', .-• - -'M v - .
delegation will altd panicipaie. Seg./'Durenbeiger .-was .notr.'really siir- menu will be ihown on Channel 4'i
: priied by the jury;r.«aid Rick Evani, 10 p.m. news; the full ditcuiiion will
i-Diirenljerger'i chief of luff, becauie .be broadcar Dec. 9 at 7 p.m. •
:
• ;,'• •.'. : -•
•'
*
'/
i
^-<' •
'; - ;
*:Dufehb«iger'i rtpulation i i built on
Ift an undersuhdihg otthe intricaciei of.
health "lyiieniJand .the concetni of;
> qua-uy t^mii^m' >
—
irprovideri,' maniged<are companiei
^ •.fniat is'jo'methlng government will
tnd dixiori,»Thli year, ha hai joined
f Rep Jim .Cooper/ D-Tenn.; to.offer
•.^.«.»R-«PWfl^'«v?'^V'-*oir-.,
! WeUnone, i f course, sees 'Acv buill
the.Mahsga.Competition it the
f around a theor/ Ihat Presidem Clin-,
"my'.Ht favors national hnhhluiPr
rtoh embraced during the pieiidenml
M
v..iin*aW«">.^*»ne baelced by. major
^ campaign, and 'o .*V W'.^I'WK'
• v .imurance ihierem. Durenbeiger layi
- ers'VoutilbfJbuiineu,-: Hr. hai mtro-,
! Vducaftl^iilitlon based: largely ion
' Ihit Miiin'ejbta'i esperience with
i , Cuiida'i lingle-payer-ayium that io'
•-^•-Cdiiwn the. moat aiippon of
--rn^Oie'Houil'to.
wVcp^pjuioi
1
-
:
rJnupiced
tcartVrlhtb • rintle-pfyertyftc
ibb* of
S ^ ^ j ^ H M O .
He praiies the ttaie't tradition of
�NOV 17 ••S3
BSUSfiM STAR TRIBUNE PHOTO
P. 12
6)
16 iMhetNA/c^senators
-.
3
^•ir^.T.'-^"'^''''^^'."^
differing'
visions of what works arid
whaltdbesttt
i
:
f .•.-:Vi. :-.,. r:.i r-t -u.
^ "•
•
vCominutd from ptgt IB
- communily-elinici and 'providing "lingle-payer has the vinuc of soundcare for all.;':.
.
,. . ing vet? limpie..
Wellstone 'doesn't put s gresi deal of
-•faith in the idea, "saying' that in an:. In Washington, Welliione'i approath ; "That experience told us'wc'vt got to
• environment of. large healih insar. *;:— •in which'the government would, :-be able to explain in. good, simple,
ance bureaucracies,-report cards can- '- take over^the role of insurance com-, clear.language hat managed compe.
not really give eoniumen much lev- v.paniei — . i i " not .given much of. a lition is about, because people do not
chance of passage. But it does very want a complicated system. We'll try
erage.
well in government cost-control stud- ftonight] io deliver that message
" Fundamenullyi'lhe two men hive a ies and public opinion forums. • • . clearly." .-v v
different vision of health economics
and potential solutioni to problems • Durenberger'i staff was stung receni- . At the lame time, he said, Durenberly when a Vciiizeni jury" studying ger wants to warn lhat the Clinton
In health care. • •
healih rrform went out of iti way to program'i reliance oii govemmentl' -, For years in the Senate, Durenberger tay it preferred Weliitone'i plan. Al- -rtgulated price limiti "are harmful to
I v has been "an advocate of mamged though the jury didn't formally "fen- managed cpmpetition."""
t . care and ;market-based refonr.i, em- done it, they rejected proposals ad- bracing'many ideu developed b> Dr. • vocated, by Durenberger and.repm-. Tonight's "discuuion will be present«
.••Paul Ellwood,'a Minnesota physician •. sentativei of the Ointon administra- ed.io a small audience in Minneapo".'."• who encouraged health maimenance tion. Durenberger'a suff hopes to ap- lis made up.pahly of.ciiizeiu who
_ _ _.
"/• orgahiiatioris CHMOi) here in the ply Itssom from that eaperience to- participated in town forums on
health reform. The Minnesou House
delegation-will alsd participate. SCE'Durenberger Vwai':noi"really, wr- mencs will be ihown on Channel 4 s
Diirehbtrjer'i jtpuliiion i i buill on ..:priwd by-ihe jury;r,uW "
Hick Evans, 10 p.m; news; the full discuinon will
»n undenunaihj ottbt imriaciei of Dunenbcrgfr's chief of itaff,.because .be broidcast Dec.-9 atl p.m. . 'v hnlih'tynaiitai'd -Uie conetmi of
vjirovideri. niinaied-cane comptniei
^tnd docion,*Thli y«r, he h » joined
jj.Rep. .Jim Coopef/ D-Tenn.: to otfer
™ ihe. Mini jed. Compeiiiion 'Acv buill
\ irbund i theory ihn Preiident Ctinr-.toh embracied durint the preiidtntiil
"."cimptiin, end "ene'Mdced by. major
: . imurance intereiu. Durenberier uyi
' thtt Miriiieibta'i experience - with
compeu'live' health plant Ihowi that
' \thCpcvate'ie?tbr can deliver' hi|b/>. quiliiy.'rc^rijat': a: raaionable con.
'' .'iThat iiTromethlni fovemment wtii
w
'^V* ^ . '.
.
f
-
;
:
,
WeUnone, Afeoune, <ee> it the btper
wiy' He favofi national health inaur-.~ iince,iwtiich would put private Infur1 enVoutfbf.'bittineai.-' H&. hu'intp^
.ydueKl^leiiilitlon'baied: larfely Von
i , Cariaaa'i ainile-peyer'ayium thario'
drawn.the molt liipportjOf
/X
^
�•2^ETETRMlHgTl
CoMM
oU
�5^
Jane 15, 1993
ANA/W«tin Hotel
Washington, DC
�roup on Health
320 TD (202) 4 8 9 3 FX (202) 4 8 9 3
D
0-33 A
0-32
'"on tr
c
is Leadership Forum on the Climon Health
had 115 attendees, representing 88 WBGH
ion employees. Almost half of those in
ided rich feedback on this conference, a needs
m - managed competition — has long been known.
/ through accountable health plans (in WBGH
The purchaser community will be organized to give
the benefits that large employers currently enjoy (e.g.,
. A national health board will: establish a uniform,
s the services that must be available to all; provide
and set standards for data collection and quality control,
outcome and patient satisfaction.
^
*5.
.t this conference that some critical decisions have yet to be
Force's plan. This presents a great opportunity for high
yer community.
"flcfe
^eas
L
Man
nerally excellent reviews. As always, he was more open,
sponsive to WBGH than to other groups. The most exciting news
subsequent exchange was the concept of "corporate health
iS only been under consideration for a few weeks. Depending on
ory participation in regional alliances, and whether or not everyone
J, the corporate alternative would allow and incite larger employers to
v'e health care purchasing. This includes the ability to negotiate for
organized systems, to provide incentives for appropriate utilization, and
/ective health promotion and disease prevention programs.
Aging, W r and Healtti • Institute for Rehabilitation and Disability M n g m n • Mental Healtti Services Po r m for Youth
ok
aae et
r ga
jm on Health • Notional R s uc Center on Worksite Health Po o o • Prevention Leadership F r m • Quality R s uc C ne
eo re
rmhn
ou
eo re e t
�I presented the
advocates
of mental ^ d
) )
gton Business Group on Health
*N.E. Suite 800 W s i go , U. 20002 (202) 408-9320 100(202) 408-9333 FX (202) 408-9332
o hn t n
A
CGROUND FOR BREAKOUT SESSIONS AT THE
ATIONAL BUSINESS LEADERSHIP FORUM
ON THE CLINTON HEALTH PLAN
Vashington Business Group on Health, in association with William M.
ted the National Business Leadership Forum on the Clinton Health Plan.
an interactive dialogue, designed to assist primarily WBGH members in
details of the Clinton plan, with particular emphasis on its effects on their
day began with Ira Magaziner explaining what will be in the health reform
employer responses to the plan. The meeting concluded with a
el discussing the political prospects of health reform. To ensure that
leave the forum with a deeper understanding of the issues involved in
tf the direction in which the White House Task Force on Health Care
the rest of the day was spent in small breakout sessions with task force
representative was present in each breakout group to answer questions
[oyer concerns. The first session focused on how the plan would work in
^nd on how it would affect employers, both generally and individually,
ers facilitated the discussions, and WBGH and Mercer staff assisted the
bants came to the meeting with a basic understanding of the issues
Irm, we asked that they first read this outline of the plan and think
Iquestions. This paper focuses on six key areas, but participants were
\e with questions that are beyond the scope of this background piece.
^ut the Clinton health plan have not been made, many of the key
been released. The basic framework still reflects the principles of
the final plan may reflect departures from the original managed
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^GROUND FOR BREAKOUT SESSIONS AT THE
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ON THE CLINTON HEALTH PLAN
Vashington Business Group on Health, in association with William M.
ted the National Business Leadership Forum on the Clinton Health Plan.
an interactive dialogue, designed to assist primarily WBGH members in
details of the Clinton plan, with particular emphasis on its effects on their
day began with Ira Magaziner explaining what will be in the health reform
employer responses to the plan. The meeting concluded with a
iei discussing the political prospects of health reform. To ensure that
leave the forum with a deeper understanding of the issues involved in
if the direction in which the WTiite House Task Force on Health Care
the rest of the day was spent in small breakout sessions with task force
representative was present in each breakout group to answer questions
loyer concerns. The first session focused on how the plan would work in
^nd on how it would affect employers, both generally and individually,
ers facilitated the discussions, and WBGH and Mercer staff assisted the
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its came to the meeting with a basic understanding of the issues
[rm, we asked that they first read this outline of the plan and think
^questions. This paper focuses on six key areas, but participants were
\& with questions that are beyond the scope of this background piece.
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been released. The basic framework still reflects the principles of
the final plan may reflect departures from the original managed
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BACKGROUND FOR BREAKOUT SESSIONS AT THE
NATIONAL BUSINESS LEADERSHIP FORUM
ON THE CLINTON HEALTH PLAN
Introduction
On June 15, the Washington Business Group on Health, in association with William M.
Mercer, Inc., hosted the Nalional Business Leadership Forum on the Clinton Health Plan.
The meeting was an interactive dialogue, designed to assist primarily WBGH members in
understanding the details of the Clinton plan, with particular emphasis on its effects on their
companies. The day began with Ira Magaziner explaining what will be in the health reform
plan, followed by employer responses to the plan. The meeting concluded with a
Congressional panel discussing the political prospects of health reform. To ensure that
participants would leave the forum with a deeper understanding of the issues involved in
health reform and of the direction in which the White House Task Force on Health Care
Reform is heading, the rest of the day was speht in small breakout sessions with task force
members.
1
At least one task force representative was present in each breakout group to answer questions
and to listen to employer concerns. The first session focused on how the plan would work in
general, and the second on how it would affect employers, both generally and individually.
WBGH board members facilitated the discussions, and WBGH and Mercer staff assisted the
facilitator.
To ensure that participants came to the meeting with a basic understanding of the issues
involved in health reform, we asked that they first read this outline of the plan and think
about some of the key questions. This paper focuses on six key areas, but participants were
encouraged to also come with questions that are beyond the scope of this background piece.
The Framework
While final decisions about the Clinton health plan have not been made, many of the key
elements of the plan have been released. The basic framework still reflects the principles of
managed competition, but the final plan may reflect departures from the original managed
competition proposals.
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�Key Questions
- What are the advantages and/or disadvantages for your company of purchasing through
Health Alliances? On what basis would you make this decision?
-- How effective would a single large Health Alliance be in working to encourage Health
Plans to compete on the basis of cost and quality?
- How important is it for employers to retain direct control over the purchase of health
insurance? Think about this question both from the standpoint of delivery system efficiency
andfromthe viewpoint of your company as a provider of health benefits.
- What type of organizations are Health Alliances likely to be? How selective could they be?
How would they be governed? How susceptible to political influences would they be?
~ How active would your company remain locally in encouraging changes among providers
if you purchased care through a Health-Alliance?
- How do you think your employees would react to this plan? Do you think they might
prefer to choose a Health Plan through a Health Alliance rather than through their place of
employment?
Financing
The Administration may propose an- employer mandate to largely finance health reform
through one of two options - a wage-based premium (payroll tax), or a fixed premium.
Both options emphasize a single, community-rated pool.
The wage-based premium might be a percentage of payroll determined by the average total
health costs of the Health Alliance region. The premium, essentially a payroll tax, would be
paid into the Health Alliance for all employees, or large employers might be allowed to pay
the premium directly to the Health Plan. Employers and employees would each pay a
percentage of the premium. The total amount for health costs in each region might be
reduced to take into account state Medicaid payments and premiums from unemployed
persons with unearned income. Under this option, similar to the Social Security taxable
maximum, the amount of wages subject to the tax would be capped.
One approach the task force has considered is an "accordion" transition to the wage-based
premium. Under this scenario, employers would gradually raise or reduce their current
percentage of payroll to the Health Alliance premium over a period of several years.
Eventually the wage-based premium might include the cost of retirees, but in the early years
those employers who cover retiree benefits might continue to maintain some responsibility
for them.
To ensure that the premium rate does not increase, the task force is considering prohibiting
states from raising it to cover shortfalls. A Health Alliance that failed to raise enough
�Standard Benefits Package
All Health Plans would be required to provide a uniform national benefit package. However,
the scope of this package is the subject of considerable debate. The task force is leaning
toward establishing a comprehensive package, with preventive care, prescription drugs,
abortion, home- and community-based long-term care, and some coverage for mental health
and dental care (particularly for children). The inclusion of abortion has been recommended,
but is expected to be highly controversial.
A comprehensive benefit package would discourage the development of large supplemental
markets and/or a two-tiered system of benefits, while at the same time encouraging Health
Plans to coordinate all aspects of health care delivery. In addition, a comprehensive benefit
package might avoid the potentially difficult political ramifications of trying to pass
legislation that is perceived as a benefit cutback for many Americans.
Another factor driving the debate over the benefit package is whether the tax exclusion or
deduction would be limited to the standard benefit package. A limit on the tax deductibility
and/or excludability affects fewer persons if the package is comprehensive and raises less
revenue.
Key Questions
-- What are the advantages/disadvantages of this scenario?
- How does this compare to what your company already provides?
- Will the benefit package spell out specific cpst-sharing requirements or will your company
have the ability to alter cost-sharing within limits?
- Where will decisions about appropriate treatment for specific conditions be made? At the
Health Plan level, in the benefit package, or by a National Board?
~ To the extent that some of these decisions are made by a National Board, how will that
board be structured?
- Will states have the ability to alter the package?
~ Does the package encourage individual responsibility for maintaining personal health and
taking advantage of clinical preventive services?
Health Plan Definition
It appears that the task force expects consumers to be offered at least three types of plans ~
HMOs, PPOs, and fee-for-service arrangements. However, prices will vary among plans
depending on the degree of choice provided in the individual Health Plan and the degree of
control over plan providers. The HMO option would require patients to use HMO providers
but have few, if any, out-of-pocket expenses. The PPO option would allow persons to
�Appropriate State/Federal Roles
A national reform plan would most likely establish a uniform national benefit package, a
nationalfinancingmechanism, a national board to develop standards for health plans, and
Health Alliances as the primary purchasers of health coverage. However, current task force
thinking gives states the ability to determine the appropriate number of Health Alliances,
responsibility for living within the health budget, and perhaps the power to enforce national
health plan standards. To the extent that a payroll tax is used tofinancethe system and is
determined and capped at a regional Health Alliance level, any additional financing
mechanisms might also be designed at the state level. Some proposals would also give states
the ability to organize the market in any way they choose as long as they could live within
the health budget and provide universal access to the standard package.
Key Questions
~ What are the advantages/disadvantages of this scenario?
- To the extent that health care delivery is considered local, what is the appropriate state
role in reform?
-- Do you think that states should be able to determine the Health Alliance market structure?
~ What elements should be designed at the national level for uniformity?
-- How does the possibility of 50 variations on Health Alliances influence multi-state
employer viewpoints on health reform?
~ How has ERISA preemption protected emplgyers? How would this change?
Public Pavers
Originally, the Administration discussed incorporating the AFDC portion of Medicaid, but
leaving out long-term care and services for the disabled (SSDI). Recently, WBGH heard
they were considering leaving out Medicaid altogether, at least initially.
The task force appears hesitant to alter the way Medicare purchases care for its beneficiaries.
However, if included, Medicare beneficiaries would be getting some improvement in their
prescription drug and long-term care coverage. Questions remain about the receptiveness of
Medicare beneficiaries to utilizing managed systems of care.
The two key obstacles to including Medicare in the plan are: 1) political, as all participants
in the discussion remember the turnaround on the Medicare catastrophic coverage legislation;
and 2) substantive, as it would be very costly to guarantee to everyone the uniform benefit
package now available to Medicare beneficiaries.
�NATIONAL BUSINESS LEADERSHIP FORUM ON
THE CLINTON HEALTH PLAN
June 15, 1993
Washington, DC
Keynote by Ira Magaziner
Senior Advisor to the President for Policy Development
It is very fitting that I talk to you today. This is the first group I spoke to when I came
to Washington, D.C. in January.
I'd like to first offer you an update on the process, then address the substance of the plan.
I am always sympathetic to those who have to find out what we're doing just by reading
the newspapers. So I apologize that all of you have had to get your news that way. Every day
I read that we have decided on issues that we never considered.
The President is focused now on the economic plan - getting that through the Senate.
Then he will address health care.
The decision was made about three weeks back to continue consultation, but not to move
on it so there can be a focus on the economic plan. One week after the economic plan gets
through conference, we will move on health care.
Now our best guess is either the middle of July - mid to end July. If not then, the
beginning of September.
If the Senate successfully concludes within two to three weeks, and if it's not too
contentious a conference, we would like to move in July. That would be our preference. Right
now it is not within the control of those of us who are working on health care.
Today I can offer you highlights of where the program is and some of thefinaldecisions.
We are still talking about a program that would aim to improve quality and control costs
through incentives to move toward^rganized delivery, believing that getting therightframework
for a competitive marketplace is good for both quality and cost control. How it works is more
difficult than theorists want it to be, but it is still workable.
We do believe you need to go to universal coverage, both as a matter of social policy,
but also for cost control.
We also believe in a defined benefits package. Not a Cadillac, but not catastrophic
either, because that won't end cost shift.
�Financing. We are still trying to work out infinalform. As we look at it now, the
current healthfinancingsystem operates as a head tax - a poor person's premium with all kinds
of factors associated with it, some as a matter of happenstance - whether you have illness in
your family, whether your co-worker is ill, whether you work for a company that does a better
job of negotiating - a whole bunch of things unrelated to you or anything you do. And it has
nothing to do with your income.
One result is that the uninsured and underinsured are primarily low-wage workers and
their families - 80% of the uninsured and more than 90% of the underinsured. Thereasonis
simple. People making $7.50 an hour, and that's not bad, make $15,000 a year. The premium
for the family may cost $5,000. That's 33% of payroll. If you add a premium for being part
of a small group, it gets even worse.
Now, if they are mixed in a pool with a higher average wage, the company can afford
to insure everybody.
If we stick to a premium-based system, those low-wage workers must receive a
significant subsidy. It gets mind-boggling. You would wind up subsidizing around one-third
of the country. It's mind-boggling ad frightening.
So the notion of keeping that system the way it is is not a simple matter. Just saying
"give subsidies" does not account for what that means.
The alternative — percentage of payroll — which may be capped at the Social Security
wage base - means that the persdn at the high end pays more than the person at the low end.
The problem is that even if you collected it at the lower end, alliance by alliance, it takes away
a lot of the incentives. It smells and looks more like a tax than a premium. Even if nothing
ever goes through the Treasury, it still takes away the sense that someone is paying for his own
health care.
So both of these ways of doing it have problems. We want to make it simple and
affordable.
We are moving toward something operating as a percent of payroll at the low end.... in
order to keep whatever subsidies have to flow at the alliance level rather thanfirmby firm.
That will be one of our final decisions. We still want to have a locally based premium — at the
local level, alliance by alliance.
Who's in and who's out? One line of thinking says have voluntary entry into the
alliance. But that would lead to serious adverse selection, a system where the alliances
themselves have an unpredictable world, making it likely that the alliance would get what is left
after the skimming. Moving Medicaid in would lead to them becoming poor people's plans.
The second option is 100 or less in, more than 100 out. It also problems. WTiat in effect
it is doing is giving the alliance the most fragmented piece of the market with no anchors. Most
businesses have anchors. Here we would have small businesses whose building cycles are
�We have gone through a very complex process with all different sets of people, both
experts and practitioners. So we assembled about 500 people and did three years worth of work
in three months. We built on what was already out there. We balanced organization with
creativity. We put people together in a room who had different opinions. And there were a lot
of shouting matches. Creative shouting matches.
By definition, we called it managed chaos. We reached out and met with more than 500
different interest groups, repeatedly. Providers, consumers, actuarials, etc. We believe it has
been both the most comprehensive policy formation process in government, and also the most
creative. The fact that we considered all these different options means we will be prepared to
respond to them.
Probably the major mistake we made, and the problem we had, was communications.
So the press thought it was a very secret process because they weren't in the room. It was a
very open process.
As we go forward, we will introduce the plan, then go on a real roller coaster. I've
already warned my children that their daddy will be called every name in the book.
But we are determined to see this through. What I appeal to you, you're not going to
like everything in the program. But what I would ask is to take a constructive view of what
we've done, and work with us over the course of the Congressional debate. Because if we fail
now, we'll be giving up another decade of opportunity. We cannot do that. The status quo is
frightening.
If not, health care will eat up more than two-thirds of the gross domestic product per
capita increases over the next decade, and comprise up to 20% of GDP by next century.
Responder: Dave Scherb
Chairman of the Board, W B G H
We agree that we would miss a tremendous chance over the next decade if we don't
move. The goal of affordable quality care is not a new goal. Our feeling is that health care
reform did not start with the President's Task Force, or the presidential campaign, but really
with the business community's work in how to provide access to the quality care that our
employees demand while controlling the costs.
Toward the end of the '80's we realized that to reach those goals, we had to affect the
system itself. So employers became purchasers, not just payers.
If you think back to 1988, Allied Signal put in a managed care network that at the time
was fairly controversial. Today there is hardly a company in this room that does not have some
form of managed care plan. More than one half the doctors are in HMOs and PPOs. A recent
�Responder: Donald McKinnon
Managing Director, William M. Mercer, Inc.
There is a lot in health care reform that employers endorse. The concept of competitive
plans. Though there has been some concern that there might have been a bit of a left turn,
hearing that states may be able to offer single-payer systems, where the alliance may not have
any competition.
Malpractice reform. Small group insurance reform. Clinical standards on a national
level that are outcome-based. The provision of consumer information to employees. All those
things are close to universally embraced. Large employers having the opportunity to opt out of
the health alliances - meeting all the standards. And the need to keep large employers engaged.
If large employers sense that at the end of the day they cannot affect their own costs or the care
delivered to their employees, they will disengage.
We have been conducting a number of focus groups around the country. One of our
people who has seen more than 200 employees in the last two weeks reported first, a lack of
information and confusion out there. We are hearing that people are perceiving that what is
being talked about is socialized medicine. W^hen probed further, why that should be a problem,
they revealed deep concern that I as an individual may not be able to continue going to my
doctor. Choice.
Second, they are concerned about some kind of government bureaucracy, without my
employer serving as my advocate. Like dealing with the Bureau of Motor Vehicles.
You'll lose the value of large employers selling the program as well as serving as an
advocate.
Flexibility - as the Task Force has struggled, with the issue of cost, it seems that one of
the dials you have to turn is plan design. That's an age-old method that employers have used - cost and quality from a pure self-interest point of view. Employers want to have access to the
dial.
Mandate. If an individual one, most will embrace. If for large employers to make
available, there is general agreement. But mandating a specific level of costs raises some issues.
Ultimately, employers will adjust - through varying compensation, pension, etc. But there is
a feeling that we have been good, so why mandate on us?
What I hear from large employers is that in the last several years we have witnessed
continuous cost shifting to the large employer structure. I f l heard your remarks correctly, we
could well be left out of the system.... There is also Congressional debate about cutting back
on Medicare. That $35 billion will be paid for by the employers in this room.
�going. We're not talking about opt-outs. That gives the impression of a two-tiered system. But
we are talking about corporate alliances and Taft-Hartley alliances. Once the system is up and
going, the framework is set, the systems are going, there will be expedited rules for the phase-in
so it is clear it will happen and proceed smoothly. My guess is sometime in the late '90's.
Similar with the requirement that all employers and employees must contribute. You
must phase, in so you don't have the negative employment effect. We'll be implementing this
thing over the next decade.
Tom Burns. NYNEX: I haven't seen enough discussion aboutretireesunder Medicare age.
We have about 35,000.... FASBE caused problems.... those with large labor contracts. What
about shared sacrifice?
Magaziner: The retiree problem is a special problem. Our feeling is that for a fixed period
of time, either current contract or number of years, must continue taking care of it like it is.
But as we move to more universal system, those populations need to be spread.
We do believe everyone must be responsible. We are looking at an individual mandate
as well as an employer mandate. Likely to look at capped premium.... We think the capping
and shared sacrifice should still leave room for the consequence of individual choice.
We do believe in having an employer role. Right now, if you work for a large,
progressive employer, they are playing that role for you.
Jeanne Prvce. General Motors:' My firm represents about 20% of the 15 million lives
represented here. We cover a lot of retirees, but we must compete with firms that don't offer
retiree coverage.
Magaziner: We do believe it should be dealt with, and ought to be spread. But it cannot be
dealt with in the first year. When you spread it across the whole economy, it amounts to a
rounding error of the total health budget....
The issue on who's in the regional alliance and who sets up their own is adverse
selection. One option is to experience-rate them as they come in so they don't destroy the pool.
I think we'll come to a solution that will be equitable and take care of the retiree.
Suzanne Mercure. Bull Information Systems: We have about 5,000 employees. What will be
the employer role for us?
Mazaginer: If you're in a regional alliance, then where your facilities and offices are located,
hopefully as a more sophisticated company than the small local company, you can sit on the
board and help guide the alliances' policies. If you choose to go that route, what Kodak does
in Rochester is very similar. Basically the benefits they achieve go to everyone. But they play
that role as a community citizen.
What we want to do is allow both possibilities for companies.
�Washington Business Group on Health
777 N Capitol Street N.E. Suite 800 W s i go , D.C. 20002 (202) 408-9320 T D (202) 408-9333 F X (202) 408-9332
.
a hn t n
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June 30, 1993
Mr. Ira Magaziner
Senior Advisor to the President
for Policy Development
216 Old Executive Office Building
Washington, D.C. 20500
Dear Mi.
MigAlii^if^TZJ^-'
On behalf of the 88 member companies of WBGH who attended the National Business
Leadership Forum on the Clinton Health Plan, and their approximately 15 million
employees, I extend our deepest gratitude and appreciation for your time, your attention and
your candor. The conferees were very impressed with your mastery of the many complex
issues in health reform, and with your responsiveness to their questions. In short, you got
excellent reviews!
.As you know, WBGH, founded in 1974, is the only organization representing the
employer community's involvement and investment in health care. Over the years, our
members have become very knowledgeable and sophisticated about every facet of service
delivery. We think of the Business Group as representing the evolution of employers from
passive payers to informed purchasers of health care.
For these reasons, WBGH is very supportive of the Clinton Administration's efforts
to reform the health care system, and anxious for you to succeed. Because the U.S. system
(or lack of system) developed piecemeal over time, these employers have a better perspective
and a deeper understanding of its flaws, and more experience with fixing those flaws, than
almost anyone in the country. This knowledge and experience was required of our member
companies because the cost of health care was devastating their bottom line. They were
compelled to either cut back on benefits or find more efficient ways to manage health care
services.
This provided strong incentive for large employers to begin using their market power
to negotiate for high quality, well managed health care from selected organized delivery
systems that met the special needs of their workers. Large employers also became quite
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�June 30, 1993
Page Three
II. Public/Private Partnerships
On the crucial issue of the infrastructure for health care services delivery, we agree
with what we know about the White House Task Force's proposal. However, we fear that
the important dimensions on which we disagree could threaten the success of structural
reform.
For example, we are very concerned about who will be part of health carereformand
who will not. Our original impression was that everyone would be included in the new
delivery systems. Then we heard that Medicare beneficiaries would not be initially included,
but phased in over time. Then we heard that the long-term care portion of Medicaid for the
frail elderly would be excluded. Then the disability services provided for SSDI recipients.
Then the AFDC-related portion of Medicaid. Veterans Administration, Department of
Defense including CHAMPUS, and even the more than 10 million beneficiaries of the
Federal Employee Health Benefit Program have all been rumored to be excluded from
reform.
Adding up all these exemptions appears to leave only employers and the currently
uninsured in the reformed health care system.
We understand the political pressures for excluding these different special interest
groups. But bowing to these pressures would threaten the success of overall reform and
sanction some of the most expensive and least efficient elements of the current health system.
It would also destroy the credibility of those who advocate reform. After all, if AHPs
provide higher quality, better coordinated care at lower cost, what is the rationale for
excluding selected groups, especially those who consume the most services at the greatest
cost? Vulnerable populations have the greatest need for organized systems of care.
We think that adding an expensive prescription drug benefit to the current Medicare
package would send exactly the wrong message. If provided within OSCs, a prescription
drug benefit would be an inducement for Medicare beneficiaries to join. But adding it
outside of organized systems perpetuates both the inefficiencies of fee-for-service care, and
the myth that it is superior to care provided in organized systems.
m. Multiple Purchasers
The size, number and structure of the health alliances that will purchase care from the
accountable health plans is very important. We strongly recommend that health reform
include multiple purchasers. If large geographic areas, including entire states, funnel the
�June 30, 1993
Page Five
V. Malpractice Reform
The Washington Business Group on Health has supported the concept of enterprise
liability (which we call system liability) for some time. It cannot stand alone, of course, but
should be incorporated into total malpractice reform, including caps on noneconomic damage
awards, the use of alternative dispute resolution mechanisms, and the increased use of
practice parameters. In this context, enterprise liability would keep the responsibility for
monitoring the quality of providers and enforcing the standards for practice exactly where we
want it ~ at the level of the accountable health plan.
Our experience with providers across the country suggests that they would be
amenable to the idea of enterprise liability. We hope that enterprise liability will be part of
system reform, and would be happy to work with you to ensure that it is.
VI. National Uniformity
Finally, while we wait for the national reform that is so badly needed, we fear that it
would be destructive to grant ERISA waivers to individual states. We understand that states
are impatient to proceed with health care reform; our CEOs are just as impatient. But we
are so close to national reform that we think the nation should concentrate on achieving it.
In the meantime, allowing states to establish 50 different systems, with 50 different sets of
rules, requirements and regulations, could destroy the best programs that are already in
place, and crush the incentive to continue these innovative efforts.
We look forward to working with you. These are exciting times filled with great
opportunity.
On behalf of our members, I thank you again for your extraordinary efforts and
achievements in health care reform.
Sincerely,
President
Enclosures: A Vision ofthe Future Health Care Delivery System: Organized Systems of
Care; The Health Reform Challenge: Employers Lead the Way
�ANY FORD COST REDUCTIONS COULD EASILY DISAPPEAR UNDER WAYS & MEANS PLAN
YEAR 2000 COST REDUCTION/(INCREASE) AS A PERCENTAGE OF BASE COSTS
EXCLUDING TREND AND WORKING SPOUSE RECAPTURE
2%
0%
(2)%
EMPLOYER
MANDATE
PRE-MEDICARE
RETIREE
DRUGS
ADDED TO
MEDICARE
ADDITIONAL
BENEFITS "
PREMIUM
TAX AND
OTHER
TOTAL
TOTAL
WRUOUT
PREMEDICARE
RETIREES
TOTAL
WfTHOl/T
PREMEDICARE
RETIREE AND
EMPLOYER
MANDATE
TOTAL
TOTAL
wmioirr
wrmour
PREMEDICARE
RETIREE,
EMPLOYER
MANDATE
AND
MEDICARE
ORUGS
PREMEDICARE
RETIREE,
EMPLOYER
MANDATE,
MEDICARE
DRUGS, AND
A TAX CAP ON
ACTIVES A N D
PRE-MEDICARE
RETIREES
NOTE: ASSUMES TAX CAP DOES H Q l AFFECT MEDICARE RETIREES
(SEE NOTE)
�11.
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Abortion and the Health Plan—Fatal Coercion
setklni to Ignore the genuine divlslona icy would do well to band together ana
By Cm btuowM
TM fedenl (onnunent my uon try that exist on this Issue by Inidtuttonalls- speak tut now, when the final shape ol the
to fore* CtrdlnaJ John O'Connor of N w Ing abonlon u a medical "nght." Rm- health can reform Is still In flux.
e
York anil his ttllav bl»hop» to pay for thtployen wfll be coerced Into helping to pay Otherwise, In the not too distant future,
atonloni of thtir dlooeiu emfloym and for this right baeause abortion will be nun-the only wording that will matter o the
n
daied u one of the core benetlts that everynation's abonlon bills win be "payment
ttnlr funlUti,
In fan, twaldi tanreformu snpotd Insunr must offer.
due m 3 days."
0
b tht atnton adnHntttradon wli requlr» Revealutgty. tha actual health can legy
tha Church of Jntu OuKt of Latttr-Diy islation doee not use the word abortion.
Mr. erlmitm It editar-tn-cknr of Our
Sahiu. the SouttMn Bajitfn ConvuUoa, But abortion supporteh have already Sunday Mjifor, tht nalUm 'j lorpeir Qittnff
thi National Rl|tit to Ufa CommlttM and forced both Bill ud Hillary Ointon to pub-pvillslttitg ktmu. hunt Huntintm. Md.
rrtn the Catholic pubUihtni conpany I licly admit that the code phrase "pregwortterto do Uie lame for all tbtlr em-nancy nlated services" Includes abortion
ployed and famllta.
as well as such nectsaary goods and serThlaradicalcomponent ef the dlnton vleea as prenatal eare.
health care package has been little noted The CUnton health care package Is a
u to nov. M a of the moral debate hu to- Trojan bone, using the perceived
p
et
moral
cused o the fan thatroneaborUone will crisis in health can to subvert Ihe cumnt
n
b paid tor with tax dollan, and that evcymoral debate about abortion In America.
e
vorkinf paraon In tha country could be The plan's secallcd empIoyeMnandate
forced to pay premium! for a core medlcalprovistons will mean that every employerbeneflu packaje that will Include abortion no natter h w morally opposed to aboro
as one of Its lervleta, Both of these Issuestton-wlL be given no cholettatto pay for
art of strtoua lodsl and moral ttmcern. the axtlngulsblng ot unborn human Uvea.
Th* White House hu taken »o trumpetBut the evil Italia of the atnton pro
posal is that II win ciwpt evervone. In- lag Its "conscltncc clause," a legal eicepcludlnf thoae leaden and Instltuaoni thit flon that would be granted to those hospihaye been m a outspokenly critical ot tals and doeton that would object to per
ot
lomlng atnrtlou. But such t dause. necabortion.
. By maklni abottlon a rtqulnmett ef entnr u It la, does not In any way protect
the basic health-benefita package, tha haapltals or docton u ntfhytn. Thsy
Clintons would use the mlfht of federal would stu be subject to the employer manUv to force a host of companies, founds. data and would ba required to pay for an
dons and etfuiluamt to chocee between abortion obtained by an employee or a
doelnr their doon for food and subeldli- member of his cr her family.
tni what thay undertund io be the deThe Ctlnuns also say that their proitruetlon of human life.
posal wfll not espand abortion coverage,,
The implications of the Ointon pra- claiming that almost all private Insurance
poial en at far-reachlnf at the Supnme plans cover abonlon. But some states have
Court's AM V. Wide decision 3 yean In ten banned ibcrtion u a required ele0
aio-and potenUally u dlsnipttvt. How- ment ot beslc Insurance plans (a ban that
tvar divided the country nay be about hu wfthstdod JudMa] challenge). The
whetber abonlon is an ethical public pol- available cvMenca euggests that abortion
o mn
icy, > consenaus ha emerttd on the nut- coverage Is mon c m o In haslth maino mn
ter of public payment for abortion. If abor- tsnance organlsattons, but Is less c m o
In
tion is a choice. It Is a private choice, and tse-tor-servlca and omployen' Milpayment for 1 shsuld be left to the Indl- funded plans, which cover ts% ot Amerl1
tdduel-thet u the mesaafe ot the annual ean worken.
Hyde Amendment debates about tha fed- The bottom line, however, Is that tha
eral nindlng of abortion. That messafe Is decision of wbether to offer abortion covvtitually unchanged even with a stronrly erage will n longer he left to the emo
piKholee president In the White House. ployer. Churchu. companies and orgmnlsatloni objecting to this coercive attempt
But now. on a scale that bacgan tht
imsglnttlon, the Clinton admlnlnratlon la toravoludonliathe nation's sbortlon pol-
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Health Care Task Force Records
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="https://catalog.archives.gov/id/10443060" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
<p>This collection contains records on President Clinton’s efforts to overhaul the health care system in the United States. In 1993 he appointed First Lady Hillary Rodham Clinton to be the head of the Health Care Task Force (HCTF). She traveled across the country holding hearings, conferred with Senators and Representatives, and sought advice from sources outside the government in an attempt to repair the health care system in the United States. However, the administration’s health care plan, introduced to Congress as the Health Security Act, failed to pass in 1994.</p>
<p>Due to the vast amount of records from the Health Care Task Force the collection has been divided into segments. Segments will be made available as they are digitized.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+1"><strong>Segment One</strong></a><br /> This collection consists of Ira Magaziner’s Health Care Task Force files including: correspondence, reports, news clippings, press releases, and publications. Ira Magaziner a Senior Advisor to President Clinton for Policy Development was heavily involved in health care reform. Magaziner assisted the Task Force by coordinating health care policy development through numerous working groups. Magaziner and the First Lady were the President’s primary advisors on health care. The Health Care Task Force eventually produced the administration’s health care plan, introduced to Congress as the Health Security Act. This bill failed to pass in 1994.<br /> Contains 1065 files from 109 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+2"><strong>Segment Two</strong></a><br /> This segment consists of records describing the efforts of First Lady Hillary Rodham Clinton to get health care reform through Congress. This collection consists of correspondence, newspaper and magazine articles, memos, papers, and reports. A significant feature of the records are letters from constituents describing their feelings about health care reform and disastrous financial situations they found themselves in as the result of inadequate or inappropriate health insurance coverage. The collection also contains records created by Robert Boorstin, Roger Goldblatt, Steven Edelstein, Christine Heenan, Lynn Margherio, Simone Rueschemeyer, Meeghan Prunty, Marjorie Tarmey, and others.<br /> Contains 697 files from 47 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+3"><strong>Segment Three</strong></a><br /> The majority of the records in this collection consist of reports, polls, and surveys concerning nearly all aspects of health care; many letters from the public, medical professionals and organizations, and legislators to the Task Force concerning its mission; as well as the telephone message logs of the Task Force.<br /> Contains 592 files from 44 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+4"><strong>Segment Four</strong></a><br /> This collection consists of records describing the efforts of the Clinton Administration to pass the Health Security Act, which would have reformed the health care system of the United States. This collection contains memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, newspaper articles, and faxes. The collection contains lists of experts from the field of medicine willing to testify to the viability of the Health Security Act. Much of the remaining material duplicates records from the previous segments.<br /> Contains 590 files from 52 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+5">Segment Five</a></strong><br /> This collection of the Health Care Task Force records consists of materials from the files of Robert Boorstin, Alice Dunscomb, Richard Veloz and Walter Zelman. The files contain memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, statements, surveys, newspaper articles, and faxes. Much of the material in this segment duplicates records from the previous segments.<br /> Contains 435 files from 47 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+6">Segment Six</a></strong><br /> This collection consists of the files of the Health Care Task Force, focusing on material from Jack Lew and Lynn Margherio. Lew’s records reflect a preoccupation with figures, statistics, and calculations of all sorts. Graphs and charts abound on the effect reform of the health care system would have on the federal budget. Margherio, a Senior Policy Analyst on the Domestic Policy Council, has documents such as: memoranda, notes, summaries, and articles on individuals (largely doctors) deemed to be experts on the Health Security Act of 1993 qualified to travel across the country and speak to groups in glowing terms about the groundbreaking initiative put forward by President Clinton in his first year in the White House. <br /> Contains 804 files from 40 boxes.</p>
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Identifier
An unambiguous reference to the resource within a given context
2006-0885-F
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Original Format
The type of object, such as painting, sculpture, paper, photo, and additional data
Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Health Care Polls and Clips [4]
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Health Care Task Force
Health Care Interns
Identifier
An unambiguous reference to the resource within a given context
2006-0885-F Segment 3
Is Part Of
A related resource in which the described resource is physically or logically included.
Box 11
<a href="http://clinton.presidentiallibraries.us/items/show/36148" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/12093075" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Format
The file format, physical medium, or dimensions of the resource
Adobe Acrobat Document
Medium
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Reproduction-Reference
Date Created
Date of creation of the resource.
3/16/2015
Source
A related resource from which the described resource is derived
42-t-12093075-20060885F-Seg3-011-001-2015
12093075