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2006-0885-F
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MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Health Care Task Force
Series/Staff Member:
Health Care Interns
Subseries:
4712
OA/ID Number:
FolderlD:
Folder Title:
Health Care Polls and Clips [5]
Stack:
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Section:
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S
53
7
7
Position:
�11.
2 2.
3 3
0 9 : 3 6
AM
Mash. f o * t | _ U - 2 1 - »
Health Plan
Assailed for
Costs to Poor
: Medicaid Recipient, but uid
iit ia neceaary to finance the
iplaa fuBMle alio noted the
Man would reduce «ttte-to: htat^vaiittlons in Medicaid
fceneftts sesity, s boon to
Ihe working poor who. now
Receive minimil Medicaid
'haalatence In some parte of
.the country.
•I About Id million welfire
- redptente were aigned up in
1992 for Medicaid's acute
care health benefite. Anothb ' t mllDon to 10 million
benefldariea. many of them
.-pregnant women and chil-Bnn, wen not on welfare.
TNfc w W hive had some
o d
ll costs if the ClinM been in effect.
Clinton ptan envisions
paying 30 percent
pf thdr health care premluma, but all thoae with infeomea less than 150 percent
pf the poverty ceiling—
pbout 115.000 for a family
pf three—would receive a
fubitdyoniiBdingacale.
• The newly requtred eolayments and premium conributlooa will add up.
latiwdGfeggHaifleyofthe
Ihildreo'i Defenie Fund. A
taraily of four with income of
II.SOO and average health
bosu could pay $265 in eotuymenti alone, he uid.
! Wyden uid he la worried
that poor people and former
Mediceid ncipienu would
be channeled mainly into
HMOs, where "they could
|ieve a hard time negotieting
ftieir way,'
;
Those Off W/are
Face Co-Rjyments
- ^aeLfto
.
PttaWanl CBnton'i heatth
car* plan came undir ( n oo
. Capttol KiD lilt VMk far
" craidnt 'Mwflninctilbur. «i«n.farnumoBo/Medicaid
redpienta who tit poof but
do notraeefr*welfare.
Tha CSnMi prepoatl
•olid ahUt all thoae ttalv
medldal benefiu In the
raHute Medicaid proi, which It vtrtuaUy fret,
lints prtntely ma health
! plana and health malnteJoaiKC organiaatioaa. The
iouM-pockM coati of wal'Jut becefldldu would con~te to be negligible. Othwould receive aubaidiaa,
would have to pay •ome
Ipremiuma ind make a anuD
ropavroenf cadi time they
ftitltoda doctor or hoapilaL
:; WMa the ammrnti an
.•amaU, critiea told tht Houee
'; Energy and Commerce
: health lubcommlnae Friday,
'. they could deter poor people
.|6om getting timely medkal
^are.
; Tleaae underatand the
laerlouaneaa with which
- 'aome of ua convey thla matter to you,' Rep. Ron Wyden
;(IK>rt.) told Bruce C.
•Vladeck, adminiatrator of
•the Health Can Financing
;Adminiatration. Subcommlt: '.tee Cbauman Henry A.
iWaxmis (D-Calif.) called the
•dlacrepancy "troubling."
• Stan Dora, managing it'torner h the Weshington
; jofllce of the Nalional Health
Liw Prognm, charged that
•the plan would punlah "poor
.people who work." Thoae
-.who leave welfare would
'"pay more for health care."
:
w
5
:
:hei»id.
,
'. Vladeck = acknowledged
that the Clinton reform plan
mikes new fininciil de-
I VUdech said the adminjuration is sware of the confern. "Esperience has been
put the better HMOs hayen't bees that Interested in
reaching out to Medicaid
|recipientil." he uid.
�11.
22.
93
0 9 : 3 6
jrupoMd nfunuon would keep e new
drug, nieh u Ttcrlne (> irealinent for
AltlMlmer'i) fnm older paUenti ind tie
Uie hindi of tliilr docton.
Prenun torationwill O gruteat In ale
Uancea that Include eltln. Inilde an t t
Ilanee, everyone paya the lame rate"communlty ratlng"-for health care
(page 871, and the premiums collected
have to cover evetyone'i needi, Including
the AIDS patient, the assault victim, and
the SM O low-btrth-weight baby. People
l . O
O
win figure out that you pay the highest pnmlums and get the least health can in alliances that Include Inner dues.
Moreover, the bill shifts medlcel costs
now paid by the federal government. Including a large pan of Medicaid, onto the
aUlances. The brunt will be borne by urban
aiuancei. For example, the bill halu Medicaid payments to the chronically Ul and
subsidies to urban hospitals that treat the
poor (pages 802,113).
ThereductionsIn federal spending an
called "savings" by the Ointon administration, but the coats an Just shifted from
the federal budget to the nglonal alliances, which must psy for everyone's
heallh needs out of local pnmlumi. For
eumple. the u.t billion annual cost of
caring for 38T,iM chronically 1 ] New York
1
City residenta win be ihlfted from Medicaid to local premiums. The coat ahlft
amounts to a hidden new tax on urban reaIdents and employen (mandated to pay
K% of their worken' pnmluma). It will
spur employen to abandon cities.
The Health Security BUI is dangerous,
because It cuts off fundi for medical can
without comldetlng our aging population
and the Hdal problems that make health
care needs grow. Price controli on premlumi wm mean too little money for the sick,
long waits for treatment, and rationing.
Price controls on docton' fees and regulations tying docton' hands will limit the
care doctors can give patients. Price controls on new dnigi wUl withhold effective
medication (ram people over U. In cities,
where premlumi will be stretched thinnest
to offset Medicaid cutbacks, people will
tace the severeit reductions in access to
the medics! care they need. Public debate
on the presldint'i bill has focused on cost;
but the critical itsue is access.
Ms. McCaughry U a ftllw! at Uie Man
kolton MjHhitf.
�11.
2 2.
9 3
O 3
: 3 S
A M
Cm et
o mn
Pull the Plug
on Welfare to
Solve Poverty
AT Ootits
KtAinHiMvzi
N
or I I thli Idei coming only from
coruervaiivea. N«>.liberil>ur.
naliii Mickiy Kau. propoied a'nmilar
Idei In hil book. "Th. End of Equillty. though In l leu Draconiin v.H{{f"P'sce welfire with a
neo-WPAJobiprogrtm.
And l u i year, eindidaie and "New
Democr.i" Bill Climon gingerly i p .
proiched ihe Idea wiih hil "iwo years
and oui" weldre-reform plin. Bui
two y u n and out." however w.n.
Imeniloned. mluei the point. Th.
point n io root out i t i n origin the
moil perverse govemm.nl incnuv.
progrim of ill, the lublldy for llleaiumicy.
Why? Beciuu ilKglnmicv n u,,
royil road lo poverty md" i l l iti
lllendint pathologlw The one-pirent fimlly I I n , umei more likely u,
be poor thin the twd.pir.m fimily.
In • compiuuve onomy and cor.
rupilng cultur.. i i Is hard enouah io
ran. a child wiih iwo pirent* To
•ueceed wiih only one requires hero,
wm on the pan of die young mother.
Heroum Ii not Impossible. But no
•oclety cm ixp«t it u i n . norm. And
•ny leciety thit doei u mvmng M d , ,
cataitrophe of the kind now on vl.w
lnlh.lnnerclueiofAm.rici.
The defender! of welfire will tell
you that young woman do noi hive
babies Just to get the check. Yei. there
are other reasons, a desire for .omeone io love, a wiih to declare independence. a way lo aecure the love of
thes. eluiiv. young m.n. Bui whether or noi the welfar. check n ihe
conlclou. reuon. It i . t h . condition
thit illowi ptopl. io ici on i l l t h .
older reuon. Take u away md ihe
•oclety built on blbin hiving babiei
cannot survivt.
MorMver uciety win noi long
T,',^?
'y
- Amerlcani f « l
a civic obllgaUon io help the unforluw o u W
( ( O « Codet Among Inner-City
^ Y o u O i " i i Die uue ol •
k-/r«mirkibl« piper prtitnted
leu week by Unlvermy of Penruylvinla profenor Elijlh Anderson lo l
seminar at the American Enieipme
liuUluu. Its 40 paies describe In
excnielsiing deull the » « and abandonment -gime" pliyed by boys and
girls In inner-city Philadelphia.
Anderion Is • scrupulous and sympaihetie student of inner-city life.
-Streeiwue." his book on life In e
ghetto. Ii a classic of urban ethiufnphy. Five years of Intensive observation and Interviews have gone Into the
sex-code nudy. It is the story of family
breakdown on an unprecedented icalt.
of a place where "casual sex with as
many women u poasible. impregnit- .
Ing one or more and gelling them to
have your toby' brings a boy the
ultlmale m esutm from hu peers and
makes him a man." As for the girl,
"her drum | i i l of a fimlly and a
home." But in i lubculture where for
the boy "to own up to e pregnancy is to
go igalmt the peer-group eihlc of hit
and run.'" abandonment Is the norm.
The rnulis w« know. Illegllimicy
riles of TO*. 80%. Inlergenenuonal
poverty. Social breakdown.
u» dollan go for widow, and orphan.
Toward the end of Uie seminar. I But by what moral logic should •
suggnud thai the only reillstic way lo •"payer b. i.ked lo „ « . , p i n of hi.
aiuck ihu cycle of lllegitlmuy uid Iu eimlngs io luiiam a child fatherKl by
mociiled pilhologia i i by eutilng off a young man who diuppun. leivine
the oxygen ihai lusuim ihe iystemi moiher ind child w.rdi of the l u i e '
Slop ihe welfire check!. The cheek Subiidlsing ingmy i i one thing. Subgenerated by the first illegilimaie btrth Kdiimg wanusnnus Ii quite mother
t t y i thai sovemmtm will play the rote
On O c u j e Sen. Daniel Pairlek
of fliher and provider. It suiuins a Moymhin held a Fimnce Commiliee
deranged locial fuuciure of children heinng on "lecul behivior and
having children and ralang them alone hea th-eare coita." Ut ipoke of the
and abandoned by iheir men.
Mploi.on of illeglUmlcy, now 30S of
l l i i a mark of how far the debate on all birihi. 5W ilmes whsi it was 30
welfire policy hu come thai my pro- yurs I j o , i trig.dy for Ui. people
poeal drew mpenful djsagreemem involved. . eilimiiy for ,ocl.°y.
from only iboui half of the panel—in,
l n I d 6 ?
" Mo>,nlh•n
cluding. I should sireu. Anderson him- u k r t ' °
Try' ihll. Don't reform welfire
self, who argued that the better answer
ii giving ihe young men jobi and hope Don reinvent IL Wh.n it come, to
ihrough Mining and educiuon for • Illegllimicy. ibollihll.
chinging economy.,
Oiarla Xravllumnrr wrtlw a n™.
In ficl. ihe idei I propoied i i noi
ongtnil. A decade ago In bll book. dialed column in Waihingicn
"Loilng Oround." Chirlei Mumy offered i h i eold-iurkey approich.u •
"thought experimcnl." Two w.ekl
ago In iht Wall Street Journal, he
propoied Ii u policy.
K
i
t
m
�Out to Push
I Health Plan
erwise oe aeuverea oy primary care
doctors.
The Clinton health plan, formally
introduced in Congress Saturday,
would require reaching hospitals to
increase thi? percentage of primary
care doctors they train to remain
eligible for" Medicare physician education paymems.
The Clinton plan proposes having
55 percent of all doctors be primary ,
care physicians by 1998.
The questions about medical education were among many from
physicians here reflecting disagreements with the plan.
In meeting after meeting around
the country, and again here yesterday, physicians have expressed concern over excess bureaucracy and
over the possibility that the Clinton
plan would create oligopolistic '
health systems run by insurance
j Specialists Fear
\ Program Will Close
j
By Dana Pimt
j ATLANTA. Nov. 22-Hillary
i Rodham Clinton, fielding questions
jfrom skeptical Georgia physicians
• about the White House health bill,
j today defended administration plans
; io use the financial leverage of the
; federal government to produce
j more general practitioners and few, er medical specialists,
j "We (the federal goverranentj
created the imbalance, and now
J we've got to create a balance and
. that is what we are going to do."
.-.she told Jeff Nugent, chairman of
: the Medical Association of Georjgia**' board of directors.
; Clinton traveled to Georgia today
;a« part of a stepped-up administra; tion effort to woo doctors and re; focus attention on the health care
; issue. A recent Gallup poil found
[that 58 percent of physicians op: pose the CUnton proposal.
Reducing the number of specialJists wil) negatively affect medical
• research and will require many ape:aali3t training programs to close,
: Nugent said. "Do you think we have
jso many specialists because of the
J wishes of the American people or
• because of government planning?jhe asked, clearly expressing his be;lief in the (prmer, as did a number
;of other speakere.\ "Because of government planjning. no doubt about i t , ' Chnton
responded. "It'i supply and demand,
cause and effect. . . . The American
(people did not stand on the street
.{comers and say. "Give us more thoracic surgeons.' "
t The federal government helped,
ito create the current imbalance in
(the supply of general practitionera
through its Medicare reimbursement program, which pays teaching
hospitals $5 billion a year to offset
the cost of training medical residents, administration officials say.
An estimated 67 percent of all
physicians are specialists, and many
lime ana agam. -nuiary Lunton
has personally stepped into the
fray.
"She's a glib speaker. She can
really rattle off the answers," said
Carl Crawford, a retired familypractitioner. "But she doesn't like
you to argue with her.'
In most meetings the exchanges
are respectful, but' slightly tense,
disagreements. Only rarely do they
break down into unpleasantries. ••
At the end of today's meeting
here. Clinton stoodjfor 15 minutes
shaking hands with members of the
audience. "I've been married to a
thoracic surgeon for many years,"
Pauline Goldfaden, pushing against
a throng of well-wishers, told Clinton. "We'll look uit« this p&n with a
lot of apprebeo&ioo^. .
"Oh, don't worrf about tt." Clintoo retponded. tmifaig. •
Measure to Allow
Worker Buyouts
Dies in Congress .
By Suphen Bur
Clinton administrauon plans to reatnjctuiv the i
ment were set back yesterday wben legislatioa to allow .
"buyouts* of federaJ workers next year died in Congress. ,
Officials and congressional aides said the bill stalled .
because of deficit-reduction poliUcs, poor timing and other legislation that sought to capitalue on the administn- .'
tion's plans to shrink the bureaucracy by 252.000 work- '
era.
Administration officials, who asked not to be identified, said they were disappointed, contending that without buyouts the government may face the prospect of
layoffs as it tries to operate inder tight tmdgeta stilting in fiscal 1995.
The bill stumbled in the House wben Congressional
Budget Officefiguresshowed that workers taking retirement early would cost an extra $519 mfflioo over
the next five years. As a result. House supporters were
rebuffed when they tried to attach it to other bills or '
prevent a similar measure from being stripped out of a '
budget package that grew out of Vice President Gore I :
National Performance. Review.
Yesterday, Democratic supponers in the Senate .
tried one last time to move a veraion al the taD forwaid ,
but failed because of the deficit^eeductkei cmcenu.
Sen. William V. Roth jr. (R-DeL) had sought to apply '
the savings from the 252,000 work force reduction to '.
deficit reduction while Sen. Robert C. Byrd (D-W.Va.)
had claimed the savings for the Senate crime bill.
Roth objected to yesterday s effort because the new
version did not lock in a 252,000 work force reductMo •
or meet his defiat-reduction goals, an aide said.
Asked if the administration could have pushed harder .
for the bill, which to generate savings had to be passed
this year, a senior official replied: "We ah tried hard. I \
think in some cases this was a product of bad timing."
The fight over the North American Free Trade Agree- I
ment "came screeching up on it." the official said.
On Oct. 1. the administration, following up on its Sep.
tember announcement to cut the federal work force by '
12 percent, sought the authority to offer buyouts as a
way to ease the transition for workers and federaJ agencies. Under the bill, up to $25,000 would be paid to each .
federal worker who resigned or took early retirement.
The Office of Personnel Management projected that
60.000 to 100.000 federal workers would take the
buyout, giving agencies a way to reduce their mid-management ranks or target jobs the government no longer
needed.
In a letter to Roth earlier this month. OPM Director
James B. King predicted "grave" times for federal agencies if they were not allowed to offer buyouu.
"Agencies already struggling to meet lower budget
caps will have no option but to implement significant :
reduclions-in-force (RIFs) or,in private-sector terminology, fire without cause. Ironically. RIFs are more '
costly to the public than separation incentives a
little impact on delayering." King said.
1
;
TLESOO. \ o v n e o 23. 1993
rwTO% POST
�Face More Scrutiny
ECONOMY
"
Cbnfinued Pram Page Al
malignant, but not covered by hen Insurnee."«ie president Implored lawmakers
in his September speech.
But there is also an economic rationale,
according to the administration, for imtmsal coverage. If health coverage were
provided to all. people would no longer be
health-cart marketplace, or setting the
ByRicaWArauii.
afraid to leave their earrent jobs because
St a 7 f t r p o n r r o j T m W*1X » T M » T SOCWMU.' rates hospitals and doctors can charge.
of the possibility of losing theirinsurWASHINGTON-It Is tlte greatehicken- "You can get cost containment without
ance-a paralysis known as "job lock.
and-egg question of the health-care reform universal coverage." says Mr. Anderson,
Moreover, every time the uninsured or
debate: Which oomes first, universal cov- who served as a health adviser during tbe
those with insuflicient coverage show up at
• erage or cost containment?
Carter administration.
the hospital, their cost of care must be
President Clinton, during his major Less Ideal.. .More Pragmatic'
home by Ihse with good benefits - a phe^
health-care address to Congress in SepThat prospect has led some to favor a
nomenon called :'cost-shifting." Some
tember, made his own view perfecdy clear. two-step strategy differenl from the presistudies show that cost-shifting is leading to
Unless every American has adequate med- dent's: First, rein In costs: then extend
tnoeases In premiums of more than 107,
ical benefits, he declared. " e will never coverage to all. "It Is less Ideal than
W
for those who are Insured; while also
be able to fully put the brakes on health- Clinton's approach, but it is more pragdriving up administrative expenses
care inflation."
matic." says Louis Sullivan, who served as
througtiout the system..
The reason? "When people don't have secretary of the Depanment of Health and
Despite such arguments, ttw notion ot
any health insurance," the president said. Human Services under President Bush.
suoolying everyone with heatth insurance
"Ihey still get health care, but they get it
PohticaJly. however, it may be impossite-mthinkable at one end of the political
when it's too late, when it's too expensive, ble to separate the two goals. Sixteen years
spectnim. To those on the far nght. "Unioften from the most expensive place of all, ago. President Carter tried to control hosversal coverage is Just a euphemism tor
the emergency room.. .So they cost us pital costs before embarking on a national
the welfariiaaon of health care." Rep:
more."
health insurance program. Trouble is.
Dick Armey IR., Texas) asserted. ObviContends Costs Would Rise
Congress never minaged to swallow the
ously, we would hope everybody would
Not everyone agrees, however. Gerard "bitter medicine" of cost oontalnmeol. Mr.
enjw health care. but.. .health care is a
Anderson, director of the Center for Hospi- Anderson recalls. "So we never even got to
cimodity. Just like bread, and just like
tal Finance t Management at Johns Hop- step two." universal coverage.
housing and everything else." _-.
kins University in Baltimore, says that
Whatever the right answer, the issue
In the middle of the spectnim are
because the uninsured would likely use has taken on enormous importance. A
moderate conservatives like Rep. Cciper
more medica) services if they suddenly couple of weeks ago, Hillary Rodham Clin-and Republican Sen. Dave Durenberger ol
were given coverage, overall heallh-care ton made clear that the administration
Minnesota who want to increase the numcosts would go up. not down.
won't back off from Its commiunent to
ber of Americans who have health insurance but would wail until cost savings are ,
In fact, the Clinton administration's provide universal coverage with a compreevident before guaranteeing universal covown preliminary projections show that hensive set of health benefits. The first
erage. "We're for univereal coverage, but
national health spending wouldrisefaster lady even lauded alternative proposals
not until you can satisfy ««.
than it otherwise would during the first lhat seek universal coverage. Including a
can people thai It can be paid .for.
four years of the new plan as the nation's plan by Republican Sen. John Chafee of
Sen. Durenberger says.
3 million uninsured were absorbed into Rhode Island. And she attacked ihose
7
the system. The Ginton plan aims to make plans lhal aren't designed to cover every"We want to go slow." says Rep.
body, Including one by Democratic Rep.
coverage universal by Jan. 1.199S.
Cooper, whose "pure managed competiMeanwhile, bringing costs under con- Jim Cooper of Tennessee.
tion-plan would try to hold down health
In making his case for universal covertrol is viewed by some as a separate
costs by relying on market forces andby
equation. Universal coverage can make age. President Ointon has painted it, first
capping the amount of health benefils
cost containment easier, this line of think- and foremost, as a matter of morality.
employers can deduct for tax P"n««L
"Think of the face of the woman who's
ing goes, but it's not a necessity.
By not going for universal coverage
By streamlining Ihe medical delivery been told not only that her condition is
right off the bat. Mr. Cooper believerills
system, fostering cximpetition in the
Please Turn to Page Ak. Cblumn 2
possible to sidestep one ol the most controversial elements of the Clinton plan: Ihe
'requirement that all employers help pay
for their workers' health coverage. The
employer mandate, the congressman says,
is "a clumsy and expensive way of achieving universal coverage."
Linking of Universal Health Coverage
To Cost Containment Endures Scrutiny
a
(
Besides, Mr. Cooper contends lhat
by knocking down the barriers that block
poor and sick people from obtaining health
Insurance, his plan would come close to
universal coverage. In the end. he says, as
few as six million Americans would be left
uninsured.
Critics don't believe that, however.
Mrs Clinton, for one, points to a Congressional Budget Office study, which concluded that an earlier version ol the Cooper
nlan would leave 25 million uninsured. The
CBO hasn't assessed Ihe latest veratr -(
the Cooper proposal.
'
The go-slow approach has other pa n
tial pitfalls as well. Currently, because
costs can be shifted to those with coverage
the uninsured receive the treatment they
need when they show up at the emergency
room. Biit if cost controls were in place, I
uninsured may find it harder 1 find care.
0
"A barely civilited system for the uninsured." warns Brookings Institution economist Henry Aaron, "could turn into on,
that is downright feral. '
1
TUESDAY. NOVEMBER 23. 1993
�Mpj-ar-igq?
B i : i 7 FROM
l*»0N-TRIH>E KEUSROOM
TO
organiMwl labor aaiu, "Uvcr uiy •mini
dead body.' Whereupon Ointon
made a beebne for tbe Republican
aide cf the aisle without even both-.
ering to send flowers.
Nothing quite so dramatic bas
happened on health care — yet.
But the signs are dear: If it's a
choice between Detaocratic dogma
and Republican votes, it may not
even be a doee call.
• Ceetlder two major changes in
the administration's health plan
since Clinton's curtaJn-raiaing
speech on Sept. 22.
;What startedasatranpetaD
for universal covenge — a rallying
cryforperhaps moat Democrats bt
Rtp. D u Rotten-'
Congress — has now been muted
kowduvatcbedthe
by Omton's decision to cap healthpeifuAininfw of
care subsidies for the poor, early
the (maidential
retirees and emaO businesses.
healdxaretai
I team. Bill aodHillaWMe administration aides asTrKodbBBCbnua,
. mre IWJVUUS Democnts tbey do
I onCuitolHilllast
not expect the program to exhaust
week and aniffed that it iruaB thethe subsidies, the existence of a cap
ater."
suggests that. If forced to chooae
hirtt'boiled pbl boiu Chica-*
between covering everybody
.80 « u tight in a U t e d acsse. but
handedly and living within a t
Bis ooomwnt wa< not free of telfClinton will choose fcagallty.
proiootion, beauw he chairs the
Leading Demoaatic liberals loet
committee — House Ways and
no time in comslainag that Clinton
Means — that will hart the toggtst
had retreatedfrom• rtmdamentai
say over whatever bealth-care biU.
principle of equity, while conservaif any. moves through Congress
tive Democrats and Republicans
next year.
teemed reassured about the
president's determination to avoid
. Certainly the preeident and first
My did not show up in the CapitoPt
an uncontrollable drain on national
heroic Statuary Ball tiniply to delivres^ces.
er a Wl; they alio came fo strike
Bethinking health oare
the dramatic pose cd youthful lead- ers •ununoning the nation to make
Then there wu the decision to
hard choices and to pttme perhaps
back away from limiting national
tbe most ambitious acheme of dohealth-care tpentEag. A'stobaT
oestic economic refcrm ever.
budget appealed to Bbenls because
it mcantthat tiie efbn to control:
. beahb-are wtta woAid be governSimt from
tomSte^ft^S^^
ed by a regulatory mandate to make
moroussittygrittydJccislatiDf,
sure that everybody would be
ahouM realise by now that Clinton,
treated alike. The bureaucratic imoo issues Lke health can and North
plications cf this approach, of
Amedcaa free trade. Is as much of a
> comae, appalled Republicans..
wheeler-dealer as any-ward boas m
As snaheraative, the adminis trathe chairman's bome town. .
tion proposed limiting the annual in.. What is especially noteworthy .
eurance-premtan mereaaes that
about Cfaton'a approach it his wilJconsumers wooM have to pay to
inxneai, after-nairofrty averting a
porehaaetheetandaribenefits. puitical train wreck over last aumpackage at tbe core of dintoo't
mer's budget taD, to teek wholesale
overall pregrsm. Thh Uctk
— Kepublicu support for bis major
arouses liberal faars that the poor
domestic programs at the cost of
would receive iaferier medical care
abenating large cbunhacd his Democratic base. : -
9120245664BE
P.04
Fihlay Lewis
HeafiKcdre
Glintons
not party
animals?
Clintons seem willing ;
tb:opurt S^public^ns
Labor eppoittton"
On the attempt to pus the North
American Free Trade Agreement.
See Health ear* on Page C-2
OonBnued trem
frl
.- '
baceuse th* system woald oootrol
tmochlBaintop'a
md plaases moat Democnts.
-Tiiaf could too be said about
Otatoo't aUdfaa^Diag cf NAFTA
•s k presidential candidate and a
fraahlykiaugiiratedpreskhntwben
tbt agmgnenf ataped» tot en- :
vtmDcot tnd Azncncin w k e n .
Hk itteBtpto to one those prob-.
kma failed to reaaroe amy NAFTAtritica.---- '•
ButlhavtagCBtmalBiedasaeocaDad diffeRst kmd dltaDOCxat,
Clinton decided to defy Us party's
gwvaifag aeabaeott on Medcan
'i-JJow the ome pocesemay b*
OMcrwaycot
�The Options
Most iJliances would
0«*r a large s*J*ction
of plans, but all must
include lUea&l one Ii
for-service option oHerrng t r t t choice
of doctors. The administration
estimates thai the average plan cost
woutd t>e SI.932 a year for an individual
and S4.360 tor a tarmly. but costs woutd
vary byVegion. Plans of any type would
vary in price: people choosing costlier .
ones would pay a higher share of
premiums. Plans coutd offer
supplememsl policie*. covering (terns
tike extra dental or mental neaith
benefits: employers could choose to
pay. lor these or consumers could buy
them with after-tax dollars
All ArMrtcans would be issued •
"health socurtty cafd" that would
enable them to receive the
guarantMd benefits listed below.
oexrai. » Moat car. lor children.
Adult preventive Detwttu
pftased in by 2000.
OHlias •
nrtatu
-
Prwcnption..
Routine vision and hearing
exammstiorts: e y e g t o a m tor
children only.
Nuraing homes or reftuintaUon
owners (as an alternative to
hospital stays). Maximum or too
d a y i each year.
-
-
— —
CA«
—
to • ^—V'^
hoepltaimtlon;
re-^raiiMtcd every 60 days.
HDsncc » For terminally-ill prcple
W S m a i a XemH>rivit> room; priveta
•rays
rooms only when medlcelly
»»ary.
n S m
*
U m t t l <
' PtychMtwrmpy; nmftwl
nospltal stays,
oevrct •
imail
ProleeaJonal aervlees.
meyc
m BTWCM. artnclal omb. or pn
O W M I i n i T • Phy^cal. n r c i i p . t t o t w l o r ^ » e h
" • W
nwapy toMonskUatoMtrera
lllrwaa or Inlury. NvwvMMtad w a r
cm
mmn.
MJWSTANCX • UlT
« end btpallent
The plana
i K m that a n not TnxMcelly
neceuaryora
L haanng aids, contact lenaaa, a « change
olsuch
'THE
N E W VORK T/MES. SUNDAY, . V O V C M M J ,
»:
�re^yZST
SW^WBiTS
Health Merchants Peddle a Red Herring
>
Stores whip up anti-FDA
campaign, but what
they're really against is
truthful product
labeliog.
T
2
<
ID
n
0)
o
houwdf al htahh-faol stora m
waraiiig n u t o n m Out Ihe Fund
•od Oras MmiaUraUan n m s to
ban ar mpdre a pracnpltan lor a wide
ru^e of vUainim and oUxr diclaiT
•mpleneoli. Thai Beaaafe la aehoed in
newalettera read b j •ipftement-lallen
and tnduxry mafatinea. Ptcflt are beinf iwfed In wiUe to Cnafnss id m*paH
d Ihe DteUry Suppienew Heallll and
Bduealim At*, ^ a m d by Sen. Onin
C. Batch (R-Ulah) and Rep. BUI RirbaMaan ID-New MeBoo). And una of
UuwainkaredoBduetlhal.
Thoae biUa would strip the PDAskich b u hiatoefcallr baea UruoDr
anti-supplemeM-el ouch ef lis traditional auUKWtty le regnkle Ihe t n t m i j .
Thai would satisfr ardnl i
t the aieoey wooM
ban maajf hamlea producta. Bm as Repi
John Dingell (O-Mkh.). a t l a a hanh
cnUc al ihe PDA, haa said. "Beery bet
available u ne inhealcs lhat FDA •
neillwr on a canskm to desaray the
nulnlmul swlenent aarkel. nor does
the agesicy have Ihe reaaunxa to I
ptkh audi a mi
wanted KL"In I M , the I
i Hit
I Ina Is tap
anpeOoo(r.
plementa h o i Uie Nuimion
Labettnf and Bducatian A d .
the new tMh-tn-labftntf law
Ihaa raqoira an health clatau
on lakeU of roods and aiwple- neola la be BWorled by rood
Make no odslake-UKfe are lecittaiale
eon con. with the ovenerllalitn of
bertn, amino acMs and similar prafurta.
Zcaku In and oid of fovemenml have
tool desdfraud lupptesnenu and would
Umea tnudulenl health daima on litaela
iilunnrUieanmrloim^iUadiealolry
Canlrary lo indiatry hypeihote. Ihe
labelmf act does DM ban produeta. t l
does ban label dainu not auppnted by
-•gnlKriM aciBdlfie apeemeM.- rood
manufactilren lhat onee were pmdieally toultng au-bran polau chips as a
heart ionic are complyms with Uie new
law. Bui anplyiac could be painful for
ceenrasiles whoae prorus depend on supplcmeau daininif to cute everyltbni
For instance. Uie Uatch/Riekanlson
MUs. taawd of miuinn* healtn elatnu to
lie baaed on nlld aoenlifle evidence,
would allow a cmspaay lo prtM on i u
label thai "A study by a leadlnf univer-
sHyindieateaUialVIUBtaX reduced Ibe
risk of cancer In aoimala by 2%.'
Industry cnnleiula lhat that kind ol
wtlhi between ^wdfic
nuuienti and piod healUi or dlaeaK
preveoUan.- Never mind Uiat the study
Iramolly, if the supplemeol Industry
pievaih. H ia likely tn remain a frinfe
taldasuy. Purveyors, honest'or. not,
would caoUnue la have Uie oredibibly of
iaod-car dnleti. And Uial would be
meat unftetunaie. bemuse there is growing aeioiuae evidence that amne si^plenenla offer real heallh benefiu. •
. Pee aample.' foijc acid, a B numin.
baa bee* shown lo reduce the risk of
spins NAda. a congenilal spinal drfecl.
One recent study found that a tniniire of
beu earolene; vKanan B and selenium
reduced the M e of stomach cancer in a
high-risk population Ul China Another
aludy foimd that a nudtiviumu reduced
Uie incukne* df colds, flu and olhcr
infeclum-related illnesses in people
over GS. And ntajov trials are under way
al Harvard liodical School and (Uewhere Lo evahiale whether high doses of
certain morienls prateci affamsl besrt
disease, cancer, ealaracla and other
hultli problem The medical BoahUahmeM. keig suuncfaly moaned u> ajpfilenenta, is begiraiing U) acAnowledge Iheir
benefiu
Kepi Cardial CoUins ID-Ill.) reeenlly
intraduced Ihe Dielary Supplenunt Consiaoer Prateetion Act, which defiven
what Uie Batch/Richardson bills pramise-wiUuut Ihe special-inlcresleiemptioa ban honat labeling. Bar tall would
faster the use af benefidai supplemeais
by permitting well-founded heallh
daima and leave hwmiesa. hmuaUy
nil alone, l l would also
e lhal stvplnaaits acbially e
what they ciaiin.
Host important. Collins'
would
mpme heallh ctaUm on sunilKaml
labels lo be )ial as rehaUc ss claasa on
food Mela. After all. why should Ihere
be a double standard (hpending upon
w betlKT a subslance is added lo a food or
eoldasssivplement?
Under Uie Collins bill, clauaa like
-helps prevent cancer" would have la be
backed 141 by good science. And defining
-good science" would be Ihe government's respantibillly. not a r
organisaliona. including Consumers
Uiuoalbe Amcricaa Heart Asm and Uie
Amoican Caneev Soaelyjuppoit Colbis' legislaUon and oppose Uie Hsleh and
Rkturdaon bills. One hops that their
cHoru will ovevesme Ihe. tuppleaent
Induslry's misleadiiig public reUtiens
praouees. which are sil loo mniiiiseen!
of U K dubious claims on some of the*
praduct labels.
Mdiaef r. Jbrabaoa ia csecalh* dincter
of IV wapre/if CntUr for Samet to Ike
fabOc limn.
Watknglat.
�I H E WALL STREET JOURNAL MONDAY. NOVEMBER 22, 1933
-^T*
U
•
THE WALL STREET JOUB)IAL «QNDAY, NOVEMBER 22,1993
'HUU.JLL
"
•
>
^Price Controls on Health Care
.1
r
and residents, and pay most of the pre- eral government limits dollars paid intc
the system, but rationing those dollars is
As I pored over the president's 1,342- mium money to insurers and HMOs.
The National Health Board will set a done by HMOs and by alliance officials
page health plan, I remembered the TV
ad: a couple discussing the plan and what .health care budget for 19% (the "baseline themselves.
HMOs have a track record of tightly
price controls on insurance premiums . year"), allocate it among the regional alwould mean. The ad (one of those ctlti- • liances, and set a price ceiling on what the controlling the use of tests and expensive
cized by the .first lady) is right on the average health plan can cost in each re- drugs, limiting patient access to doctors
point: The administration's health bin is a gion. To sen health coverage in a region, through gatekeepers,restrictingpatient
system of price controls that will keep you HMOs and insurers must agree to stay un- choice of pharmacies and hospitals, and
from getting medical care when you need der the ceiling (pages 974, 979, 984, 987). penalizing patients who get nonemergency
it. Limiting how much people can choose to After 1996, health care spending is strictly care outside the HMO network. Despite
pay for insurance limits how much money limited by an "inflation factor" based on these cost controls, if HMOs see medical
is in the pot to take care of them when the consumer price index. The bill pro- spending exceeding the per-capita limits
they're sick. "But what if there's not hibits aregion'saverage premium from set by the National Health Board, the bill
enough money?" the woman in the ad
asks. " I mean, what happens then?"
The regional health alliance Umits what we can pay
The Health Security Bill spells out the
troubling answer. A National Health
our own doctors. The alliance posts a schedule of doctors'
Board-seven people appointed by the
fees, and it is illegal for doctors to accept more.
president-will decide how much the nation can spend on health care each year.
97
Based on that budget, the board puts price rising more than the CPI plus 1% in 1 9 requires them to cut payments to doctors,
caps on premiums to limit the money paid (about 4.5% total), or more than just the staif and hospitals to stay within budget
(pages 1,001,1,003).
into the health care system (pages 252,974- CPI beginning in 1999 (page 968).
What most of us mean by fee-for-serMandatory limits on health care spend77). If medical needs exceed that budget
and premium money nms low, the bill re- ing may wring waste out of the system in vice insurance, which allows us to choose
quires state governments and insurers to the first year or two, but will cause hard- our doctors and get a second opinion when
make "automatic, mandatory, nondiscre- ship in succeeding years, as the 77 million we want one, will be hard to buy. The bill
tionary reductions in payments" to doc- baby boomers age and require more med- outlaws health plans that would push the
tors, nurses and hospitals to "assure that ical care. Limiting spending growth to the region above its average premium ceiling
expenditures will not exceed the budget" CPI, in defiance of this population trend, or that cost more than 20% above the averwill have predictable results. In Britain, age plan: mosi fee-for-service is too ex(pages 109,134).
What if a flu epidemic or a surge in where health care is rationed, people over pensive to qualify (pages 129, 184). What
the bill calls fee-for-service is something
AIDS cases breaks the budget,, and pay- 55 routinely are denied kidney dialysis.
Limiting spending growth to the CPI by different, because of price controls and raments to hospitals are slashed, as the bill
requires? New York City hospitals, which government fiat also ignores the chronic tioning. Where it is possible to buy it, the
operate with only four days' cash on hand, social problems underlying health care de- alliance limits what we can pay our own
would experience life-threatening short- mand. It amounts to rationing the remedy doctors. The alliance posts a schedule of
ages: nurses working without pay, med- without addressing the malady. It costs doctors' fees, and it is illegal for doctors to
$158,000, for example, to save a low-birth- accept more (pages 131,231-232). The conications withheld because of cost.
weight baby. Most such infants are the re- sequences of price controls are preGovernment-Run Monopolies
sult of teen pregnancies, which are twice dictable.
Even without an unforeseen crisis, as common in the U.S. as in Canada. As
In Japan, where similar controls are in
however, price controls on premiums will Mr. Clinton told doctors at Johns Hopkins: place, doctors hurry from examining room
mean people cannot get the care they "We'll never get the cost of health care to examining room, seeing on average 49
need. Here's why.
down to where it is in other countries as patients a day to compensate for low fees
Under the health bill, almost all Amer- long as we have higher rates of teen preg- and to make ends meet. American doctors
icans must buy basic health coverage nancies and higher rates of low-birth- will do the same. In the U.S., when
through the "regional alliance" where weight births and higher rates of AIDS, Medicare administrators froze physician
they live (pages 15, 240). -Regional al- and most important of all, higher rates of reimbursement rates a decade ago, docliances are government-run monopolies violence." The wisdom is in the presi- tors compensated by stretching out treatments over several quick visits, to see pathat decide which health plans will be of- dent's words, not in his rationing plan.
fered, collect premiums from employers
Who does the actual rationing? The fed- tients more often. In a last-ditch effort to
By ELIZABETH MCCAUCHEY
All
�Congress Gete^
Formal Version
Of Health Plan
Proposal Incorporates
Hundreds of Changes
By Dana Priest and David S. Broder
WstuiKton Post Suff Wmm
Two months after President Clinton unveiled his plan to overhaul the
nation's health system in an address
to Congress, his Health Security Act
was formally, but quietly introduced
late Saturday in the Senate and
House.
The bill contains several hundred
changes from the last, 1,342-page
printed version that the Clintons delivered to Congress in a "relaunching" ceremony two weeks ago.
The vast majority of the changes
are technical or clerical, but, in response to actuarial pressure, the administration cut in half the length of
treatment of drug and mental health
problems covered by the benefits
package.
Part of the delay in introducing
the legislation was the result of the
White House's desire to have as
many cosponsors as possible (there
were 100 in the House and more
than 30 in the Senate), part because
the administration insisted on producing a "clean" bill and part because
of congressional disputes over which
committees would be given jurisdiction over which parts of the bill.
Last week, for instance, a squabble erupted when the Senate Finance
Committee insisted it be given jurisdiction over a greater portion of the
bill—including proposals concerning
the regional health alliances—that
Mtjority Leader George J. Mitchell
(D^Maine) proposed. The regional
health alliances are state health purchasing cooperatives.
!E WASHINGTON POST MONDAY. NOVEMBER 22.1993
On the other hand, a congressional
ally of the president complained last
week that First Lady Hillary Rodham
Clinton and her principal assistant,
Inj Magaziner, "don't want to let go
ofjthe bill, even though we've told
them it will be substantially rewritten after it gets here, no matter
wiiat they do."
During the holiday recess that begins this week, officials said, the^
Wiite House will concentrate on
wiiming doctors' support for the administration plan. On Friday, Magaaner held a 2V$s-hour meeting with
representatives of state medical
groups and specialty societies. Hiliarv Clinton plans to speak to the
Mtdkal Association of Georgia to•iearings on the plan have been
conducted almost daily in as many as
ei^ht committees of the House and
Senate, using the outline of the bill
provided by the White House.
Many of the issues that have
enierged as likely sticking points are
financial. At hearing after hearing
critics questioned the ability of the
gOTemment to accurately estimate
th^ cost of medical programs. Time
ant} again the specter of "runaway
entitlements" has clouded discussions of the bill. Other contentious
issues are the White House proposal
to JHmit increases in health premiums, the ability of patients to choose
theu: doctors and the possibility the
new system would be too bureaucnfcic.
Backers of six major alternatives
to the Clinton plan have made use of
the last two months to drum up suppcnjt for their bills or, in some instapces, to introduce new legislative
proposals. Only the Clinton plan,
however, has made it to the congressional hearing stage.
�S N B.D M R G S E N W R O ! 1 1-22-93 S O S M ! D M R G S E N W912024562362;* 4
E T Y'. , E I T R E S O M
IHP
. . EITR E S
1
White House
Nw Smay
es umr
Page
*\
THE REGISTER'SEDITORIALS
— • —
Limits of health-care refonn
Reform wont make Americans
live healthful lifestyles
IJ/
hat
v
e w else health-care refonn natal care under its national health servwiil accomplish for America, it ice. But the infant-mortality rate among
WW won't make us any healthier. the poor remains three times as high as
That's up to us, not to the professionals — among other social classes.
and we aren't that interested.
Another of those endless surveys on
Health-care reform can see to it that health and exercise released recently
every American carries insurance, has ac- showed not only that Americans know
cess to preventive medicine, and pays out
enough exercise, they
of pocket only a fraction (if any) of the cost they don't get to do anything aboutalso
don't intend
it.
of other medical needs. But it can't change Two-thirds of those polled said they got
your lifestyle. Smokers know that their too little exercise but don't have time, an
habit is killing them and may be killing excuse that masks a preference for sitting
those around them. But 26 percent of •nd watching TV to avoid the Spartan pain
Americans still smoke cigarettes.
exercise.
Infant mortality ia a common Indicator of ofAn alarming proportion of the lazy and
a society's health, meaning that free prenagroup that
tal and neonatal care must be the comer lumpy are under age 45, the on; their pretoday's health Insurers count
stones of any reform. But infant mortality
is and will remain high when children who miums pay the costs of older insureds, who
have children also smoke crack, eat junk use health care more. But the apparent
food and ignore the health and nutritional trend away from physical activity among
younger Americans means they, too, will
ne^ds of their babies.
Dr. Robert Blendon, professor of health gobble up benefits beyond what their preillcy at the Harvard School of Public miums cover.
ealth, notes that making health care free Quite poeslbly, all the savings achieved
will bring in some people who might other* under the most efficient of health-care rewise have avoided doctors. An educational forms wouldn't match the potential
effort will brin$ in some more. But to get savings if Americans simply adopted the
the rest, "you literally have to send the healthful lifestyles they know they need.
But medicine, after all, is capable only of
vans out to get them."
And even that won't round up everyone. miracles, not of persuading us to use good
For 30 years, Britain has offered free pre- sense.
E
�"
aft teES-i.:--
! CiintGn "5 Chcxe
Left or Right
In Health Care':
W
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33
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2:
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00
HILE MOST PEOPLE have
been busy tending to other knitNE THING IS CERTAIN: The
ting, President Clinton has quination's new health plan will be
etly reached a crucial juncture in his
some blend of all these apquest to overhaul ftf> nation's healthproaches.
care system.
In essence, the president must decide And therein lies President Clinton's
soon whether to move to his left or to his choice: Move to the left to align with the
right to win allies for next year's health single-payer crowd and their passion for
debate. S m in the Clinton camp big change and universal coverage? Or
o e
clearly want to move left. But that move right to team up with the "new
could be a miscalculation that costs the Democrats" leery of too much governpresident the support of friends whose ment intervention?
Some Clintonites point to the 93
help he'll need badly to se!! reform to
House members who co-sponsor the sinmiddle America.
This isn't just some inside-baseball gle-payer plan, and the 100 who back the
debate. The way the White House de- Clinton plan, and argue that the action is
cides this tactical on the center-left. (That's at least a
question will say litUe misleading, though, because some
much about the kind lawmakers are backing both measof program it gets: ures).
In one possible sign of a move to the
how expensive, how
reliant on govern- left the White House is considering
ment programs, bringing on Harold Ickes. a liberal activand how ambitious ist who is anathema to many conservain its timetable for tive Democrats, to take charge of selling
change.
health care on Capitol Hill. S m Clino e
To picture the tonites dream of forming a winning
situation, imagine a coalition by somehow linking together
f ^ > £ £ j r t f l police-station line Mr. Clinton. Sen. Chafee and the singleiilllllllli lilHk I p of politicians payers, all of whom are at least united in
holding health plans, each plan bearing their commitment to provide universal
some vague resemblance to the others. coverage.
In the center stands President Clinton with his health plan. It promises to
UT THAT COULD LEAVE Rep.
provide coverage to all Americans by
Cooper and Sen. Breaux standing
1 9 through a combination of market
98
off to the side. They make a
forces and government intervention. compelling argument that their apCompetition would drive down costs, as proach, while unsatisfying to the White
Americans join new regional alliances House right now. at least provides a
to shop for insurance and health serv- vehicle for pulling together centrist
ices. Government would compel employers to pay 80% of employee costs, Democrats and Republicans whose supoffer subsidies to small businesses, port will be essential before this drama
cover the unemployed, and control costs is over. coalition that's out there to
"The
by capping insurance premiums.
pass the bill is a centrist coalition, not a
To the president's left stands Rep. center-left coalition." argues Sen.
Jim McDermott of Washington state Breaux. And Rep. Cooper maintains
with his single-payer alternative. Its that White House demands for universal
beauty is its simplicity. Government
met by expanding
would be put in charge of a national coverage can becost savings kick in. his
health-care system financed through a approach, once the key point is this:
Politically,
payroll tax and covering everybody.
While Americans are enthusiastic about
To the president's right stand the President Clinton's call for a new health
conservative Democrats, Rep. Jim Cooget scared il they
per of Tennessee and Sen. John Breaux system, theyrole too intrusive orsense a
government
expenof Louisiana. They offer a more-modest sive. Cooperative conservative Demoplan relying exclusively on market
forces and tax changes to drive down crats can help damp those fears.Mack
White House Chief of Staff
costs. Employers and individuals would
McLarty says the White House hopes for
join purchasing cooperatives, and the
a "consensus" in which "many of the
tax code would be altered to create
powerful incentives for them to buy the £ta|*cte" ofthe conservative Democrats'
iftfatthqare included. By whatever
most cost-efficient plans. Coverage
wouldn't be guaranteed for everybody. Ii IttMte/sPrtsldent Clinton would do well to
Looking for a place in this lineup is - f MWJI'JMB"!party's right flank standing
WtttfHifflJ =•liberal Republican Sen. John Chafee of
Rhode Island, whose plan is hard to
place on the spectrum. Like the Democratic liberals and President Clinton, he
promises universal coverage. But he
doesn't require employers or the government to provide it. Instead, individuals
would be required to find some kind ol
insurance, many with the help of gov
emment subsidies.
O
rT
U
B
�A18 Mo\DAY,NovE»iEin2y. l993.
AN INDEPENDENT NEWSPAPErt
A Vote on Health Care Costs
ART OF the problem when Congress takes in rounding up votes. Partly the argument was a
up health care costs next year will be to ploy, a way of providing cover for wavering members
distinguish between real cuts and shifts. The whn up* wJiiinr. •« .r«»o
/ r>
•»--
p
1 1 . 2 9 . 9 3
P I S
0 2 : 1 5
Bait. Sun» 11-25-93
Take Your Medicine
One of the goals of the CUnton administration'sSurveys have found that something aa simple as
health care reform effort la to help Americans take
having the pharmacist, rather than an assistant,
moreresporutbtlityfor their own health. The phar-hand the patient the prescription can increase
maceutical induatry haa one suggestion for doing compliance. That's not surprising. Trust Is an imthat: Take your medicine. A task force funded by
portant part of the healing process.
the Industry has pinpointed what (t terms a costly Prescription drugs play a big role in health care,
problem — the failure of Americana to take theirUsed properly, they can slgnlflcantly increase the
medicine aa prescribed.
effectiveness—and reduce the cost — of care.
"Noncompliance," aa medical professionals term
the problem, can be as simple aa skipping a doee of
medldne or aa serious aa the spread of tuberculosis
by patients who refuse to take the drugs prescribed. Noncompliance Is a major factor in the
failure of kidney transplants.
A survey by the American Association of Retired
Persons found that 42 percent of Americans who
are 46 or, older aay they do not fully follow their
doctor's instructions on prescriptions. They may
stop taking the drug before It runs out, take less
than prescribed or never take the medldne at all.
The results can range from costly relapses, hospital Ization — and. in cases like organ transplants,
even death — to relatively benign discomfort that
nevertheless interferes with productivity.
Perhaps the task force's m o Important recomot
mendation is better communication between doc*
ton and patients. For Instance. In several yean
working as a pediatrician in the South Bronx. Dr.
Hazle Shorter found thatfayexplaining to a mother
the purpose and effects of a particular medication,
the child was far more likely to get proper care.
The lesson holds true for pharmacists as well.
�T H E CRISIS
People Without Insurance Each Year
58 million
People With Pre-existing Conditions
81 million
People With Lifetime Limits On Coverage
133 million
�GUARANTEED PRIVATE
INSURANCE
Comprehensive Benefits
No Lifetime Limits
Insurance That Can't Be
Taken Away
�R E A L INSURANCE
REFORM
Illegal for insurers to:
• Drop coverage or cut benefits
• Increase your rates if you get sick
• Use lifetime limits to cut off
your benefits
• Charge older people more
�P R E S E R V E MEDICARE
Protect Choice of Doctor
Cover Prescription Drugs
Begin Long Term Care
�AMERICA'S CHOICE
• Government Insurance
[^Guaranteed Private
Insurance
• No Guarantee of Coverage
�HEALTH BENEFITS
GUARANTEED AT WORK
Employed: Covered at Work
Small Business: Discounts
on Insurance
Unemployed: Help from
Government
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PO Box 57438 Washinflton DC 20036 1202) 338-83B3
Voices For H a i t i i s a nationwide e f f o r t of action and advocacy f o r
a U.S. p o l i c y towards H a i t i t h a t supports the r e s t o r a t i o n of democracy
and the free f u n c t i o n i n g o f a c i v i l society.
Campaign p a r t i c i p a n t s
include n a t i o n a l and r e g i o n a l organizations from across the U.S.,
i n c l u d i n g s o l i d a r i t y , women, r e l i g i o u s , peace and j u s t i c e , human r i g h t s ,
law reform and p o l i c y development groups.
Voices For H a i t i advocates the adoption by the U.S. government of a
consistent,
clear p o l i c y p l a t f o r m that
includes:
* support f o r the immediate r e s t o r a t i o n of President A r i s t i d e t o
Haiti;
,
* pressure f o r the immediate departure of the Haitian m i l i t a r y
high command;
* consistent,
a c t i v e support f o r the human r i g h t s of H a i t i a n
c i t i z e n s and against blanket amnepty f o r v i o l a t o r s of human r i g h t s ;
* an end to the i n t e r d i c t i o n and forced r e p a t r i a t i o n of f l e e i n g
Haitian citizens;
* an end to U.S. funding of programs that undermine human r i g h t s ,
democracy or equitable development i n H a i t i ;
* a genuine, e f f e c t i v e sanctions program that targets the m i l i t a r y
and i t s c i v i l i a n supporters;
* leadership w i t h i n the U.N. and O.A.S. f o r adoption of the above
measures by the i n t e r n a t i o n a l community;
* a commitment that the U.N./O.A.S. Human Rights Mission w i l l remain
i n Haiti despite recent threats and demands by the Haitian military
that
they leave.
This demonstration i s part of an on-going weekly presence i n front of
the White House that began June 15th.
Voices for Haiti, i n partnership
with other organizations, w i l l b<i holding weekly demonstrations at the
White House u n t i l democracy i s restored to Haiti.
FELLOWSHIP OF RECONCILIATION
BOX 271. NYACK, NEW YORK 10960 914/358/4601 FAX: 914/358/4924
�LEVEL 1 - 9
OF 16 STORIES
C o p y r i g h t 1993 Cable News Network, I n c .
A l l r i g h t s reserved
CNN
CNN S p e c i a l s
February
10, 1993
T r a n s c r i p t # 150 - 1
TYPE: S p e c i a l
SECTION: T r a n s i t i o n
LENGTH: 7104 words
HEADLINE: A Town Meeting W i t h P r e s i d e n t C l i n t o n
BYLINE: SUSAN ROOK
HIGHLIGHT:
P r e s i d e n t B i l l C l i n t o n i s responding t o t h e n a t i o n ' s concerns d u r i n g an
�CNN T r a n s c r i p t s , February 10, 1993
FOCUS
o l d - f a s h i o n e d town meeting i n D e t r o i t . He reassures t h e people o f h i s i n t e n t t o
keep h i s campaign promises t o t h e best o f h i s a b i l i t y .
BODY:
SUSAN ROOK, Anchor: Moments from now, P r e s i d e n t B i l l
Clinton w i l l begin h i s
f i r s t t e l e v i s e d Town H a l l s i n c e t a k i n g o f f i c e .
P r e s i d e n t C l i n t o n i s expected
t o appear f o r about an hour, answering q u e s t i o n s from a t e l e v i s i o n s t u d i o
o u t s i d e o f D e t r o i t . Other audiences w i l l q u e s t i o n him from t e l e v i s i o n s t a t i o n s
i n S e a t t l e , A t l a n t a and Miami.
P r e s i d e n t C l i n t o n i s expected t o t r y t o
prepare t h e American people f o r what he says are ' p a i n f u l and d i f f i c u l t
measures' needed t o reduce t h e f e d e r a l budget d e f i c i t .
Mr. C l i n t o n has s a i d
t h a t he i s ready t o t a l k about and e x p l a i n h i s economic p l a n . One o f t h e
reasons why he i s u s i n g t h i s forum i s - he says i t i s because he b e l i e v e s p u b l i c
o f f i c i a l s s h o u l d be h e l d a c c o u n t a b l e , so he i s g o i n g d i r e c t l y t o t h e American
people u s i n g t h i s Town H a l l forum.
B i l l Bonds, anchor man w i t h WXYZ-TV, w i l l be t h e moderator from D e t r o i t .
This,
as U.S. S e c r e t a r y o f S t a t e Warren C h r i s t o p h e r announced today t h a t t h e U.S.
might be w i l l i n g t o l e t U.S. t r o o p s be used as p a r t o f an i n t e r n a t i o n a l
peace-keeping f o r c e i n Bosnia. T h i s p a r t i c u l a r Town H a l l meeting has been
�CNN
universal
through?
T r a n s c r i p t s , February 10,
1993
h e a l t h care, so t h a t no one e l s e has t o go t h r o u g h what we've gone
Pres. CLINTON: Let me, f i r s t of a l l , say I thank you f o r b e i n g on t h e program,
and I hope y o u r c h i l d w i l l be w e l l .
I d i d c a l l two o t h e r s e t s of p a r e n t s , who
are i n t h e h o s p i t a l w i t h t h e i r c h i l d r e n , on the way out here, j u s t t o i n q u i r e
about t h a t and t o get t h e i r ideas about what we should do.
Let me answer y o u r second q u e s t i o n f i r s t .
As I'm sure you know, I've asked my
w i f e t o head a t a s k f o r c e t o come up w i t h a b i l l , w i t h i n 100 days, which w i l l
b r i n g a new system t o h e a l t h care t o America, which o f f e r s us t h e chance t o
p r o v i d e b a s i c h e a l t h coverage t o everybody, t o stop people from l o s i n g t h e i r
h e a l t h coverage when t h e y l o s e a j o b , t o s t o p people from t h e i r i n a b i l i t y t o
change j o b s because they've had someone i n t h e i r f a m i l y s i c k , and t o b r i n g the
cost of h e a l t h care i n l i n e w i t h i n f l a t i o n .
I t h i n k we can do t h a t , and i f we don't do i t , w e ' l l never balance t h e budget,
and w e ' l l never r e s t o r e h e a l t h t o t h i s economy. F i f t y p e r c e n t of t h e p r o j e c t e d
d e f i c i t growth, between now and the year 2000, i s a l l i n h e a l t h - c a r e c o s t s .
So,
i t ' s a hard- i t ' s a t e r r i f i c human i s s u e , but i t ' s a b i g economic i s s u e f o r
America.
�CNN T r a n s c r i p t s , February 10, 1993
And t h e answer t o your q u e s t i o n i s , w i t h i n 100 days o f my becoming P r e s i d e n t ,
we're g o i n g t c have a b i l l t o t h e Congress t o do j u s t what you s a i d .
Now, t h e second t h i n g - t h i s e. c o l i t h i n g - have you a l l been f o l l o w i n g i t , up i n
Washington? I t ' s - I've asked t h e S e c r e t a r y o f A g r i c u l t u r e , Mike Espy, who i s
r e s p o n s i b l e f o r t h e r e g u l a t i o n o f t h e slaughter-houses and t h e meat b e f o r e i t
comes t o a r e s t a u r a n t , t o go up t h e r e and l o o k i n t o t h e s i t u a t i o n . And we t h i n k
t h e r e a r e two t h i n g s t h a t have t o be done. F i r s t o f a l l , we've g o t t o make i t
c l e a r t o people who a r e p r o v i d i n g f a s t food t h a t they've g o t t o do e v e r y t h i n g
they can t o comply w i t h our cooking r e g u l a t i o n s . Some o f those v i r u s e s would
have c l e a r l y d i e d , had t h e heat been observed.
On t h e o t h e r hand, we've g o t t o f i n d ways t o do more i n s p e c t i o n s and t o t r y t o
do them i n a more e f f e c t i v e way. And so, we are r e v i e w i n g , now, t h e p o s s i b i l i t y
of n o t o n l y h i r i n g more i n s p e c t o r s , which I've a l r e a d y agreed t o do, b u t
secondly, s e e i n g i f t h e r e i s some way we can do a b e t t e r j o b o f a c t u a l l y
i n s p e c t i n g t h e meat, empowering t h e i n s p e c t o r s t o do some more t h i n g s . We have
got t o do t h a t , and I can t e l l you, i f you have any o t h e r ideas, I ' d l i k e t o
have them.
The p a r e n t s , i t s t r u c k me, t h a t I t a l k e d t o , today, had some, a c t u a l l y , some
q u i t e good ideas t h a t we're g o i n g t o pursue. And I want t o i n v i t e you, and
�CNN T r a n s c r i p t s , February 10, 1993
gnawing i n s e c u r i t y o f t h i n k i n g t h e y ' r e going t o be thrown onto t h e scrap heap o f
h i s t o r y , t h e y ' r e g o i n g t o l o s e t h e i r j o b and never g e t another one, o r t h e y ' r e
going t o l o s e a j o b and then g e t another one making a t h i r d o f what t h e y used t o
make. That's o u r g r e a t c h a l l e n g e , and we a r e w o r k i n g on i t . That i s something
t h a t I t h i n k America ought t o be able t o l e a d t h e w o r l d i n , and now we're behind
some o f o u r o t h e r c o u n t r i e s .
BISHOP: Mr. P r e s i d e n t , i s i t p o s s i b l e t o pay them and g i v e them b e n e f i t s , as
w e l l , l i k e h e a l t h b e n e f i t s , while they're learning?
Pres. CLINTON: Oh, I t h i n k so. What we're going t o t r y t o do, w i t h t h i s
h e a l t h - c a r e p l a n , i s t o make sure t h a t everybody, whether employed o r
unemployed, has access t o a b a s i c package o f comprehensive b e n e f i t s .
Every
o t h e r c o u n t r y i n t h e w o r l d - advanced c o u n t r y - does t h i s .
Every
i n d u s t r i a l i z e d c o u n t r y b u t South A f r i c a does t h i s - everybody. And y e t , we
spend 3 0 percent, more o f o u r income on h e a l t h care than anybody e l s e .
Now, i f you have access t o h e a l t h care i n America, i t ' s t h e best i n t h e w o r l d ,
and a l o t o f good t h i n g s about i t . But t h e r e are ways t o g i v e people a choice
of d o c t o r s , h i g h - q u a l i t y care, and do i t f o r lower c o s t , i f we're w i l l i n g t o
take on t h e i n s u r a n c e c o s t s , i f we're w i l l i n g t o take on a l o t o f t h e o t h e r
waste i n t h i s system, t h e phenomenal waste. We- t h e paperwork i n t h e American
�• '
CNN T r a n s c r i p t s , February 10, 1993
h e a l t h - c a r e system alone i s enough t o cover v i r t u a l l y everybody w i t h o u t h e a l t h
insurance.
You know- l e t me j u s t g i v e you an example. We are h i r i n g - most h o s p i t a l s i n
America, today, f o r t h e l a s t f i v e y e a r s , have h i r e d c l e r i c a l workers a t f o u r
times t h e r a t e o f h e a l t h - c a r e g i v e r s , l i k e nurses, even though t h e r e ' s been a
n a t i o n a l n u r s i n g s h o r t a g e . Why? Because we're t h e o n l y c o u n t r y i n t h e w o r l d
w i t h 1,500 s e p a r a t e h e a l t h insurance companies w r i t i n g thousands o f d i f f e r e n t
p o l i c i e s , c o v e r i n g s m a l l , s m a l l groups, w i t h a b l i z z a r d o f r u l e s t h a t would
choke a horse.
Plus, t h e government makes i t worse by t h e way we r u n Medicare
and Medicaid. And we're g o i n g t o t r y t o f i x i t .
I t ' s t h e most c o m p l i c a t e d
problem I ' v e ever messed w i t h , b u t i f we don't f i x i t , we can't c o n t r o l t h e
d e f i c i t , we can't r e s t o r e h e a l t h t o t h e economy, and most i m p o r t a n t , we can't
r e s t o r e s e c u r i t y t o t h e l i v e s o f people l i k e those who have asked these
questions, t o n i g h t .
BONDS: Ann Bishop,
Nigut.
thank you v e r y much.
We're g o i n g t o s w i t c h now t o B i l l
ROOK: We're g o i n g t o c u t away t o take a q u i c k commercial
back, w e ' l l b r i n g you up t o date. Stay tuned.
break.
When we come
�Universal Health Cart,
ost Containment
FaceMoreScrutiny
ECONOMY
Continued From Page AZ
malignant, but not covered by hetf Insurance." the president imptyred lawmakers
in his September speech.
But there is also an economic rationale,
according to the administration, for universal coverage. If Health coverage were
provided to all. people would no longer be
bealth-care marketplace, or setting the
By RICK WAKTZMAN
afraid to leave their current jobs because
rates hospitals and doctors can charge,
Staff Reporter of T O T W A U L S I R t i l J O U R N A I .
of the possibility of losing their insurWASHINGTON-It is the great chicken- "You can get cost containment without
ance - a paralysis known as "job lock.
and-egg question of the health-care reform universal coverage," says Mr. Anderson,
debate: Which comes first, universal cov- who served as a health adviser during tbe
Moreover, every time the uninsured or
erage or cost containment?
those with insufficient coverage show up at
Carter administration.
the hospital, their cost of care must be
President Clinton, during his major 'Less Ideal.. .More Pragmatic'
bome by those with good benefiu - a phehealth-care address to Congress in SepThat prospect has led some to favor a
tember, made his own view perfectly clear. two-step strategy different from the presi- nomenon called "cost-shifting.' Some
Unless every American has adequate medstudies show that cost-shifting is leading to
rein in costs;
ical benefits, he declared, "We will never dent's: First,all. "It is lessthen extend
increases in premiums of more than 1 %
0
coverage to
Idea) than
be able to fully put the brakes on health- Clinton's approach, but it is more pragfor those who are Insured, while also
care inflation."
matic," says Louis Sullivan, who served as driving up administrative expenses
throughout the system.
The reason? "When people don't have secretary of the Department of Health and
Despite such arguments, the notion oi
any health insurance," the president said, Human Services under President Bush.
supplying everyone with health insurance
"they still get health care, but they get it
it may be impossiwhen it's too late, when it's too expensive, blePolitically, however, goals. Sixteen years is unthinkable at one end of the political
to separate the two
spectrum. To those on the far right. "Unioften from the most expensive place of all, ago, President Carter tried to control hosversal coverage is just a euphemism for
the emergency room.. .So they cost us pital costs before embarking on a national
the welfarization of health care." Rep.
more."
health insurance program. Trouble is,
Dick Armey (R.. Texas) asserted. ObviContends Costs Would Rise
Congress never managed to swallow the
ously, we would hope everybody would
"bitter medicine" of cost containment, Mr.
Not everyone agrees, however. Gerard
enjoy health care. but.. .health care is a
Anderson, director of the Center for Hospi- Anderson recalls. "So we never even got to
commodity, just like bread, and just like
tal Finance & Management at Johns Hop- step two," universal coverage.
housing and everything else."
kins University in Baltimore, says that
Whatever the right answer, the issue
In the middle of the spectrum are
because the uninsured would likely use has taken on enormous importance. A
moderate conservatives like Rep. Cooper
more medical services if they suddenly couple of weeks ago, Hillary Rodham Oinand Republican Sen. Dave Durenberger of
were given coverage, overall health-care ton made clear that the administration
Minnesota who want to increase the numcosts would go up, not down.
won't back off from its commitment to
ber of Americans who have health insurIn fact, the Clinton administration's provide universal coverage with a compreance but would wait until cost savings are
own preliminary projections show that hensive set of health benefits. The first
evident before guaranteeing universal covnational health spending wouldrisefaster lady even lauded alternative proposals
erase "We're for universal coverage, but
than it otherwise would during the first that seek universal coverage, including a
not until you can satisfy the Amen;
four years of the new plan as the nation's plan by Republican Sen. John Chafee of
car. people that it can be paid for.
3 million uninsured were absorbed into Rhode Island. And she attacked those
7
Sen. Durenberger says.
the system. The Clinton plan aims to make plans that aren't designed to cover every"We want to go slow," says Rep.
body, including one by Democratic Rep.
coverage universal by Jan. 1,1998.
Cooper, whose "pure managed competiMeanwhile, bringing costs under con- Jim Cooper, of Tennessee.
tion" plan would try to hold down health
trol is viewed by some as a separate
In making his case for universal cover- costs by relying on market forces and by
equation. Universal coverage can make age, President Clinton has painted it, first capping the amount of health benefits
cost containment easier, this line of think- and foremost, as a matter of morality.
employers can deduct for tax purposes.
ing goes, but it's not a necessity.
"Think of the face of the woman who's
By not going for universal coverage
By streamlining the medical delivery been told not only that her condition is
right off the bat, Mr. Cooper believes, it is
Please Turn to Page Ak. Column 2
system, fostering competition in the
possible to sidestep one of the most contro
versial elements of the Clinton plan: the
*~»
-i T-\
•
rvr
requirement that all employers help pay
for their workers' health coverage. The
employer mandate, the congressman says,
is "a clumsy and expensive way of achieving universal coverage."
Linking of Universal Health Coverage j
To Cost Containment Endures Scrutiny
1
Besides, Mr. Cooper contends that
by knocking down the barriers that block
poor and sick people from obtaining healt
insurance, his plan would come close to
universal coverage. In the end, he says, a
few as six million Americans would be lef
uninsured.
Critics don't believe that, however.
Mrs. Clinton, for one, points to a Congre
sional Budget Office study, which concluded that an earlier version of the Coope
plan would leave 25 million uninsured. Th
CBO hasn't assessed the latest version o
the Cooper proposal.
The go-slow approach has other poten
tial pitfalls as well. Currently, because
costs can be shifted to those with coverag
the uninsured receive the treatment they
need when they show up at the emergenc
room. But if cost controls were in place, t
uninsured may find it harder to find care
"A barely civilized system for the unin
sured." warns Brookings Institution econ
omist Henry Aaron, "could turn into om
that is downright feral."
TUESDAY. NOVEMBER 23, 1993
�
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Health Care Task Force Records
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Is Part Of
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<a href="https://catalog.archives.gov/id/10443060" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
<p>This collection contains records on President Clinton’s efforts to overhaul the health care system in the United States. In 1993 he appointed First Lady Hillary Rodham Clinton to be the head of the Health Care Task Force (HCTF). She traveled across the country holding hearings, conferred with Senators and Representatives, and sought advice from sources outside the government in an attempt to repair the health care system in the United States. However, the administration’s health care plan, introduced to Congress as the Health Security Act, failed to pass in 1994.</p>
<p>Due to the vast amount of records from the Health Care Task Force the collection has been divided into segments. Segments will be made available as they are digitized.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+1"><strong>Segment One</strong></a><br /> This collection consists of Ira Magaziner’s Health Care Task Force files including: correspondence, reports, news clippings, press releases, and publications. Ira Magaziner a Senior Advisor to President Clinton for Policy Development was heavily involved in health care reform. Magaziner assisted the Task Force by coordinating health care policy development through numerous working groups. Magaziner and the First Lady were the President’s primary advisors on health care. The Health Care Task Force eventually produced the administration’s health care plan, introduced to Congress as the Health Security Act. This bill failed to pass in 1994.<br /> Contains 1065 files from 109 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+2"><strong>Segment Two</strong></a><br /> This segment consists of records describing the efforts of First Lady Hillary Rodham Clinton to get health care reform through Congress. This collection consists of correspondence, newspaper and magazine articles, memos, papers, and reports. A significant feature of the records are letters from constituents describing their feelings about health care reform and disastrous financial situations they found themselves in as the result of inadequate or inappropriate health insurance coverage. The collection also contains records created by Robert Boorstin, Roger Goldblatt, Steven Edelstein, Christine Heenan, Lynn Margherio, Simone Rueschemeyer, Meeghan Prunty, Marjorie Tarmey, and others.<br /> Contains 697 files from 47 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+3"><strong>Segment Three</strong></a><br /> The majority of the records in this collection consist of reports, polls, and surveys concerning nearly all aspects of health care; many letters from the public, medical professionals and organizations, and legislators to the Task Force concerning its mission; as well as the telephone message logs of the Task Force.<br /> Contains 592 files from 44 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+4"><strong>Segment Four</strong></a><br /> This collection consists of records describing the efforts of the Clinton Administration to pass the Health Security Act, which would have reformed the health care system of the United States. This collection contains memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, newspaper articles, and faxes. The collection contains lists of experts from the field of medicine willing to testify to the viability of the Health Security Act. Much of the remaining material duplicates records from the previous segments.<br /> Contains 590 files from 52 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+5">Segment Five</a></strong><br /> This collection of the Health Care Task Force records consists of materials from the files of Robert Boorstin, Alice Dunscomb, Richard Veloz and Walter Zelman. The files contain memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, statements, surveys, newspaper articles, and faxes. Much of the material in this segment duplicates records from the previous segments.<br /> Contains 435 files from 47 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+6">Segment Six</a></strong><br /> This collection consists of the files of the Health Care Task Force, focusing on material from Jack Lew and Lynn Margherio. Lew’s records reflect a preoccupation with figures, statistics, and calculations of all sorts. Graphs and charts abound on the effect reform of the health care system would have on the federal budget. Margherio, a Senior Policy Analyst on the Domestic Policy Council, has documents such as: memoranda, notes, summaries, and articles on individuals (largely doctors) deemed to be experts on the Health Security Act of 1993 qualified to travel across the country and speak to groups in glowing terms about the groundbreaking initiative put forward by President Clinton in his first year in the White House. <br /> Contains 804 files from 40 boxes.</p>
Publisher
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William J. Clinton Presidential Library & Museum
Identifier
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2006-0885-F
Text
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Paper
Dublin Core
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Title
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Health Care Polls and Clips [5]
Creator
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White House Health Care Task Force
Health Care Task Force
Health Care Interns
Identifier
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2006-0885-F Segment 3
Is Part Of
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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
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Clinton Presidential Records: White House Staff and Office Files
Publisher
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William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
Medium
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Reproduction-Reference
Date Created
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3/16/2015
Source
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42-t-12093075-20060885F-Seg3-011-002-2015
12093075