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FOIA Number:
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:
Gatz, Carolyn/Klein, Jennifer
Subseries:
5107
OA/ID Number:
FolderlD:
Folder Title:
Boorstin
Stack:
Row:
Section:
Shelf:
Position:
s
56
5
5
3
�May 17, 1993
MEMORANDUM FOR: BOB BOORSTIN AND IRA MAGAZINER
FROM: CAROLYN GATZ
RE: MEDIA COVERAGE OF HEALTH REFORM
Responding to Bob's request for suggestions about timing and message strategy, I
spent some time thinking about aspects of the proposal that could be highlighted during each
of the seven time periods you outlined last week. This list trails off after Phase 4/5, although
Ifront-loadedthe whole thing so much that there's enough for 7 phases:
•
Phase 1: Despite all the hunger for details of the plan
and its financing, we still need to focus on defining the
problem — lest all the coverage of the possible scale of
change frighten people into thinking we can avoid
dealing with this issue.
The message: Although the prospect of change may be
frightening, the prospect of no change is even more
frightening — unthinkable.
1.
Small business owners who pay exorbitant premiums
for their own coverage. Maybe Mrs. Clinton could go
visit some of the people who've written her letters about
this, of which there are many.
2.
We need to drum in the message that we pay for health
care countless ways in this country: We pay, we pay,
we pay — through federal taxes, through local and state
taxes, through the inability to address other problems...
"The hidden costs of health care:" States in which the
budget burden thwarts education reform (I know some
of these)....States in which the budget burden crowds
out social services...
We need to call attention to those numbers Ken Thorpe
had the other day that showed exactly how much each
of us spends for Medicaid, Medicare, etc. — We need
to send the message that we're all paying much more
than we think we are.
1
�County officials and mayors across the country could
talk about the drain on their budgets....Make the
connection between the problem of health insurance and
uncompensated care funds in communities all across the
country.
Make the connection between limits in private insurance
for mental health coverage and the need for massive
spending on public mental hospitals and the fact that
homeless mentally ill people wander the streets of our
cities.
Mrs. Clinton could go visit a hospital and talk about
how much money the uncompensated care delivered at
that institution will cost every other patient who comes
into that hospital this year.
3.
A different message: We can't overcome our economic
problems unless we address the economic drag of health
care costs...Maybe an event built around the $670 in
wages that American workers would have earned in
1991 if health insurance premiums had not increased at
the rate they did as a share of total compensation in the
1980s.
Maybe the President or First Lady could go someplace
where a labor conflict has arisen because of health
benefit cutbacks/ retiree benefit cutbacks — supposedly
the leading cause of labor-management conflict.
4.
Other possible focuses of events or story angles:
Administrative waste
Workers' compensation (waste and duplication)
People between the ages of 58 and 65 who can't get
insurance because of health problems — early retirees
not yet eligible for Medicare but on their own in the
insurance market.
An event built around the theme that any gathering of
Americans includes a bunch who are uninsurable —
including the Task Force working groups.
�An event that focuses on: Who are the uninsured? By
and large they're not people living in poverty...They're
working-class Americans, most of them employed,
people just like you and I...
An event about "coding" and other ways providers game
the system — the existence of whole hospital
departments devoted to figuring out what codes to use
on insurance claims.
Maybe we could talk some reporter into following a
nurse around in a hospital to clock how much time she
really spends taking care of people and how much she
spends on paperwork. Follow a doctor around for the
same purpose — We could tout this as replicating the
research that Ira's people did in Rhode Island.
Spend a shift in an emergency room (we have an
emergency physician from LA on our provider review
group) keeping track of how much time goes into
bureaucracy, dealing with lack of insurance, etc.
Lack of substance abuse treatment coverage — social
repercussions
Maybe we could interest somebody in writing about
major hospitals that have adopted quality management - we have the CEOs of several on our administrative
review group, including the University of Michigan
teaching hospital. They are developing what's called
"critical paths," which is a method for determining the
best course of treatment for specific diagnoses within
the hospital.
Underlying message for all these: The system's got to
change
Other issues that warrant coverage:
o Variations in practice patterns across states.
o The development of practice guidelines
o The trend toward managed care —
Message: Even if we were all sitting around
the OEOB twiddling our thumbs, in a few
years we'd all be in managed care plans —
the Clinton plan is a way for consumers to
�wrest control of where we're headed away
from the managed care bureaucrats.
o The Medicare mindset that dominates
official Washington (including Congress and
agencies) — There's every reason to believe
the federal government will stand as the last
bastion of fee-for-service medicine, the
most costly structure for health care
delivery.
o State models — Places new approaches
work — Rochester, etc.
Phase 2: Releasing pieces of the plan before the President's address.
Possible pieces include:
Malpractice reform^Altemative dispute -resohrtiem-scheme
Consumer protection under health reform
Administrative simplification^^.
<^ /QualityAssurance
~~~ ^
>j/ Fraud and abuse
Long-term Care
Treatment of Medicare under health reform
ERISA reform (and how it has stymied state efforts to
bring about reform)
Insurance reform — new protection
^
National Health Budget
Regulatory relief under health reform
Health workforce development — mix of providers,
% changes in ORE funding, etc., expanded practice latitude
for nurses.
�•
Phase 3: Release of the plan — themes of Security and Cost
Control. Built around developing familiarity with new system. See
attached memo.
•
Phases 4 and 5: Continue themes of security and cost control and
add emphasis on Quality.
A. Do an event that says hospitals won't have to spend
so much money on marketing — perhaps make fiin of
current state of hospital marketing, which involves a
very large sum of money and revolves more around
color of the wallpaper and taste of the food than
anything having to do with medical care.
Message: In the new system, hospitals won't compete
on the color of wallpaper but on quality of care, quality
issue.
B. Mental health — because the benefit is different
from conventional insurance coverage.
C. Prevention — we'll cover more — a whole new
approach to insurance coverage.
D. Reducing hassle factor for provider and consumer.
•
Phase 6: Church picnics — see attached memo
•
Phase 7: Relaunch — If a march on Washington is too big
logistically or too risky, maybe a very large gathering of people
who gain from the Clinton plan — i.e. those who do not have
health insurance, or have pre-existing conditions, or own small
businesses that offer insurance, etc. We could invite everyone
who's written a letter to the White House.
�This material m a y be protected by copyright l a w
(Title 1 7 . U.S. Code)
N.V.TIMES.05/03/93
because total spending on health care
$270 billion over five years. That monin the United States s already increas
ey is to reduce the Federal budget
ing by $100 billion a year. They say Mr. deficit, not to pay for his health-care
Clinton's plan will eventually slow the plan, which will require large amounts
increase.
of revenue beyond those already reMost of the new money — $69.5 bil- quested.
lion to $82.2 billion, not all of it from the
In a speech last week, Mr. MagaGovernment — will be needed to pro- ziner seemed to minimize the political
vide coverage for people who do not difficulty of getting Congress to raise
h f v e any health insurance, the actu- taxes.
"Often," he said, "our friends in the
aries said.
media focus their whole attention on
•The Health Care Financing Adminisi health-care reform as if what specific
tration runs Medicare and Medicaid,
piece of money might have to be raised
the programs for 67 million people who
next year to help us insure the uninare elderly or poor. The agency's chief
sured is the most important thing in
actuary, Roland E. King, and his staff
health care.
have decades of experience estimating
"We know better. We know that what
l i ^ l t h costs jmd.|Mpulatjon,tr^^
C^pttoI^Hill, th^y are respected for is really going to matter to the Ameriindependence, integrity and accuracy. can people five years from now. 10
Out some economists at other agencies years from now, is not what amount of
money was raised initially to get over
still f a v w loWer"estimates. ''
the hump of getting the uninsured in- I
Hillary Rodham Clinton, the head of
sured What's really going to matter is
the task force, said in an interview IrtSi
what happens when I go to my doctor.
week that it was "very difficult" to get
What happens when I get ill? How does
Government agencies to agree on cost
estimates or even on procedures fnr my insurance coverage look? Does it
estimating. To some extent, the dis
really protect me or not?"
agreements involve technical issues.
Businesses, households and GovernBut they could have a big political ment are listed in the documents as the
ef/ect on members of Congress, who main sources of money for Mr. Clinwill be asked to help finance Mr Clin- ton's plan, if the Federal Government
ton's plan with new taxes.
pays less, businesses and households
pay more.
Clash Between Agencies
HATCR C SS
ELHAE OT
MY B ICESD
A E NRAE
$0 BL N A YA
10 I I
LO
ER
FIGURES BEGIN T EMERGE
O
U.S. Financial Experts Estimate
Spending on 3 Proposals
Clinton Is Considering
;
:
By ROBERT PEAR
Special to The New York Times
WASHINGTON. May 2 - Government financial experts have told the
White House that President Clinton s
health-care plan may require $100 billion to $150 billion a year in new public
and private spending by Government,
business and consumers, depending on
the scope of benefits guaranteed to all
Americans.
Several Administration officials contend that those numbers are too high
and are urging the financial experts to
f^uce-.theirvestunates, So far. they
Have? refused to do so
The estimates, coming at a time
when Congress is anxious about new
taxes needed to pay for a reorganization of the health-care system, are in
confidential work papers from the
President's Task Force on National
Health Cjre Reform.
Beginning to Circulate
Financial experts have been working
on cost analyses for months, but only
recently, as the Administration's thinking has crystallized, have estimates of
overall costs begun to circulate inside
the Government. They have not been
made public before.
The financial experts, from the Federal Health Care Financing Administration, estimated the cost of three
possible packages of benefits. The least
generous would cost $99.5 billion a
year, while the most generous would
cost $150.6 billion, they said.
Not all that money would come from
the Government, but the Administration has not decided how the cost might
be divided among government, businesses and households. Nor has Mr.
Clinton decided which type of package
to propose when he unveils his plan this
month, though White House officials
have said it will be comprehensive.
Cost and Coverage Vary
The three possible benefits packages
» ould cover hospital and doctors' services and some prescription drug costs,
but they vary widely in how much of
the cost would be covered by insurance
and how much consumers would have
to pay
The manager of the task force, Ira C.
Magaziner, estimated in early February that the health program might
require $30 billion to $90 billion a year
in new spending by the Federal Government alone. The nation as a whole is
expected to spend more than $900 billion on health care this year.
While House officials say the new
estimates are subject to change because final decisions on the details of
the President's plan have not been
made. Moreover, they argue, people
should not be alarmed by the estimates
The Cost of Employers
Work piapers from the task force
Thus, under one set of assumptions
* o w - i disagreements between two
^ e h c l e s in particular. The Agency for used by the White House, American
Health .,Care Pblicy^and .Resea rch. ;'a businesses would pay $168 billion a
unit of UielUnitetf States Public Health year in health insurance premiums for
9ervice;v.6ffered lower, estimates for' employees under current law Many
"insuring'the uninsured": $42.6 billiqri* small businesses do not now provide
to'$49:3>bilIi6n a year from all sources, i health coverage, but if the Governmeni
o r i r o u g h t y M . percent of the cost corri^ required all employers to provide a
piiteti by financial experts from the' low-cost set of health benefits, spendHealth Care Financing Administration ing by employers would rise by $59
The lower estimates assume that billion, to a total of $227 billion a year,
imihsured
people
are
generally the work papers say.
If the Government required empln;. •
lieaith^, like ihsiired - workers. The
h'ighe'restimates assume that .subsian- ers 10 provide a generous set of health
tial numbers'* of the uninsured will be benefits to their workers, the emp! : .
heavy users of health care, like Medic-: ers' cost mighi rise by $87 billion :u
$255 billion a year, the documents s.r.
aidiriecipients.
Mr. Clinton has said for more than a
At (he heart of M r Clinton's pian is i
year that he wants to require employers to provide or arrange health insur- proposal to guarantee a uniform set -M
ance coverage for their workers. He health benefits for all Americans All
has said his plan will provide "the three packages would help pay for hossecurity of guaranteed access to com- ! pital and doctors' services. X-rays and
prehensive health care" for all Ameri- laboratory tests, prescription drugs
and some mental health services. Dencans.
tal care would be covered under two of
White House officials say it will rethe three plans.
duce administrative costs, curb inflaThe austere plan, as conceived by
tion in the health-care industry and
sa^e money in the long run. But signifi- the Administration, would provide
cant savings are not expected for five more extensive coverage than 20 peror TIB 'years, and Mr. Clinton wants to cent of private health insurance plans
take immediate action to provide cov- now in force. The generous plan would
e r i g e tor the 37 million people who lack provide more protection than 90 percent of the existing private plans. The
health insurance.
medium-cost proposal would provide
Kenneth E. Thorpe, the Federal offi- more coverage than half the plans now
cial j n charge of cost estimates for the in effect. Under Mr. Clinton's proposal,
task force, said the work papers were private health insurance would continprepared as part of " a conceptual exer- ue, but the Government would regulate
cise" to help Mr. Clinton understand the industry to guarantee that all
the cost of various options proposed by Americans had access to a minimum
his health-policy advisers.
set of benefits.
Work papers from the task force
In public comments over the last
show these costs for other elements of three months, Administration officials
the President's plan but do not specify have often discussed their desire to
how these costs would be divided:
guarantee comprehensive health beneflBetter coverage for families with fits. But they have generally refused to
meager health insurance could cost discuss the cost or the tax increases
$12.5 billion to $38.3 billion a year, needed to finance it, and they have
depending on the scope of benefits. In emphasized potential savings rather
many families, the head of the house- than new costs for employers or emhold has coverage from an employer, ployees.
but his or her dependents have no
When asked for an estimate of cost.
insurance.
Robert O. Boorstin, a spokesman for
^Coverage of prescription drugs for the task force, said. " I ' m not going to
Medicare beneficiaries would cost $8 talk about that one."
billion to $10.3 billion a year.
Mr Magaziner said: "There will be
•(Coverage of long-term care, in the significant savings in what we propose.
form contemplated by the White The difficulty is that those savings
House, might cost $7.7 billion to $15 mostly begin to come in a five- to 10billion a year.
year time frame. If you want to move
o Upgrading care for poor people, quickly to expand coverage, you've got
homeless people, migrant farm work-ij to spend money before that. So there is
ers and others who are "medically j a liming issue here."
underserved" would cost $1.8 billion to
$4.8 billion a vear.
|
Mr Clinton has already asked Con-;
gress for a tax increase of more than j
(
1
�This material m a y be protected by copyright l a w
(Title 17. U S Code)
'
) r
N.Y.TlMES:05'03/93
The Hearth-Care Plan: How Much Will It Cost?
Government estimates of various proposals, in billions of dollars a year. Costs would be divided
among Government, businesses and households.
EE
AUSTERE PLAN
GENEROUS PLAN
$69.5
$75.5
$82.2
12.5
22.2
38.3
Prescription drugs for
Medicare beneficiaries
8.0
9.3
10.3
Long-term care
7.7
13.8
15.0
Upgrading public health
programs for the needy
1.8
4.8
4.8
$99.5
$125.6
$150.6
Insurance for the uninsured
Improved coverage for people
with meager health insurance
Totrf
How Benefit Packages Might Look
Possible combinations of benefits. Final decisions have not been made.
'AUSTERE PLAN
MEDIUM PLAN
GENEROUS PLAN
G e n e r a l plan d e s i g n
$200
$400
$150
$300
None
Coinsurance
(patient's share of the bill)
20%
20%
$10 per encounter
Annual out-of-pocket limit
per individual
$3,000
$1,000
Overall
deductible
Individual
Family
None
Hospital MTVICM
Inpatient
$250 deductible
per admission
Outpatient
Subject to overall deductible, coinsurance
Full coverage
Surgical services
Subject to overall deductible, coinsurance
Full coverage
Physician services
Subject to overall deductible, coinsurance
$10 per encounter
X-ray and laboratory teste
Subject to overall deductible, coinsurance
$10 per encounter
Prescription drugs
$50 a year deductible
40 percent coinsurance
$7 payment for
each prescription
Mental heaMi servtces
Details undecided
Dental services
No coverage
Source. White House. Task Force
on National HeeAn Can Raform
Subject to overall
deductible, coinsurance
Full coverage
$25 a year deductible
Patient pays $10 a
$1,000 maximum
visit for preventive
annual benfit for each
services. $25 a
person. Patient pays
visit for treatment
20 percent of the bill for
prevention and treatment.
�May
10,
1993
MEMORANDUM FOR:
BOB
BOORgPTIN AND
IRA MAGAZINER
FROM: CAROLYN GATZ
RE:
PROSPECTIVE NEWS EVENT
I want to make a new p i t c h for c r e a t i n g a news event around
members of the working group t a l k i n g about t h e i r own experiences
with the h e a l t h c a r e system, i n l i g h t of the F i r s t Lady's request
for l o c a l media coverage of working group members.
The notion here i s to c r e a t e an event t h a t i l l u s t r a t e s
through r e a l people the problem of the h e a l t h c a r e system (why we
are undertaking reform) and simultaneously sends the message t h a t
the working group i s made up not j u s t of "experts" but of people
who are l i k e any other group of people -- i . e . Americans with
l o t s of personal experience with how our system doesn't work.
We could introduce the two babies born during the t a s k f o r c e
process and then have people t a l k about t h e i r own experiences.
Let me remind you of some of the p o s s i b i l i t e s I l o c a t e d :
L o i s Quam brings with h e r Y T i t t l e boy who i s
so s e v e r e l y asthmatic.
•
Jane Schadel, the r u r a l h e a l t h expert from
Iowa who had to only work on the task f o r c e
p a r t time because she couldn't r e s i g n her
p o s i t i o n because she was r e c e n t l y diagnosed
as d i a b e t i c .
Josh Wiener, whose son has a heart d e f e c t
Robyn Stone, who had a benign " c a r d i a c
episode" t h a t makes her uninsurable.
Me, who
outside
to Mrs.
similar
discovered that she's uninsurable
of a l a r g e group by reading a l e t t e r
C l i n t o n from a c i t i z e n who shares
medical conditions.
Steve Gleason, who has a chronic d i s e a s e the
name of which I cannot r e c a l l .
•
Bob B o o r s t i n
•
A woman from the mental h e a l t h group i s a
small business owner ( c o n s u l t i n g firm) who
has a c h i l d with a s e r i o u s h e a l t h problem and
has had trouble g e t t i n g insurance.
�Gatz memo/ page 2
Susan Daniels, from HHS, or Fernandes Torres,
both of whom are disabled, so they have
first-hand experience dealing with health
insurance from that perspective.
Plus however many more we think we need -- l i k e I said,
there's a million stories i n the OEOB.
�c
ITEM
Policy Publication
LIST OF MATERIALS FOR RELEASE OF PLAN
DESCRIPTION
DATE OF RELEASE
A compilation of policy papers describing in great
detail the current situation, all elements of the plan,
and likely effects of reform - written for academics
and health care policy experts.
By the end of the
summer
Legislation
For submission to Congress.
June?
The Plan
Pre-legislative language ("specs") describing the plan
and its components in relatively detailed policy
language, including changes in current laws and
regulations. For Congressional staff, health care
policy experts, etc.
Day of the President's
speech.
Reportto Congress
A 100-page document ~ similar to the OMB report
Sent to Congress the
produced for the day after the Joint Session Address morning after the
~ that outlines the current situation and the way in President's speech.
which our reform solves these problems. It will be
detailed yet written for more popular consumption - with graphs, sidebars, charts, etc.
Booklet
A 20 to 30-page document for health professionals
that write in asking for information about the plan.
Pamphlet
An 8-page document to be very widely distributed — Day of the President's
speech.
at rallies, speeches, in letters, etc.
Day of the President's
speech.
.03
Single Claim Form
To illustrate how the plan will reduce paperwork.
Event the week before
the plan's release.
�LIST OF MATERIALS FOR RELEASE OF PLAN
ITEM
DESCRIPTION
DATE OF RELEASE
Contract with the American People
A statement of principles - i.e., a covenant between
the President and the American people ~
guaranteeing affordable comprehensive care.
A preface to the Report
to Congress as well as
pamphlet and booklet.
Health Security Card
A sample card to be held up by the President during Night of the speech to
his speech to Congress.
Congress.
Talking Points: General
1-2 pages of talking points about the plan for White
House officials who are not surrogates.
Day of the President's
speech.
Talking Points: Process
1-3 pages of talking points about the Task Force,
the Tollgate Process, the President's role, etc.
Day of the President's
speech.
Talking Points for Groups: Older
Americans, Disability Community,
Veterans, Providers, Unions, SinglePayer, Rural, Business Leaders,
Children and Families, Consumers,
Labor, Indian Health, Military
An update of what we will have already prepared
for Congress - from this constituency's perspective:
the current problems, a description of the plan and
how it will solve these problems, talking points for
surrogates, and likely questions and answers.
Day of the President's
speech.
Talking Points for the States
To highlight the state/federal partnership and the
flexibility states will have in implementing these
reforms.
Day of the President's
speech.
Talking Points: Timetable
To explain which aspects of the plan will be
available by 1994, at which stage each component
will be implemented, etc.
Day of the President's
speech.
�LIST OF MATERIALS FOR RELEASE OF PLAN
ITEM
DESCRIPTION
DATE OF RELEASE
Attack and Response
For White House officials, cabinet members, and
surrogates -- outlining the likely attacks and our
responses to them.
Day of the President's
speech.
Reforms: Models, States, Foreign
To highlight the successful "real-life" application of
many of the principals that guide our proposal and
inoculate us against expected attacks.
Day of the President's
speech.
Stump Speech
For surrogates' use following the plan's release.
Day of the President's
speech.
Graphics Package for Media
To be distributed to media (print and TV) as well
Day of the President's
as made into overheads and slides for speeches. [See speech,
attached list]
A series of Op Eds from noted health care
authorities that will appear across the country
endorsing the plan.
Videos
Week after the Plan
release.
Videos with the four principals outlining the
specifics of the plan. To send to events/groups we
are unable to attend.
Week after the Plan
release.
�LIST OF MATERIALS FOR RELEASE OF PLAN
OUTLINE OF GRAPHICS PACKAGE FOR PLAN RELEASE
Costs
1.
2.
3.
4.
5.
6.
7.
What you pay now and what you will pay (for different constituencies)
Savings projections — for individuals, deficit - under our plan
U.S. costs over time
Cost comparison: U.S. vs. Other Industrialized Countries
How health care costs affect employee compensation / business profits / government spending
Projected health care costs until 2000 -- and affect on wages, budgets, economy
What happens if we do nothing - Families, Workers, U.S. businesses, Deficit
Administration
8.
Administrative Costs: U.S. vs. Other Industrialized Countries
9.
Graphic depiction of hassle factor for doctors and patients
Security/Insurance
10.
Increase in number of uninsured
11.
Middle-class uninsured
12.
Number of Americans in "job lock"
Our Plan
13.
14.
15.
16.
17.
18.
19.
20.
21.
Sample Health Security Card
List of guaranteed benefits
Comparison with "cadillac" programs today
Structure of new system
Comparison of relationships between employers, employees, health alliances, MDs in old and new systems
Sample Report Card
Single Claim Form
A Community Health Information Network (Information systems)
A Timeline for Change
Miscellaneous
22.
Declining numbers of primary care doctors
23.
Polling information
�LIST OF MATERIALS FOR RELEASE OF PLAN
April 2,1993
WHAT
WHO
COORDINATE/
WHO DO
DEADLINES
DRAFT
NOTES/COMMENTS
FINAL
Report of the President's Task Force
Paul/Caroline
All policy papers/500 pages??
Report to Congress
Paul/Caroline
100 pages/similar to OMB document
Booklet (letter response)
Bob's Shop
20-30 pages
Pamphlet (mass distribution)
Bob's Shop
8 pages
Single Claim Form
Jason/Paul
Contract with the American People
Bob/Stan G
Health Security Card
Jason/Christine
Talking Points: General
Bob's Shop/Christine
Talking Points: Process
Bob's Shop/Christine
Talking Points for Groups: Older
Americans, Disability Community,
Veterans, Providers, Unions, SinglePayer. Consumers
Bob's Shop/Christine/
Mike Lux
Model Reforms/State Reforms/
Foreign Systems
Stump Speech
Paul
Bob's Shop
Graphics Package for Media
Meeghan
Op Ed Project
Caroline
Video Scripts for Principals
Bob's Shop
�MATERIALS FOR RELEASE OF PLAN
April 2,1993
WHAT
WHO
COORDINATE/
WHO DO
DEADLINES
DRAFT
FINAL
NOTES/COMMENTS
TO PRODUCE FOR DNC
Video #1
Mandy
Video #2
Carter E
Pamphlet
Bob/Celia
Stump Speech
Bob's Shop
Graphics Package
Meeghan
Op Ed Project
Caroline
Personal testimony/Assuage fears
Technical Q & A
�BOB'S HEALTH CARE SHOP: LIST OF ASSIGNMENTS
April 2,1993
WHAT
Follow FACA lawsuit
WHO
COORDINATE/
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|
�May 19, 1993
MEMORANDUM TO:
IRA MAGAZINER AND BOB BOORSTIN
FROM: CAROLYN GATZ
SUBJECT: ANSWERS TO QUESTIONS POSED BY G O D HOUSEKEEPING
OO
MAGAZINE
Attached I s a d r a f t o f proposed answers f o r Good
Housekeeping's "The Better Way" section f o r t h e i r August issue.
Please review f o r accuracy, c l a r i t y , focus, e t c .
Thanks
�Good Housekeeping
D r a f t : May 19, 1993
1. Under the P r e s i d e n t ' s h e a l t h care reform plan, what w i l l a
t y p i c a l h e a l t h c a r e p o l i c y cover? What w i l l not be covered?
The P r e s i d e n t ' s plan w i l l guarantee to a l l Americans the
s e c u r i t y of coverage for a comprehensive package of h e a l t h
b e n e f i t s , i n c l u d i n g the f u l l range of h o s p i t a l and p h y s i c i a n c a r e
normally included i n the best insurance p o l i c i e s .
The comprehensive b e n e f i t package w i l l emphasize primary and
preventive care, o f f e r i n g coverage for c l i n i c a l preventive
s e r v i c e s such as p e r i o d i c checkups and mammograms often not
covered i n other insurance p o l i c i e s .
The n a t i o n a l l y guaranteed b e n e f i t package a l s o w i l l provide
coverage f o r i n p a t i e n t and outpatient mental h e a l t h s e r v i c e s ,
another f e a t u r e not always provided by other p o l i c i e s .
2.
way,
For persons who a r e now insured by t h e i r employers, i n what
i f any, w i l l t h e i r coverage or b e n e f i t s change?
A l l Americans w i l l gain s e c u r i t y from the C l i n t o n plan f o r
h e a l t h reform. Americans who c u r r e n t l y have insurance w i l l know
t h a t they need never f e a r l o s i n g coverage because of a change of
jobs, l o c a t i o n or h e a l t h s t a t u s .
Americans already insured w i l l have the option of continuing
i n t h e i r c u r r e n t h e a l t h plan and with t h e i r c u r r e n t doctor i f
they want to do so. Americans who c u r r e n t l y have adequate
insurance coverage w i l l have a wider choice of h e a l t h p l a n s . I n
most c a s e s under the current system, employers o f f e r only l i m i t e d
c h o i c e s -- and often choose one plan to cover a l l employees.
Once h e a l t h reform i s implemented, most Americans w i l l have
a wider choice of plans, s e l e c t i n g the one t h a t f i t s t h e i r needs
best from among a v a r i e t y offered through a l o c a l h e a l t h
alliance.
For many Americans whose employers c u r r e n t l y provide only
minimal insurance coverage, the n a t i o n a l l y guaranteed
comprehensive b e n e f i t w i l l expand both s e c u r i t y and b e n e f i t s .
Health reform w i l l mean lower c o s t s , greater s e c u r i t y and more
e x t e n s i v e coverage f o r those Americans.
For a l l Americans, the comprehensive b e n e f i t package w i l l
cover some h e a l t h s e r v i c e s that probably a r e not provided under
r r e n t p o l i c i e s , such as preventive c l i n i c a l s e r v i c e s and mental
�health services.
3.
How w i l l persons who are not currently covered apply for
ealth insurance?
I f Americans who are not currently covered by health
^/insurance are employed, they probably w i l l receive information
'''Ijabout health a l l i a n c e s and plans from their employers. I f they
are not associated with a work place, they w i l l v i s i t the o f f i c e
of a regional health alliances to review information about health
plans offered i n their area and choose among them.
4.
Will persons be given any choice as to the ty
'care plan they will be enrolled in?
i/ujLaYes, a l l Americans w i l l choose the typ<
in which they e n r o l l . Local health alliances w i l l "offer a
variety of plans -- although how many and how they are organize
w i l l vary from one community to another -- from which consumers
w i l l choose their plan. Consumers who want to continue r e c e i v i n
care through the t r a d i t i o n a l fee-for-service system w i l l have t h
option of doing so.
^|^tr>JL Ov
1
5.
Will persons be able to remain under the care of t h e i r fj)/
current physician?
A l l Americans w i l l be able to continue receiving care froi
their current physicians. Physicians and other health providers
w i l l i ^ ^ t h e opportunity to participate i n a number of health
plans, i f they desire, and patients can follow their physician
into a p a r t i c u l a r plan. Consumers also w i l l have the opportunity
^ , to^change) <|)hysie±an or plans during'?an annual enrollment ,;per±od. /
l^t A> ^ . f c d L - c ? ^ ^ ^ ^ fv ^^^itfLU-c^ . -HHO, o^J 4* wis p tstA' £
J
6. Will ajpersoji be ablef to obtain private insurance to pay for^-,,
services not covered under his or her plan?
^<Z4^Cl
I t i s too soon to know i f a supplemental insurance market + A
w i l l develop once health reform i s implemented. Because the
guaranteed national benefit package includes a comprehensive
array of health services, a supplemental insurance market may not
develop. I f a market for supplemental benefi<ts e x i s t s , consumers
w i l l be free to purchase policies.
/
7.
Will Medicare s t i l l exist, or w i l l 1 t become part of the new
/
plan? Will there be any significant changes i n cost predelivery
for older Americans?
(LAA
^ M e d i c a r e w i l l s t i l l e x i s t , d e l i v e r i n g the 4gaa- b e n e f i t s 0
tsl5rough the~same~ providers^. Health reform w i l l p r e v i a
b^nel^tZjEKajb^will Gicpan&rM^iicare eoverage-to include
p r e s c r i p t i o n drugs.
A^J^.
x
�Health reform also will expand public funding for long-term
care services delivered at home and in the community and will set
a course for the gradual expansion of long-term care benefits.
The Clinton plan for health reform also calls for reforming the
private long-term care insurance market.to improve its quality
and reliability. ~4nfL- d A j ^ d J f r J ^
^^JtUn^tA^
8.
W i l l persons have t o pay taxes on t h e h e a l t h c a r e coverage
t h e i r own?
r
The t a x e n ^ S ^ a is make/p
t o w a r d t h e c o s t o f t h e i n s u r a n c e coverage f o r t h e compi l e n s i v e 1
b e n e f i t package w i l l remain unchanged from c u r r e n t law. Some
l i m i t may be imposed on tax-exemptions f o r spending t o purchase
a d d i t i o n a l coverage beyond t h e comprehensive b e n e f i t package, b u t
any l i m i t w i l l a f f e c t a s m a l l number o f Americans who choose t o
dS^c.
spend t h e most on h e a l t h c a r e . (???? -- t h i s i s t r i c k y -- CG) / V - ^ ^ J J .
9.
What changes w i l l t h e r e be i n t h e way c a r e i s d e l i v e r e d ?
For example, w i l l t h e r e be t r e a t m e n t p r i o r i t i e s o r r e s t r i c t i o n s ?
One o f P r e s i d e n t C l i n t o n ' s p r i m a r y g o a l s i n h e a l t h r e f o r m i s
t o e s t a b l i s h a n a t i o n a l framework t h a t w i l l c r e a t e i n c e n t i v e s f o r
h e a l t h p r o v i d e r s t o search f o r i n n o v a t i v e approaches t o
d e l i v e r i n g t h e h i g h e s t y - q p a l i t y care i n t h e mqfst cos t ^ e f f e e t i v
manner.
Many American enjplqyers, health care) institutions, (/oca^/^"—*
communities and state*"have led the way in designing new and
effective approaches to health care delivery, improving
tYi&jKLj
quality of care and controlling costs. Under health
reform/
President Clinton intends to build on that track record of
innovation, creating incentives for those ideas to spread,./ C
improving care for everyone.
(JML
Treatment p r i o r i t i e s and r e s t r i c t i o n s w i l l n o t a r i s e as
r e s u l t o f h e a l t h r e f o r m . Opponents o f change o f t e n r a i s e t h e
s p e c t e r o f h e a l t h c a r e " r a t i o n i n g " i n an a t t e m p t t o f r i g h t e n
American consumers i n t o r e j e c t i n g p r o p o s a l s f o r change. The
t r u t h i s t h a t t h e American h e a l t h c a r e system wastes so many
r e s o u r c e s on unnecessary t r e a t m e n t and bureaucracy t h a t
e l i m i n a t i n g t h o s e d r a i n s on t h e system w i l l f r e e up r e s o u r c e s t o
d e l i v e r c a r e t h a t i s needed.
10. What p r o v i s i o n s a r e b e i n g made f o r l o n g - t e r m n u r s i n g home
and at-home care?
P r e s i d e n t C l i n t o n ' s p l a n f o r h e a l t h c a r e r e f o r m makes a
comprehensive system of
s e r i o u s s t a r t toward p u t t i n g i n p l a c e
derly citizens who
l o n g - t e r m c a r e f o r America's d i s a b l e
r e q u i r e such care.i
�The President's plan emphasizes home and community-based
long-term care because most Americans prefer to remain secure i n
their homes for as long as possible. The President's plan
attempts to right the imbalance i n the current system that
inadvertently favors entering nursing homes rather
than obtaining long-term care at home or i n the community.
11. How long w i l l i t take before the national health plan i s i n
operation? What w i l l happen i n the meantime? I f people have
questions, where can they c a l l or write for information?
Fully implementing national health reform w i l l require a
number of years. The schedule for implementation cannot even
begin u n t i l Congress enacts reform, a goal that President Clinton
hopes can be accomplished this year. The President's plan c a l l s
for providing thA^gr-.^^Jty of gnarantP.eri health coverage to a l l
Americans by thgt|end^of^~the decade7^>at the l a t e s t . The length of
time required to implement tne new neaith system w i l l vary from
state to state, with some states already i n position to move ^
quickly and others further behind.
Winning passage for President Clinton's plan from the
Congress i s the f i r s t order of business, however. I t i s a
challenge on which the President w i l l require the support o
Americans interested i n health reform.
As the process of consideration i n Congress unfolds,
Americans interested i n obtaining additional information about
President Clinton's plan can c a l l or write
�May 19, 1993
MEMORANDUM TO:
IRA MAQAZINER AND BOB BOORSTIN
FROM: CAROLYN GATZ
SUBJECT: ANSWERS TO QUESTIONS POSED BY GOOOD HOUSEKEEPING
MAGAZINE
A t t a c h e d i s a d r a f t o f proposed answers f o r Good
Housekeeping's "The B e t t e r Way" s e c t i o n f o r t h e i r August i s s u e .
Please r e v i e w f o r accuracy, c l a r i t y , focus, e t c .
Thanks
�Good Housekeeping
D r a f t : May 19, 1993
1. Under the P r e s i d e n t ' s h e a l t h care reform plan, what w i l l a
t y p i c a l h e a l t h care p o l i c y cover? What w i l l not be covered?
The P r e s i d e n t ' s plan w i l l guarantee to a l l Americans the
s e c u r i t y of coverage f o r a comprehensive package of h e a l t h
b e n e f i t s , i n c l u d i n g the f u l l range of h o s p i t a l and p h y s i c i a n c a r e
normally included i n the best insurance p o l i c i e s .
The comprehensive b e n e f i t package w i l l emphasize primary and
preventive care, o f f e r i n g coverage for c l i n i c a l preventive
s e r v i c e s such as p e r i o d i c checkups and mammograms often not
covered i n other insurance p o l i c i e s .
The n a t i o n a l l y guaranteed b e n e f i t package a l s o w i l l provide
coverage f o r i n p a t i e n t and outpatient mental h e a l t h s e r v i c e s ,
another f e a t u r e not always provided by other p o l i c i e s .
2.
way,
For persons who a r e now insured by t h e i r employers, i n what
i f any, w i l l t h e i r coverage or b e n e f i t s change?
A l l Americans w i l l gain s e c u r i t y from the C l i n t o n plan f o r
h e a l t h reform. Americans who c u r r e n t l y have insurance w i l l know
t h a t they need never f e a r l o s i n g coverage because of a change of
jobs, l o c a t i o n or h e a l t h s t a t u s .
Americans already insured w i l l have the option of continuing
i n t h e i r c u r r e n t h e a l t h plan and with t h e i r c u r r e n t doctor i f
they want to do so. Americans who c u r r e n t l y have adequate
insurance coverage w i l l have a wider choice of h e a l t h p l a n s . I n
most c a s e s under the current system, employers o f f e r only l i m i t e d
c h o i c e s -- and often choose one plan to cover a l l employees.
Once h e a l t h reform i s implemented, most Americans w i l l have
a wider choice of plans, s e l e c t i n g the one that f i t s t h e i r needs
best from among a v a r i e t y offered through a l o c a l h e a l t h
alliance.
For many Americans whose employers c u r r e n t l y provide only
minimal insurance coverage, the n a t i o n a l l y guaranteed
comprehensive b e n e f i t w i l l expand both s e c u r i t y and b e n e f i t s .
Health reform w i l l mean lower c o s t s , greater s e c u r i t y and more
e x t e n s i v e coverage f o r those Americans.
For a l l Americans, the comprehensive b e n e f i t package w i l l
cover some h e a l t h s e r v i c e s that probably a r e not provided under
c u r r e n t p o l i c i e s , such as preventive c l i n i c a l s e r v i c e s and mental
health s e r v i c e s .
�3.
How w i l l persons who
h e a l t h insurance?
are not c u r r e n t l y covered apply f o r
I f Americans who are not c u r r e n t l y covered by h e a l t h
insurance are employed, they probably w i l l r e c e i v e information
about h e a l t h a l l i a n c e s and plans from t h e i r employers. I f they
are not a s s o c i a t e d with a work place, they w i l l v i s i t the o f f i c e
of a r e g i o n a l h e a l t h a l l i a n c e s to review information about h e a l t h
plans o f f e r e d i n t h e i r area and choose among them.
4.
W i l l persons be given any choice as to the type of h e a l t h
c a r e plan they w i l l be e n r o l l e d i n ?
Yes, a l l Americans w i l l choose the type of h e a l t h c a r e plan
i n which they e n r o l l . Local health a l l i a n c e s w i l l o f f e r a
v a r i e t y of plans -- although how many and how they are organized
w i l l vary from one community to another -- from which consumers
w i l l choose t h e i r plan. Consumers who want to continue r e c e i v i n g
care through the t r a d i t i o n a l f e e - f o r - s e r v i c e system w i l l have the
option of doing so.
5.
W i l l persons be able to remain under the care of t h e i r
current physician?
A l l Americans w i l l be able to continue r e c e i v i n g c a r e from
t h e i r c u r r e n t p h y s i c i a n s . P h y s i c i a n s and other h e a l t h providers
w i l l be the opportunity to p a r t i c i p a t e i n a number of h e a l t h
plans, i f they d e s i r e , and p a t i e n t s can follow t h e i r p h y s i c i a n
i n t o a p a r t i c u l a r plan. Consumers a l s o w i l l have the opportunity
to change p h y s i c i a n or plans during an annual enrollment period.
6.
W i l l a person be able to obtain p r i v a t e insurance to pay
s e r v i c e s not covered under h i s or her plan?
for
I t i s too soon to know i f a supplemental insurance market
w i l l develop once h e a l t h reform i s implemented. Because the
guaranteed n a t i o n a l b e n e f i t package includes a comprehensive
a r r a y of h e a l t h s e r v i c e s , a supplemental insurance market may not
develop. I f a market for supplemental b e n e f i t s e x i s t s , consumers
w i l l be f r e e to purchase p o l i c i e s .
7.
W i l l Medicare s t i l l e x i s t , or w i l l i t become part of the new
plan? W i l l there be any s i g n i f i c a n t changes i n c o s t or d e l i v e r y
for older Americans?
Medicare w i l l s t i l l e x i s t , d e l i v e r i n g the same b e n e f i t s
through the same providers. Health reform w i l l provide a new
b e n e f i t t h a t w i l l expand Medicare coverage to include
p r e s c r i p t i o n drugs.
Health reform a l s o w i l l expand p u b l i c funding for long-term
c a r e s e r v i c e s d e l i v e r e d at home and i n the community and w i l l s e t
a course f o r the gradual expansion of long-term c a r e b e n e f i t s .
The C l i n t o n plan for h e a l t h reform a l s o c a l l s for reforming the
�p r i v a t e l o n g - t e r m c a r e i n s u r a n c e market t o improve i t s q u a l i t y
and r e l i a b i l i t y .
8.
W i l l persons have t o pay t a x e s on t h e h e a l t h c a r e coverage
t h e y g e t from t h e i r employers o r purchase on t h e i r own?
The tax-treatment of payments employers and employees make
toward the c o s t of the insurance coverage f o r the comprehensive
b e n e f i t package w i l l remain unchanged from c u r r e n t law. Some
l i m i t may be imposed on tax-exemptions f o r spending to purchase
a d d i t i o n a l coverage beyond the comprehensive b e n e f i t package, but
any l i m i t w i l l a f f e c t a small number of Americans who choose to
spend the most on h e a l t h care. ( ? ? ? ? -- t h i s i s t r i c k y -- CG)
9.
What changes w i l l t h e r e be i n t h e way c a r e i s d e l i v e r e d ?
For example, w i l l t h e r e be t r e a t m e n t p r i o r i t i e s o r r e s t r i c t i o n s ?
One o f P r e s i d e n t C l i n t o n ' s p r i m a r y g o a l s i n h e a l t h r e f o r m i s
t o e s t a b l i s h a n a t i o n a l framework t h a t w i l l c r e a t e i n c e n t i v e s f o r
h e a l t h p r o v i d e r s t o search f o r i n n o v a t i v e approaches t o
d e l i v e r i n g t h e h i g h e s t - q u a l i t y care i n t h e most c o s t - e f f e c t i v e
manner.
Many American employers, h e a l t h c a r e i n s t i t u t i o n s , l o c a l
communities and s t a t e have l e d t h e way i n d e s i g n i n g new and
e f f e c t i v e approaches t o h e a l t h care d e l i v e r y , i m p r o v i n g t h e
q u a l i t y o f c a r e and c o n t r o l l i n g c o s t s . Under h e a l t h r e f o r m .
P r e s i d e n t C l i n t o n i n t e n d s t o b u i l d on t h a t t r a c k r e c o r d o f
i n n o v a t i o n , c r e a t i n g i n c e n t i v e s f o r those i d e a s t o spread,
i m p r o v i n g c a r e f o r everyone.
Treatment p r i o r i t i e s and r e s t r i c t i o n s w i l l n o t a r i s e as a
r e s u l t o f h e a l t h r e f o r m . Opponents o f change o f t e n r a i s e t h e
s p e c t e r o f h e a l t h c a r e " r a t i o n i n g " i n an a t t e m p t t o f r i g h t e n
American consumers i n t o r e j e c t i n g p r o p o s a l s f o r change. The
t r u t h i s t h a t t h e American h e a l t h c a r e system wastes so many
r e s o u r c e s on unnecessary t r e a t m e n t and bureaucracy t h a t
e l i m i n a t i n g t h o s e d r a i n s on t h e system w i l l f r e e up r e s o u r c e s t o
d e l i v e r c a r e t h a t i s needed.
10. What p r o v i s i o n s a r e b e i n g made f o r l o n g - t e r m n u r s i n g home
and at-home care?
P r e s i d e n t C l i n t o n ' s p l a n f o r h e a l t h c a r e r e f o r m makes a
s e r i o u s s t a r t toward p u t t i n g i n p l a c e a comprehensive system o f
l o n g - t e r m c a r e f o r America's d i s a b l e d and e l d e r l y c i t i z e n s who
r e q u i r e such c a r e .
The P r e s i d e n t ' s p l a n emphasizes home and community-based
l o n g - t e r m c a r e because most Americans p r e f e r t o remain secure i n
t h e i r homes f o r as l o n g as p o s s i b l e . The P r e s i d e n t ' s p l a n
a t t e m p t s t o r i g h t t h e imbalance i n t h e c u r r e n t system t h a t
i n a d v e r t e n t l y f a v o r s e n t e r i n g n u r s i n g homes r a t h e r
�than obtaining long-term care a t home or i n the community.
11. How long w i l l i t take before the n a t i o n a l h e a l t h plan i s i n
operation?
What w i l l happen i n the meantime? I f people have
questions, where can they c a l l or w r i t e f o r information?
F u l l y implementing n a t i o n a l h e a l t h reform w i l l r e q u i r e a
number of y e a r s . The schedule f o r implementation cannot even
begin u n t i l Congress enacts reform, a goal that P r e s i d e n t C l i n t o n
hopes can be accomplished t h i s year. The P r e s i d e n t ' s plan c a l l s
for providing the s e c u r i t y of guaranteed h e a l t h coverage t o a l l
Americans by the end of the decade, a t the l a t e s t . The length of
time r e q u i r e d to implement the new h e a l t h system w i l l vary from
s t a t e to s t a t e , with some s t a t e s already i n p o s i t i o n to move
q u i c k l y and others f u r t h e r behind.
Winning passage f o r President C l i n t o n ' s plan from the
Congress i s the f i r s t order of business, however. I t i s a
challenge on which the President w i l l r e q u i r e the support of a l l
Americans i n t e r e s t e d i n h e a l t h reform.
As the process of c o n s i d e r a t i o n i n Congress unfolds,
Americans i n t e r e s t e d i n obtaining a d d i t i o n a l information about
P r e s i d e n t C l i n t o n ' s plan can c a l l or w r i t e
�phi I Lr<L.
6
To: I r a Magaziner, Judy Feder, Carolyn Gatz
Fr: Bob B o o r s t i n , Jason Solomon
Re: Surrogates
Date: A p r i l 26, 1993
i
SURROGATE LIST
Obviously, we w i l l be using a wide range o f working group members
t o speak t o d i f f e r e n t audiences and t a l k t o d i f f e r e n t members o f
the media i n t h e weeks f o l l o w i n g t h e release o f t h e plan.
However, we need approximately 10 surrogates f o r extensive r a d i o ,
TV and p r i n t i n t e r v i e w s — as much as an hour a day f o r t h e three
weeks f o l l o w i n g t h e release o f t h e plan. These i n t e r v i e w s w i l l
supplement t h e work o f people l i k e I r a , Judy and Carol Rasco.
The surrogates were chosen based on t h e f o l l o w i n g c r i t e r i a :
1) Professional c r e d i b i l i t y , ( i . e . doctors are great)
2) Geographic d i v e r s i t y .
3) A b i l i t y t o t a l k i n English about h e a l t h care. They w i l l be
used e x t e n s i v e l y on l o c a l TV and r a d i o — i n places from Indiana
t o Arizona.
The f o l l o w i n g people are t h e people who we are considering asking
t o make t h e necessary time commitment. Please comment on t h e l i s t
and suggest possible changes.
Walter Zelman
Paul Starr
/ L o i s Quam )
v.
Dr. Risa Lavizzo-Mourey
Dr. Roz Lasker
/. Shoshana Sofaer
Denise Denton
Robyn Stone
y-* Dr. David Eddy
S a l l y Richardson
Linda Bergthold
Dr. Arnie Epstein
-Dr. Bob Berenson
7^
�To: I r a Magaziner, Judy Feder, Carolyn Gatz
Fr: Bob B o o r s t i n , Jason Solomon
Re: Surrogates
Date: A p r i l 26, 1993
SURROGATE LIST
Obviously, we w i l l be using a wide range o f working group members
t o speak t o d i f f e r e n t audiences and t a l k t o d i f f e r e n t members o f
the media i n t h e weeks f o l l o w i n g t h e release o f t h e plan.
However, we need approximately 10 surrogates f o r extensive r a d i o ,
TV and p r i n t i n t e r v i e w s — as much as an hour a day f o r t h e three
weeks f o l l o w i n g t h e release of t h e plan. These i n t e r v i e w s w i l l
supplement t h e work o f people l i k e I r a , Judy and Carol Rasco.
The surrogates were chosen based on t h e f o l l o w i n g c r i t e r i a :
1) Professional c r e d i b i l i t y , ( i . e . doctors are great)
2) Geographic d i v e r s i t y .
3) A b i l i t y t o t a l k i n English about h e a l t h care. They w i l l be
used e x t e n s i v e l y on l o c a l TV and r a d i o — i n places from Indiana
t o Arizona.
The f o l l o w i n g people are t h e people who we are considering asking
t o make t h e necessary time commitment. Please comment on t h e l i s t
and suggest possible changes.
Walter Zelman
Lois Quam
Dr. Risa Lavizzo-Mourey
Dr. Mark Smith
Dr. Roz Lasker
Shoshana Sofaer
Denise Denton
Robyn Stone
Dr. David Eddy
S a l l y Richardson
Linda Bergthold
Dr. Arnie Epstein
Dr. Bob Berenson
Paul S t a r r
�HEALTH CARE COMMUNICATIONS CALENDAR
April 16,1993
Page 1
Date
Event
Location
Person
Organizing
R: Educate Congress
M: Mental Health is cost effective
Hill
Skila
DC
John Edgell
Gn
PO:
Gn
PO:
Principal
MEG
Rationale/Message
4/27 [??]
Mental Health: Tipper
to Hill
4/26 - 4/28
Technology Fair:
Commerce Dept.
AGJ/
Sec. Brown
R:
M: Quality; low cost, broad
application
End April/
Early May
Second Task Force
Hearing: Model
Reforms
Task Force
R:
Present the successful reforms
from across the country: to highlight elements of our plan and
inoculate against attacks
M: Our plan is based in reality not
untested theories
D.C.
[Hospital?]
Meeghan/
Bob/Jennifer
Early May
Trip to Rochester/
Kodak/Xerox
BC/HRC
R:
Very successful example of many
parts of our plan
M: It works well in Rochester; costs
down, 94% insured, waste cut,
cooperation
Rochester,
NY
[Kodak
employees?]
Bob/Jason
Farly May
Meeting with Physicians
BC
R:
White House
Alan
Sunday, 5/9
MOTHER'S DAY
Form "Physicians for Health
Reform"
M: Our plan is supported by family
doctors
Groups to Include/
Public Officials
Notes:
Gn [Bemie?/Skila?]
PO: House Mental
Health Working
Group, Chafee,
Domenici
Gn Chamber of
Commerce (Alan?)
PO: D'Amato, It^fi^j ^
Moynihan, Roch. ^
Mayor
Gn AAFP, ACP,
Pediatricians,
Emergency
Physicians
PO:
HRC and Chelsea
�HEALTH CARE COMMUNICATIONS CALENDAR
April 16,1993
Page 2
Date
Event
Principal
5/6 - 5/9
National Nurses Week
BC/HRC
5/10
[Monday]
Small Business Event
[5/9 begins "Small
Business Week"]
BC/
Sec Brown/
E. Bowles
Wk of 5/10
[Wed/Thurs]
Reducing Paperwork:
Single Insurance Form
Wk of 5/10
Interview with Business
Wk of 5/10
1 Wk of 5/10
| or 5/17
R: Build up nurses; get on our side
M:
Location
White House
Alan
R:
Groups to Include/
Public Officials
Gn American Nurses
Association,
Pediatric Nurses
PO:
Notes:
Virginia Kelly to
come; nurses from
50 states; satellites
Inoculation on small business,
key constituency
M: Go to business whose insurance
got cut off, our plan guarantees it
can't happen
Mike Lux
BC
R: Appeal to MDs
M: Our plan will ease administrative
burdens of patients and doctors
so they can spend more time
together
Christine
Gn AMA, Hospital
Administrators
PO:
Stack up insurance
forms; visit
record/billing dept
of hospital, private
BC
R:
Explain our plan to [small]
business community
M: Health Care and Business
DC
Bob/Lisa
Gn
PO:
Delay?
Interview with Inc.
IraM
R:
Explain our plan to [small]
business community
M: Health Care and Business
DC
Bob/Lisa
Gn
PO:
Interview with Wall
Street Journal
Mac
R:
Explain our plan to [small]
business community
M: Health Care and Business
DC
Dwight/
Bob/Lisa
Gn
PO:
** Reno/Justice Event
Reno
R:
M:
DC
PaulB
Gn
PO:
Week
I Wk of 5/10
Rationale/Message
Person
Organizing
PO:
-—
�HEALTH CARE COMMUNICATIONS CALENDAR
April 16,1993
Page 3
Date
Event
Principal
Rationale/Message
Location
HRC/MEG/
Shalala
R: Helps with women's groups
M: Concern about women's issues/
focus on preventive care
Cannon
Caucus
Room??
BC
R: Appeal to MDs/Public
M: Cost control and less hassle for
MDs with malpractice reform;
not afraid to go against
traditional constituency
5/13
[4 - 7 p. .]
Prevention Event/
Women's Issues
Wk of 5/17
Malpractice Reform:
Speech
Wk of 5/17
Prescription Drugs:
Return to Mary Annie
and Edward Davis
BC/HRC
Wk of 5/17
Workers' Compensation
BC
May
Mental Health/Older
Americans event in
Rhode Island
MEG
R:
Older Americans and mental
health are big issues for Chafee
M: Community-based mental health
and senior programs are key to
our plan
May
Union event
BC/
Reich
R: Build labor support
M:
m
R: Older americans event
M: No longer have to choose
between drugs and food
Person
Organizing
Groups to Include/
Public Officials
Notes:
Combine with event
in Cannon Caucus?
Public? Real
people? Union
members?
Mike Lux
New Hamp/
Florida
Gn Society for
Advancement of
Women's Health
PO:
Gn
PO:
ATLA Speech?
Bob B
Gn
PO:
Lisa C
Bob
Gn Business community
- small and large
PO:
Rhode Island
Skila/
Jennifer
Gn AARP
PO: Sen. Chafee [Pell?]
White House
Mike Lux
R: Attract business support
M: Workers' comp will be reduced
(15-30%) through our plan
Gn
PO:
Go out? HOLD
�r
Date
Event
Waste/Fraud Event:
launch crackdown w/
800 number and new
criminal penalties
Latex Glove Event
(Chiles)
Principal
AGJ/Reno/
Shalala
HEALTH CARE COMMUNICATIONS CALENDAR
April 16,1993
Page 4
Rationale/Message
R:
M: part of VP's reinventing
government
Location
Person
Organizing
DC
K. Pollitz
Groups to Include/
Public Officials
Gn
PO:
R;
Demonstrate Cost Shifting/
Uncompensated care [Buyers 4Club theme?]
M: Hold up two latex gloves - 1 cost
$15 in a hospital and 1 cost 14
cents at the local Price Club
Gn
PO:
R:
M:
Gn
PO:
R:
M:
Gn
PO:
R:
M:
BC
Gn
PO:
HOLDING FOR LAUNCH OF PLAN:
Contract with the American People (Stan)
Carville Stack of Studies (Paul B: use in response to charges that we are going too fast/need to study more)
Chiles Emergency Room Event
Car event, steel company
Mandy/Lisa - Big Media - month of May - Sunday Shows - Network: launch and pre-launch
Notes:
IG problem? AG?
State & local
governments?
�
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
Boorstin
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Health Care Task Force
Carolyn Gatz
Identifier
An unambiguous reference to the resource within a given context
2006-0885-F Segment 4
Is Part Of
A related resource in which the described resource is physically or logically included.
Box 42
<a href="http://clinton.presidentiallibraries.us/items/show/36149" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/12093616" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
An entity responsible for making the resource available
William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
Medium
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Reproduction-Reference
Date Created
Date of creation of the resource.
4/16/2015
Source
A related resource from which the described resource is derived
12093616
42-t-12093616-20060885F-Seg4-042-005-2015