In his hand-operated automobile, he drives off to rejoin his family. But for the insurance representative, the narrator warns, "rehabilitation does not end here. Unless there's planned home care and medical follow-up programs, much of the special training will have been wasted." The insurance representative inspects modifications being made at the patient's home, including wheelchair ramps, widened doorways, grab bars in the bathroom. Certain basic equipment also can assist a paraplegic in his mobility. Though it varies from patient to patient, it generally includes: Parallel bars for exercise; a regular bed with special mattress; a second wheelchair if the patient intends to work; and, special equipment for the family car if the rehabilitation staff and the insurance company deem it appropriate. For quadriplegics, the addition of an extra room to the house as a private room is sometimes necessary. So may be a hydraulic lift. The question of whether an attendant is needed must be resolved by the rehabilitation staff and the insurance company. Most well-trained paraplegics will not need special assistance. The degree of a quadriplegic's restoration will determine the extent of attendance required. "Keep members of the family involved throughout all your activities," the program advises. "They must understand the care needs of the patient. They have to realize that over-treatment-pamperingshould be avoided since it breeds dependency." In cooperation with the center, the insurance representative makes sure a local physician is selected to establish and supervise a preventive medical program. He also makes arrangements with the local pharmacy so all supplies will be available as needed. "When work is a definite possibility," the narrator explains, "the insurance representative should map out a program to pursue that goal. Great ingenuity and resourcefulness may be required on your part to solve the work problem. Hopefully, this will involve a return to the former employer. If this is not possible, other employment must be considered. Further vocational testing can provide valuable guidance. "Experience has proven that the disabled are excellent workers. More and more employers are becoming aware of that fact. If you set your work sights correctly and knock on enough doors, chances are you'll succeed. There's nothing easy about handling cord injuries, no easy solutions. But the rewards are enormous, beyond words." The video tape shows the reunion of a paraplegic with his family at home. Being greeted warmly by his wife. In the backyard with his children. Reading to them in the living room. Toward this happy ending, three points are again emphasized: (1) Recognize the problem early. (2) Transfer the patient to the treatment center. (3) Plan a home care program. "Remember," the narrator concludes, "there are different degrees of success. Not every cord injury will return to drive a tractor or teach class despite a wheelchair. But the goal is always the same. To make a functional life possible for the severely disabled. One day, it may be your responsibility to show a cord-injury victim why 'There Is A Way'." Congressman PAUL G. ROGERS, SOUTHERN PERINATAL ASSOCIATION, Chairman, Commerce Health Committee, DEAR CONGRESSMAN ROGERS: This position statement represents the views and concerns of members of the Southern Perinatal Association concerning provisions necessary for mothers and their unborn or newly born infants in our region. I would sincerely appreciate your considering this statement as testimony for the February 11 hearing of the Commerce Health Committee concerning "What benefits should be covered" as well as the February 19 meeting concerning "Who should be covered" in any proposed National health insurance program. An executive officer of our committee would be delighted to participate in any way or answer any questions concerning this. Sincerely, GEORGE CASSADY, M.D., Enclosure. President. POSITION PAPER-NATIONAL HEALTH INSURANCE The Southern Perinatal Association was organized three years ago to serve as an advocate for maternal and child health care. Representing the medical and paramedical community of the 14 southeastern and southwestern states, this group has as its goal the assurance that adequate care during pregnancy, the delivery process and the immediate post-delivery period be provided for all mothers and their infants in this region. Two extraordinary obstacles have been apparent: (1) Need is great in this region, in relation to poorer socioeconomic and educational factors. As a single simple index of this fact, infant mortality rates in this region have consistently been dramatically higher, particularly during the early days after birth.' (2) The unborn and newly-born infants are politically vulnerable because they have little representation and few effective advocates. As precise examples, (a) While public funds pay most of the bill for the aging (67% of the 15.7 billion dollar medical care outlay for those 65 years of age and over), private funds pay for most of the care in the young (73% of the 9.3 billion dollars for those 18 years of age and under). Also, 27% of the health care dollar is spent on the 10% of the population age 65 or over while but 16% is spent on those 36% who are age 18 years or under. (b) Adequate insurance coverage for maternity care is the exception rather than rule in our society, only one-third (White) to one-fifth (Black) of 19641966 births having so-called "complete" insurance coverage.' Drastic limitations in even these policies, often denying fetal diagnostic or therapeutic procedures prior to time of delivery, further restrict availability of perinatal health care for these patients. (c) Exclusion or limitation of coverage for the newly-born infant in family and group health insurance policies persist in most of our states. With these basic facts in mind, it is apparent why the medical community responsible for care of these patients, as represented by the Southern Perinatal 1 Infant Mortality Trends Vital and Health Statistics: National Vital Statistics System; Series 20, No. 1. 2 Cooper, B. and McGee, M. F. Medicare care outlays for three age groups: young, intermediate and aged. Social Security Bulletin: May. 1972 (DHEW). 3 Health Insurance Coverage for Maternity Care DHEW Publication No. (HSM) 721009. Vital and Health Statistics; National Vital Statistics Sysems; Series 22, No. 12. Association, has been intensely interested in recently developed proposals for a National Health Insurance program. With clear understanding and sympathy for the current, urgent needs to curb inflation, we nevertheless realize that every public dollar invested in a healthier start in life yields a higher rate of return (in terms of primary prevention of physical as well as mental disabilities) than an equal investment in health care at any subsequent stage in life. We therefore go on record in support of basic inclusion, in any national health insurance legislation, of care funding for mother and child to include: (1) Preventive, diagnostic and therapeutic care for the mother from conception through the post-partum period, (2) Prevention, diagnostic and therapeutic care for her baby from conception, through labor and delivery, and during the neonatal and early infancy period (to 3 months after birth), (3) Transportation costs for mother and/or baby as necessary to assure access to this care. No single bill before Congress at the present time contains all these provisions. Assurance of financial availability of health care for all mothers and babies during that formative period of all human life, pregnancy, as well as during those treacherous hours and days surrounding the "valley of the shadow of birth", must be basic provisions in any national health insurance bill ultimately approved. The Southern Perinatal Association, and any or all of its executive officers, stand ready to provide any guidance, consultation or help necessary to assure this goal. In this manner, we endorse and wish to reaffirm the principle which states: "Whenever the miracles of modern medicine are beyond the reach of any group of Americans, for whatever reason-economic, geographic, occupational or other-we must find a way to meet their needs and fulfill their hopes. For one true measure of a nation is its success in fulfilling the promise of a better life for each of its members. Let this be the measure of a nation.” Hon. PAUL ROGERS, WASHINGTON BUSINESS GROUP ON HEALTH, Chairman, Subcommittee on Health and the Environment, Rayburn House Office Building, Washington, D.C. DEAR MR. ROGERS: Your extensive efforts to develop the background information so essential for the design of a national health insurance program is appreciated. We will, during the next weeks, submit materials relevent to some of the specific topics the Subcommittee is studying, and to the questions contained in your challenging opening remarks. Enclosed are sufficient copies for the Subcommittee Members and Professional Staff of our Survey on Dental Insurance. Although conducted in June 1975, and certainly not representative of all employers, it remains the most timely and comprehensive information now available. Further materials will be submitted as they are prepared and I am always available for questions. We would also be happy to arrange for other surveys or additional information exchange efforts should you so request. Sincerely yours, Enclosure. WILLIS B. GOLDBECK, Staff Director. John F. Kennedy Special Message to Congress. February 27, 1972. WASHINGTON BUSINESS GROUP ON HEALTH July 1, 1975 DENTAL INSURANCE: A SURVEY OF WBGH MEMBERS INTRODUCTION: One of the recommendations made to Congress by the WBGH was to exclude dental insurance from the legislation seeking to provide emergency health insurance for the unemployed. We based our position on these considerations: A. The primary purpose of the proposed legislation for the unem- B. Dental insurance has an experience level and resulting premium C. Only a small proportion of the nation's employers have dental D. Dental emergencies resulting, for example, from an auto acci- In the weeks following the enunciation of our position, we were challenged to provide the data which would support or contradict our assumptions. Since no single source existed for such information, we conducted a survey of our 128 members. Despite being given only 10 working days to respond, 100 did so. This report gives the details of their replies. We also offer the recently published results of a Fortune Magazine survey of their 1st and 2nd 500. Please note that we make no attempt to prescribe an interpretation of these results. They must speak for themselves and the reader is cautioned that our survey is by no means a pure, scientific sample with concomitant statistical analysis. We simply hope to shed some light on an area which has suffered from a lack of information. It should further be noted that the WBGH does not represent all employers. To aid the reader in making your own evaluation, a list of responding firms is attached. 815 15th. STREET, N. W. WASHINGTON, D.C. 20005 (202) 347-3140 THE FORTUNE MAGAZINE SURVEY They received responses from 157 and 180 of the 1st and 2nd 500, respectively. Group Dental coverage is now provided by 20% of the Top 500 and 18% of the 2nd 500. An additional 28% of the Top 500 and 21% of the 2nd 500 stated that Group Dental was being seriously considered. To assist in comparing the responses received by Fortune with those of the WBGH, below, it may help to know that 37 of our members are in the Top 50 Fortune companies. THE WBGH SURVEY RESULTS The Sample: We asked 128 companies of which 100 responded. The Questions: 1. Does your employee health plan include dental insurance? 2. (For the 47 which do not now provide dental insurance) Do you plan to establish a dental program? 2a (For the 26 which plan to establish a program) When do you plan to start the new dental program? All questions which follow pertain to the 53 respondents (also 53/100) which do provide dental insurance. 3. Do you provide equal dental benefits for all your employees? |