A broad based coalition is working to defeat the tax cap. Senator Bob Packwood recently spoke to a gathering of representatives from HSAC, business, labor, senior citizens groups, professional societies and the insurance industry. He said he expected a tax cap would lead to sizeable cutback in company health plans. It would place a heavy burden on the lowest paid workers in any group, older workers, workers in regions of the country where health costs are highest, and in hazardous industries and environments. PROFITING FROM SICKNESS: While President Reagan in his state of the union message referred to the need to contain health care costs, health-for-profit has become one of America's fastest growing industries. Wall Street brokers recommend one profit maker whose net profits rose 61% a year and cash dividends 47% a year for the last five years. At least ten commercial entrepreneurs are similarly well-regarded on Wall Street. They are rapidly changing the face and the focus of sickness care in America, as Paul Starr describes in "The Social Transformation of American Medicine". Profitmaking chains own kidney dialysis centers, labs, medical office buildings, ambulatory surgical centers, and shopping mall emergency centers. Large insurance companies are buying HMOs; nearly 80% of nursing homes are operated for-profit. 600 of the 6000 U.S. community hospitals are owned by profit-making companies, which alsɔ maRAÇA 300 more under contract. In the first quarter of 1982, one company reported $48 million profit, and recent acquisition of hospitals in 13 states. The curbing of Health Systems Agencies (HSA ended review of hospital applications, eight for-profit chains applied to build in two suburbs within 5 miles of major hospitals. Combined with the increase of physicians per capita, expected to be down to 1/440 people by 1990 (now 1/536 people), the face of health care will be drastically altered in ways unrelated to budget cuts and consumer needs. Concern about the public and inner-city hospitals, and the availability of decent care for the poor and those with complex illnesses has increased when the profit makers take over. As for-profit chains advertised $40,000 salaries for a nursing director, New Orleans Charity Hospital had to close 700 of its 1500 beds because it could not afford nurses salaries. The Health Advocate reports that Cook County Hospital is managed by Hyatt Medical Management, a subsidiary of American Medical which owns a fleet of airborn C.T. scanners, ready to fly instantly anywhere in the world. At Cook County Hospital, emergency scans are frequently delayed for 24 hours, and then done in private hospitals, which charge the County $800 per scan. The Committee to Save Cook County Hospital wonders why Hyatt has been unable to find just one earthbound scanner for the patients of Cook County. Health Security Action Council 1757 N Street, N.W. Washington, D.C. 20036 21 NON-PROFIT ORG. U.S. POSTAGE PAID WASHINGTON, D.C. PERMIT NO. 4229 Milton Wilkotz State Chairman Health Security Action Council Toms River, N.J. 08753 New Health Care Cost Containment Plan Proposed A broad based coalition has proposed a comprehensive plan to contain fast-rising health care costs as an alternative to further destructive cutbacks ir such program; as Medica.d and Medicare. Called H.A.L.T., or Health Action to Limit Takeaways, the plan was drawn up over the past several months by health care experts working with the Health Security Action Council. The coalition includes more than a hundred labor, consumer, religious, senior citizen, business, civil rights and farm groups. Legislation embracing the cost containment proposals will be introduced earl" in the next session of Congress, according to MILTEN WILKOTZ Chairman of the Health Security Action Council.I WilkorZcalled 1. "The only constructive alternative that has beer offered thus far to further cuts in programs." If adopted, the plan would immediately save $5 billion annually in federal expenditures and would result in comparable savings in the private health sector. Over several years, the H.A.L.T. plan is aimed at bringing down yearly increases in health costs to the level of increases in the Consumer Price Index. Over the past year or so, the health care component of the C21 has continued rising at a double-digit pace despite the overall lessening of inflation: The plan would be implemented in two phases. Under the first phase, hospital and nursing homes charges, doctors' fees and other health care costs would be limited to the necessary cost increases of the previous year. These limits on charges would include the Medicare and Medicaid programs as well as private insurance. After two years of this initial phase, the plan would be fully in place. The states would have the flexibility to work out specific budgets to contain health care costs within the general cost increase limits, as well as federal guidelines. These budgets would be determined in annual negotiations among a state health commission, Medicare intermediaries, providers, insurance companies and consumer representatives. The .A.L.T. plan is "comprehensive rather than drastic," according to Melvin A. Glasser, Director of the Health Security Action Council. "It's a systematic rather than a piecemeal approach 22-020 0-83--11 to containing health costs" and thus would be likely to succeed where previous measures have failed". "It embodies long-advocated principles like prospective budgets for hospitals, already approved In principle" by the hospital and health insurance industry". Glasser added that "negotiation is a major element." "Hospitals and doctors would be encouraged to work together and eliminate expey · sive duplications," he added. For ex The Council acknowledges that plan is limited. it wouldn't help the unemployed who have lost Insurance cover or the working poor who have lost Medicaid protection under the budget cuts of the past two fiscal years. "A comprehensive national health insurance program is needed to help these people and millions of others," said the Council. But "since it does not appear politically viable at this time, H.A.L.T. offers an immediate program of restraining costs and protecting consumers." Under the Reagan budget cuts approved by Congress, over a million people have been cut from the Medicaid rolls and millions of others have suffered reduced benefits. Rep. Charles B. Rangel (D-N.Y.) recently wrote his House colleagues, "We want to avoid the annual agony and bloodletting which has been taking place as we seek piecemeal economies in a health system which is out of control. The H.A.L.T. plan gives us an opportunity to do that." Dear Colleague: I am deeply concerned with what is happening to the beneficiaries of health programs as a result of budget chances Congress made last year and last month. Increased deductibles and copayments are hurting the niderly poor. Over a million people have been cut from the Medicaid rolls. Those who still have Medicaid struggle to stay on the tightrope between larger and larger holes in the safety net, as limits and restrictions proliferate. Nineteen states have already limited use of Emergency Rooms and Outpatient Departments, while twenty-one have decreased numbers of visits to doctors, podiatrists and optometrists. Two states will no longer supply eyeglasses, excnol. to children. states have limited the frequency of prescriptions one state to a maximum of $30 per month. Nine Co-insurance requirements have multiplied in the last year from 50 cents per prescription, to $2 for ambulance services. One state requires a medically needy individual, who already has proved indigency, to pay $30 as a condition of admission to a hospital. The millions of workers who have lost their jobs and family health protection as well, the elderly diabetic no longer able to afford insulin, the inner city hospitals under pressure to discharge extremely ill patients when their allowable twelve days art up, confront us with Some of the results of Congressional actions and state implementation. I believe that surely, with the evidence now accumulated, the Members of Congress recognize that the way we have gone about reducing, Federal expenditures for health programs as unsatisfactory. We know that it will probably be necessary to go through a similar unsatisfactory process next year. A constructive alternative plan of achieving importent savings in Madera programs has been developed an session on Wednesday, Septemb in Room 2322 kayburn iron purpose of on tiina in *proposal. ditures for health I am convening a briefing .9, 1982, at 2:00 p.m. Pulding for the the cislative would make possible a reduction the uimo stat required to spend for medicaid matching. Rather than restraining increases in cost of hospital care alone, or hospital care under medicare alone, the plan deals with all the principle cost increasing elements in the health care system. Finally, this is a cost containment, rather than cost shifting, program. As such it is a major constructiva alternative to the present decreases in Federal expenditures in health programs by means of increasing obligations of the state, the locality, the private sector and individual patients. I hope it will be possible for you to attend the briefing session at which technical experts will be available to outline the plan and answer questions. Pharlie Charles B. Rangel CBR/rll |