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What is H.A.L.T.? (Health Action to Limit Takeaways)
It is a comprehensive plan to contain health care costs
It was developed by an expert group advisory to a coalition
Because under the pressure of declining federal resources
A." No. Costs of health services continue to rise at a sub
stantially more rapid rate than the C.P.I. Most of the
But regardless of the merits of the Administration and
No. The Administration and some members of Congress have already indicated. that additional major reductions are likely to be proposed in Medicare, Medicaid and child health programs.
Why is the private sector included in the HALT plan?
Because experience to date indicates that health care
What order of magnitude of savings might HALT be able to achieve?
For Medicare, Medicaid and other personal health services
Are these reductions in present expenditures?
No. They are containment of increases which will certainly occur without the intervention of the HALT plan. Over several years. HALT's cost containment plan would bring down yearly increases in health costs to the level of increases in the Bureau of Labor Statistics annual cost of living index.
Most states are being hard pressed by the increasing pressures
Well how does HALT do all this?
No, by applying cost containment procedures which have already
HALT has two phases. Phase I is operative for the first two years: It calls a halt to all hospital price increases except for an allowable increase up to the previous year's increase in the "market basket" hospital costs. The allowable increase takes account of wage increases of non-supervisory hospital employees. Phase II begins in the third year sooner if a state is able to complete its organization work in less time.
What about doctors and other professional providers?
Would laboratory, x-ray, nursing home and other health
Yes. All major health expenditures would be required to
14. Q. Who would supervise the program?
under Federal guidelines.
15. Q. Since hospitals are the major area of health expenditures,
must they all operate under the same cost containment formula?
A. No. States which already have official cost containment
programs which are holding down cost increases to the
16. Q. What happens in Phase II?
A. The full HALT plan becomes operative. Hospitals would be required
to have prospective budgets negotiated with a state organized
17. Q. What about HMO's?
A. The state commission would negotiate annual budgets with them.
18. Q. Would HALT be flexible enough to take into account major changes
in population, unusual incidence of disease, and the financial problems of institutions which serve disproportionately large numbers of senior citizens, the poor and near poor?
A. HALT would take these factors into account in annual budgeting
and in retrospective budget adjustments, when appropriate. 19. Q. What would HALT do about the unemployed who have lost insurance
coverage, the working poor who have lost Medicaid protection,
A. Unfortunately HALT would not be able to help them. It would
not extend or improve eligibility or benefits. A comprehensive national health insurance program is needed to help these people and millions of others. HALT is simply a constructive alternative to containing health care costs, without further penalizing consumers.
Q. But isn't this a rather drastic proposal, likely to be opposed
by many of the special interest groups?
A. HALT is comprehensive rather than drastic. It's a systematic
rather than piece-meal approach to containing health costs. It embodies long advocated principles like prospective budgets for hospitals, already approved in principle by the American Hospital Association, the Health Insurance Association of America and Blue Cross Blue Shield, and embodied in Medicare legislation passed by the Congress. It covers both public and private insurance programs, advocated in principle by the Health Insurance Association of America, negotiated payments for HMO's, approved for Medicare by the 97th Congress, and a limitation on physician fee increases, approved by the U.S. Senate in the summer of 1982.
PREPARED STATEMENT OF HOWARD D. SLOBODIEN, M.D.
I am Howard D. Slobodien, M.D., President of the Medical Society of
New Jersey I appreciate the opportunity to appear before you and to present the collective opinion of the 9,300 physician members of the
Practicing physicians are concerned with a number of proposals that are being considered by the Administration to curtail the costs of
Medicare. While these proposals are well-intentioned, they may not achieve the desired result. If they do have a salutary effect on cost containment, they can have an adverse impact on the quality of care and the health of
our senior citizens.
Diagnosis Related Groups
The DRG program is being hailed by the Health Care Financing Administration as the answer to controlling hospital costs. Its effectiveness as a cost containment measure has not been established, and New Jersey
is the only state in which it has been tested.
That test has not been
completed nor properly evaluated. The reconciliation called for under the Federal Waiver has not been completed and will not be completed without modification of the original protocol.
As a practicing surgeon, I had great hopes for DRG. After all, I have been reimbursed along DRG lines since entering private practice.
My charge to the patient in the vast majority of cases includes the fee
for both the operation and the total hospital care, regardless of the