Page images
PDF
EPUB

September 1990

Dear colleague,

In P.L. 100-360 the Congress called upon the Pepper Commission to recommend legislation that would ensure all Americans coverage for health care and long-term care. With this report, the Commission fulfills that charge and calls upon you-our colleagues in the Congress, the President, and the American people-to turn its recommendations into law.

The Commission's intensive efforts to develop recommendations have not been an academic exercise. This report presents a workable plan of action to address the rapidly growing crisis in health and long-term care. To agree on that plan, Commission members have had to make hard choices and compromise strongly held positions. Members who believed action was critical refused to allow their personal vision of the best to become the enemy of the good.

In health care, a workable plan means we have no choice but to build universal coverage by reforming and extending the job-based and public coverage we now have to make it work well for all Americans. In long-term care it means we must establish priorities to build the protection we now lack. And in both areas, we must build deliberately, a step at a time, to allow all parties to adjust and to ensure a sound and stable structure.

Some will say that it is naive to pursue even such worthwhile social investments in the current fiscal environment. But there will never be a day when the answers become easy or cheap. There will never be a day when all of us can have our first choice or ideal solution. There will never be a day when some of us will not have to make some sacrifices to achieve what is best for all of us.

As the nation's political leaders, we face a choice: we can continue to duck our heads and hope this issue will not bring the nation to its knees, or we can use the Commission recommendations as the rallying point for the political consensus that can make universal

coverage in an efficient system a reality.

I urge you to join with me in pursuing the latter course-not only because it can work but because it is the only responsible means to take action we know is imperative. The recommendations presented here provide the tools we need to build a health and long-term care system we can all be proud of. Now we must put those tools to work.

[graphic]
[blocks in formation]

In Memory Of The Honorable Claude Pepper

My dear friends, this is an opportunity that will be rare for us in our legislative experience... when you go home tonight and you close your eyes and you sleep and you ask, "What have I done today to lighten the burden upon those who suffer," at least you could say, "I helped a little bit today; I voted to help those who needed help."

– Claude Pepper, floor statement
on his home care proposal,
U.S. House of Representatives,
June 8, 1988

Acknowledgements

The deliberations and recommendations of the Pepper Commission would not have been possible without the extensive support of individuals and organizations too numerous to mention. First and foremost, the Commission is indebted to the many individuals who shared the hardships they have faced in obtaining or financing health and longterm care, so that we might benefit from their experience. Second, a multitude of organizations and individual experts identified problems and proposed specific solutions which influenced the Commission actions.

Third, in its deliberations and preparation of its report, the Commission benefited from the extraordinary expertise and commitment of particular individuals. The Congressional Reference Service contributed invaluable support. Janet Kline, Mark Merlis, Beth Fuchs, and Janet Lundy provided information and analysis throughout the process. Specific analyses were prepared by Richard Price, Carol O'Shaughnessy, Melvina Ford, Ed Klebe, and Jennifer

O'Sullivan. Joan Sokolovsky provided valuable research support.

Fourth, as indicated in the supplementary volume to this support, the Commission drew upon numerous agencies and individuals to prepare background materials for the Commission's deliberations. The efforts of the General Accounting Office, the Office of Technology Assessment, and the Department of Health and Human Services are particularly appreciated.

Fifth, the Commission is grateful for the invaluable editorial support provided by Felicity Skidmore and Lynn Lewis, and for the capable production assistance of Leon Stern.

Finally, the analysis presented here would not have been possible without the assistance of numerous consultants. The Commission is particularly appreciative of the efforts of David Kennell, Lisa Alecxih, John Sheils, Marilyn Moon, and Kenneth Thorpe.

[blocks in formation]
« PreviousContinue »