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." "Hospital: and doctors would be encouraged to work together and eliminate expen sive duplications," he added.

The Council acknowledges that is plan is limited. For ex it wouldn't help the unemployed who have lost insurance Cover 1 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 changes Congress made last year and last month. Increased deductibles and copayments are hurting the eiderly 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, excrot. to children. Mine states have limited the frequency of prescriptions one state to a maximum of $30 per month.

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 are 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 yay we have gone about reducine, 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 ir eder:1 bet.ditures for health programs han Farm devoleged and session on Wednesday, Septem! in Room 2322 Rayburn iron

pusuose of on

proposal.

i am convening a briefing , 1982, at 2:00 p.m. Fuilding for the

the legislative

would make possible a reduction Ju the io states required to spend for medicaid matching.

Rather than restraining creases 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 a cost shifting, program.. As such it is a major constructive 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 question:

Charlie

Charles B. Rangel

Chairman

CBR/rll

H.A.L.T.!

HEALTH ACTION TO LIMIT TAKEAWAYS

A CONSTRUCTIVE APPROACH TO HEALTH CARE COST CONTAINMENT

20 QUESTIONS AND ANSWERS

HEALTH SECURITY ACTION COUNCIL
1757 N Street, N.W., Washington, DC

21

1. Q.

A.

2. Q.

A.

3. Q.

A.

4. Q.

A.

5. Q.

A.

6. Q.

A.

What is H.A.L.T.? (Health Action to Limit Takeaways)

It is a comprehensive plan to contain health care costs
in the public and private sectors while at the same time
protecting consumers of care.

Where did H.A.L.T. originate?

It was developed by an expert group advisory to a coalition
of labor, business, civic, fraternal, religious, senior
citizen and farm organizations working together in the
Health Security Action Council.

Why is H.A.L.T. needed now ?

Because under the pressure of declining federal resources
Congress has made deep slashes in needed major health
programs like Medicare and Medicaid, causing hardships
to the elderly, the disabled, the working poor and the
poor, and threatening the fiscal soundness of hospitals,
nursing homes and other institutions which serve the sick
and the handicapped. And it seems clear that further
program cuts are in prospect.

Has not the action of Congress in each of the last two
years put a stop to the runaway inflation in health care
costs?

No. Costs of health services continue to rise at a sub-
stantially more rapid rate than the C.P.I. Most of the
"savings" in the Federal budget achieved by the health
cuts adopted in the last two years have been achieved
through denying people needed health services, or trans-
ferring costs to the private sector, to the states, and
to consumers of care. These are not genuine cost reductions.

But regardless of the merits of the Administration and
Congress' actions, hasn't the problem already been dealt with?

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
financing is like a balloon. If one part, e.g. public
expenditures are squeezed, the rest of the balloon, private
insurance and out of pocket costs, get fatter. The aim of
HALT is to take some of the air out of the balloon.