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EFFORTS TO REDUCE MEDICARE BENEFITS RESISTED: The interest of the
At the December meeting, Chairperson Dr, Otis Bowen listed four issues the Advisory
Several groups cited their opposition to limiting Medicare to only the financially needy. Hacking opposed any means test as a flagrant breach of contract. Henry Nicholas of the National Union of Hospital and Health Care Employees also strenously opposed any change in the social contract between the government and its citizens. Father Harvey of Catholic Charities pointed out that means-tested programs have been far more severely cut than social insurance programs. Speaker after speaker cited the inadequacy of present benefits and their concentration on expensive institutional care rather than on care for the predominant problems associated with chronicity and aging. Numerous witnesses called for coverage of drugs, eyeglasses, dental care and long term care.
Jacob Clayman, testifying for the Leadership Council of Aging Organizations, called for health-system-wide cost controls (public and private) as did Seidman of AFL-CIO
and Glasser of HSAC. Medicare-specific cost containment, said Hacking of AARP, will : not contain costs over the long run. Several groups called for system-wide prospective reimbursement, with assurances of accessibility and quality. At the January hearings, testimony by groups of insurors, providers, and others demonstrated the conflict and uncertainty about what needed to be done. The Health Insurance Association of America (HIAA) affirmed support of the extension of a hospital prospective payment plan to all payors, public and private (although not necessarily the DRG plan). The "Blues" stated their opposition to such extensions too regulatory. The Group Health Association of America (HMOs) reported the problems and increased costs they have experienced with the New Jersey DRG system. Trustees of voluntary hospitals recommended increasing co-payments for people with gross incomes over $40,000. There was general discussion of means-testing, and the HHS staff was asked to look at alternative ways of means-testing for Medicare. NEXT PUBLIC HEARINGS: San Francisco 2/24/83, Chicago 3/9/83. For information, contact the Council at 200 Independence Ave., S.W., Washington, D.C, 20201 (202-7558670).
MEDICARE VOUCHERS AGAIN: Rejected by the Congress in December 1982, the Administration's plan to allow Medicare beneficiaries to opt out of Medicare and receive credits to buy a prepaid insurance plan, H.M.O., of preferred provider program has surfaced again. This is of grave concern because of its potentially adverse effect on beneficiaries and on the long term soundness of the basic Medicare structure.....
A brochure, written for laymen, discussing Medicare vouchers, is available from the Health Security Action Council. l-5 copies, no charge; 6-100 copies, 154 each; 100 or more, $14 per 100; 1000 or more, $130 per 1000. HEALTH INSURANCE FOR THE UNEMPLOYED: Health Security Action Council Chairman Douglas Fraser called on Congress to provide health insurance for unemployed workers and their families. Testifying January 24th before the Energy and Commerce Committee of the House, Fraser, speaking also for the UAW and the AFL-CIO, estimated 25–30 million people lost health protection in 1982. With predictions of slow economic recovery and up to 5 more years of high unemployment rates, Fraser said: "This tragic. by-product of unemployment may .... cost the nation as much in damaged and lost lives as the unemployment itself".
Describing the impact of joblessness on the health of the unemployed and their families,
Costs up 11%, nearly triple overall
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 hybrafit-making_companiesamwbich_8]52. marec 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 dela 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 earthbrund scanner for the patients of Cook County.
Health Security Action Council
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 Cuttacks is such programi a.; Medicinci mini 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, civii rights and farm groups.
Legislation embracing the cost containment proposals will be introduced earl. in the next session of Congress, according to MOLTSN WILHOTZ Chairman of the Health Security Action Council. Naj Winkoricaised in "The only constructive alternative that has been offered thus far to further cuts in programs.
If adopted, the plan would iminediately 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 custs to the level of increases in the Consumer Price Index. Over the past year or so, the health care component of the C?! 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 previous year.
These limits n charges would include the Medicare and Medicaid prograns as well ilds 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 lealth care costs within the general cost increase limits, as well as federal guidelines. These budgets would be determined in annual negotiations anong a state health commission, Medicare intermediaries, providers, insurance companies and consumer representatives.
She is. A.I.T. plan is "comprehensive rather than drastic;" according to Melvin A. Glasser, Director of the lealth Seality Action Council. "It's a systematic rather than a piccome il f':'I och