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Text File | 1994-02-01 | 107KB | 1,786 lines

                        OF NOTE...
                        News to Use

Special Health Care Edition (41-50)                   December 1, 1993
Earl Appleby, Jr., Editor                             CURE, Ltd.

                           Courting Disaster

"Times change. First ladies can now aspire to being 'de facto public
officials,' formal extensions of the president, presumably even
getting themselves into positions to be impeached or, if their
husbands are men enough, fired. The US Court of Appeals for the
District of Columbia made it official: Hillary, as head of the Task
Force on National Health Care Reform, is the equivalent of a
"government employee." (No salary, but look at the benefits.) She
doesn't have to open her meetings to the public." (First Lady's New
First, Suzanne Fields, op ed, Washington Times, 6/28/93)

"Americans want quality health care. To achieve that goal, to assist
the president and Mrs. Clinton in this effort, we must make sure we do
our part...to eliminate excessive costs and delays in setting up an
efficient, effective health care system." --Attorney General Janet
Reno, announcing new guidelines by the Department of Justice to let
health care providers know if they can enter mergers and joint
ventures without violating federal antitrust laws. Mrs. Clinton,
visiting the Justice Department, applauds the DOJ action. Dr. James
Todd, AMA executive vice president, finds it "a good first step," but
calls for further relaxation a federal antitrust laws. (Health Care
Industry Gets Government Antitrust Help, Jerry Seper, WT, 9/16/93)

"Setting a cap like this is a little like a man or woman bringing home
a paycheck but not knowing how many children he or she has to feed."
--Sybil Goldrick, co-director, Command Trust Network, on global
settlement proposed by silicone breast implant manufacturers. CURE
Comment: This is CURE's criticism of global budgeting and spending
caps under so-called health care reform. ($4.75 Billion Proposed for
Breast Implant Cases, Sandra Boodman, Washington Post Health, 9/21/93)

                               Dateline World

"According to the polls, most Canadians are happy with their system,
but the average Canadian does not require significant specialized
care. For those who do there are often problems. In the attempt to
control escalating costs resulting from excessive demand for 'free'
services, waiting lists have lengthened, while technology has lagged.
The Fraser Institute's Morton Walker notes that while 'controls can
keep overall costs down, they do so only by reducing the availability
of advanced diagnostic and treatment technology and by rationing
care.' The Institute reported this year that an estimated 177,297
Canadians were on waiting lists for surgery during 1992." (Should We
Copy Canada? Robert Lee, New American, 11/1/93)

As the health system falls apart and epidemics of diphtheria, typhoid,
measles, and other diseases become rampant, the death rate in Russia
could double in the next five years. (Deaths Outstrip Births and Trend
May Worsen, Washington Times, 11/16/93)

A human resources manager at Medtronic Japan, Yvonne Moore has
sparkling teeth. She should after six visits to her Tokyo dentist.
That's par for the course in Japan, where dentists disgruntled over
government decrees limiting charges clean five or six teeth at a time
at the legal maximum of $40 a visit. (Japanese Rx for Keeping Healthy,
Washington Times, 11/19/93)

                      Health Care Plans and Pans

"I can understand how many of you feel when, instead of being trusted
for your expertise, you're expected to call an 800-number and get
approval for even basic medical procedures from a total stranger. It
remains a mystery to me how a person sitting at a computer in some
air-conditioned office a thousand miles away could make a judgment
about what should or should happen at a patient's bedside in Illinois
or Georgia or California." --Hillary Clinton, addressing the American
Medical Association. (Hillary Clinton Takes Her Case to AMA, Dana
Priest, Washington Post, 6/14/93)

"In a perverse way, Raymond Bridge knew he was fortunate when doctors
decided after five years that his daughter, Edith, suffered from a
physical disorder rather than a mental illness. Now, at least, his
insurance company would pick up the cost. Bridge, a federal worker who
lives in northern Virginia, exhausted the lifetime caps on five
different insurance plans before the diagnosis was changed." (Mental
Health Advocates Seek Equal Insurance for Mentally Ill, MJ, 6/21/93)

"Public confidence in the Clinton administration's ability to overhaul
the nation's health care system has declined sharply, with fewer than
half of all Americans interviewed in the latest Washington Post-ABC
News poll [45 percent] expecting the president to make significant
progress on health care reform." (Americans in Poll Doubt Health Plan,
Richard Morin, Washington Post Health, 6/22/93)

"It seems the Americans have realized that the country with the most
expensive health care system in the world has little to learn from the
country with the second most expensive system. If we didn't have you
people next store spending a lot more money than we are, we'd look
pretty bad." --Brian Ferugson, Canadian health economist. (Canada's
National Health Plan, Anne Swardson, Washington Post Health, 6/22/93)

"The Clinton administration insists that its upcoming reform package
will preserve the rights of Americans to choose their own physicians.
But some House members are concerned that in the rush to mollify
conflicting constituencies--doctors, insurers, hospitals, and
corporations--consumers may be left out in the cold." CURE Comment:
Not just House members. (Be Careful with Health Care, Jack Anderson
and Michael Binstein, op ed, Martinsburg Journal, 6/29/93)

"Clinton pitched elements of his still-unrevealed health reform plan
to a group of skeptical small business owners...But business owners
weren't lining up in support...Terry Neese, owner of an Oklahoma City
personnel agency, said that if small businesses are required to
provide health insurance, 'I think you are going to see hundreds of
thousands of small business owners close their doors.'" (Businesses
Get Pep Talk on Health Reforms, Judi Hasson, USA Today, 6/30/93)

At their spring meeting in New Orleans, LA, the National Conference of
Catholic Bishops (NCCB) unanimously approve a resolution endorsing the
following criteria for health care reform: respect for life, priority
concern for the poor, universal access, comprehensive benefits,
pluralism, quality, cost containment and controls, and equitable
financing. (Bishops Discuss Health Care, A.J. Matt, Jr, Wand, 7/1/93)

Over a dozen groups, including the American Association of Retired
Persons, the AFL-CIO, and the American Hospital Association, agree to
coordinate a nationwide campaign to push the Clinton health care
package. "The White House can't do it for legal reasons. The DNC can't
do it for partisan reasons," confides John Rother, the AARP's
legislative director, who is filling in as president of the newly
incorporated nonprofit Health Project. The group was "nurtured into
existence" by Sen. John D. "Jay" Rockefeller the IV (D-WV). CURE
Comment: Mr. Rother's protestation that Democratic National Committee
(DNC) partisanship precludes such a drive notwithstanding, "the DNC
still plans a grassroots media and educational campaign." (Groups to
Promote Clinton's Health Plan, Dana Priest, Washington Post, 7/1/93)

"The medical costs that President Clinton hopes to tame are rising
fastest because of administrative expense, not high-tech equipment or
medical salaries, the Annals of Internal Medicine reports...The study
blames government regulation." (Health Costs, USA Today, 7/2/93)

"Giving pregnant women health insurance might not improve their health
and might increase the proportion of women undergoing Caesarean
sections, a study [of Massachusetts' Healthy Start program] found."
CURE Comment: Note the implied assumption that Caesareans are  per se
unnecessary. (Poor Pregnant Women Not Being Helped by Insurance, Study
Says, Martinsburg Journal, 7/10/93)

"All Americans are living longer, but the poor and ill-educated are
losing ground to people who are better off a study found... The study
in [the] New England Journal of Medicine raises questions about
whether changing the nation's health care system will change the
disparities. Differences in death rates between the classes increased
between 1960 an 1986, a time when Medicaid programs were set up to
improve access to care for the poor, researchers [at the National
Center for Health Statistics] found." CURE Comment: Recall the
previous item. Suddenly a plethora of studies tell us poor folks do
not benefit from increased access to health care. But far from
demonstrating that  the disadvantaged do not benefit from increased
care per se, they stand as indictment of the quality of care poor
Americans receive. (When Will You Die? It Could Depend on Your
Paycheck, Martinsburg Journal, 7/10/93)

US Rep. Bob Wise (D-WV) says the June 30 House vote on the Hyde
amendment restricting federal abortion funding points to "the so many
different emotions" on abortion and taxpayer funding. "I don't think
this should be an issue in the health care package. It complicates and
confuses things." Wise voted against the Hyde amendment, while West
Virginia's other Congressmen voted with the overwhelming majority to
retain it. (Wise Against any Abortion Clause in Clinton Plan, Scott
McCaffrey, Martinsburg Journal, 7/11/93)

"The people who brought you Bill Clinton's winning presidential
campaign are turning their attention to selling his health care
reforms. Once the plan is released, probably this fall, the Democratic
National Committee, and its offshoot, the National Health Care
Campaign, will embark on a coast-to-coast blitz designed to nudge
people into pressuring their representatives in Congress to vote for
it...Other groups are getting ready to help with the sales job: The
AFL-CIO has 287,000 members lined up to run phone banks and generate
mail in support of Clinton. The American Association of Retired
Persons has trained 1,400 members to talk up Clinton's reforms." CURE
Comment: Without having been told what they are? Or do they know
something you and I don't? Sounds like blind faith. (Down to the
Grassroots, Videos, Buttons, T-Shirts, Judy Keen, USA Today, 7/12/93)

"Nothing frightens the cost-cutters quite like calculating mental
health care expenses. Direct costs from those suffering from chronic
mental illness in 1908 were estimated at $7.4 billion, according to
the American Journal of Psychiatry. That sum represented 43 percent of
mental health care that year, but covered only 7 percent of the
country's mentally ill." (Mental Health Shrinkage, Suzanne Fields, op
ed, Washington Times, 7/12/93)

"The White House, the Democratic Party, and their supporters are
gearing up to spend millions of dollars to win acceptance of President
Clinton's health care reform in Congress and across the nation. As
soon as Clinton releases his plan, probably in September, a new slogan
will appear on bumper stickers, T-shirts, buttons, and yard signs:
'Restore Peace of Mind--Support the Clinton Health Plan.'...The White
House won't say how much it will spend or where the money is coming
from. The Democratic Party will raise hundreds of thousands from
special interests. Political action committees will bundle donations--
all destined to sway Congress." (Millions to Be Spent on Health Care
Blitz, Judy Keen, USA Today, 7/12/93)

"The government helps to pay the medical bills of the elderly and poor
through Medicare and Medicaid. It also helps to pay the health
insurance premiums of the working population through the tax code.
Employer-paid health insurance premiums are excluded from employee
income for tax purposes, at a current cost to the Treasury of $43
billion. If the goal is to get at the deficit by putting a lid on
entitlements, why not also these?" CURE Comment: CURE opposes taxing
health care benefits of working men and women as though they were cash
income. (Those Entitlements, editorial, Washington Post, 7/12/93)

"It is easy to get lost in the arcane language and concepts used to
discuss this fundamental issue. So after digesting the details
described here, step back for a moment. Lurking behind such
technicalities...are larger questions...questions about Americans'
values...Do Americans believe in taking care of those who cannot take
care of themselves, and how much are they willing to pay to do it?...
Will Americans accept a change that might mean that some people might
pay more than they have now for health care or have less choice over
which doctor they visit?...Do Americans believe that government
bureaucracy can be trusted to play a role in something as essential as
health care?" (Framework of the Health Reform Plan Is Set, Dana
Priest, Washington Post Health, 7/13/93)

"Many employers offer employees a choice of plans and pay the full
cost of any plan the employees choose, in part because it is tax-free
to the employee...The best solution to this problem is for employers
to offer their workers choices that include the most efficient HMOs,
and then contribute to toward the employees' purchase of coverage only
as much as it costs to subscribe to these lowest-priced plans."
-Alain Enthoven, co-founder Jackson Hole Group. (CURE Comment:
"Lowest-priced" is the rich man's way of calling what the rest of us
know as "lowest-care." Reconsider the previous item. The next step in
the forced march to checkbook euthanasia will be denial of any choice
but care-denying "managed care." (Good Cap, Bad Cap, Enthoven, op ed,
Washington Post, 7/13/93)

Hawaii is the only state requiring employers to pay part of their
employers' health coverage. As such, Hawaii offers a look at what life
might be like under the Clinton administration plan. While 55% of
small businesses surveyed by the Kaiser Family Foundation would
support Hawaii's employer mandate law if proposed today, many admitted
finding undesirable ways to offset the cost. Almost four in 10
employers said they had to reduce the number of employees, and one in
10 said they have hired people to work less than 20 hours per week.
55% said they had restricted wage increases, and 33% acknowledged
reducing other employee benefits. 60% raised prices to offset
insurance costs, and one in five knew of firms that had failed due to
the insurance burden. (Clintons Soak Up Sun, Surf, and Health Plan,
Dana Priest, Washington Post, 7/14/93)

"President Clinton's health care plan has not even made it to Capitol
Hill and already the health and insurance industries have increased
their political action committee donations by 20%, giving $2.2 million
in the first five months of 1993, most of it to key health committee
members." (Health Plan Worries Spur PACs, Dana Priest, WP, 7/14/93)

"As you read through the plan you'll see all sorts of ideas cooked up
by the bureaucrats in their little committee rooms...buried deep...are
sleeper clauses that use the word 'doctor' followed by a paragraph
explaining that the word with other terms such as 'physician
assistant,' 'nurse practitioner,' 'chiropractor,' and so
on...Remember, this thing is written by bureaucrats who know how to
package garbage so people think it is a gift." --Glen Griffin, MD, one
of the practicing physicians who have actually reviewed the cover
Clinton health care reform plan. (Varuba! Communique, 7/23/93)

"This coming Saturday, a group of friends and neighbors will hold a
car wash and bake sale at the St. John's United Church of Christ in
Sabillasville, MD. The proceeds will go to help Devin Weant, a 3-year-
old who needs an operation to remove a massive growth on his spinal
cord. We mean no disrespect to the concerned citizens who'll be
participating in these activities, but this isn't the way to fund
health care in America." (Help for the Uninsured, ed, MH, 7/27/93)

According to a high-ranking administration health official, the United
States has too many doctors, and should trim their ranks by reducing
the number of residencies. But the president's health care reform plan
may disregard the problem because it's "too complex," advises Dr.
Philip Lee, head of the Public Health Service. Other issues apt to be
ducked, in Lee's view, are medical malpractice and workers'
compensation. (Doctor Explosion May Be Ignored in Health Reform, Karen
Riley, Washington Post, 7/28/93)

"Sad to say, but we Americans are no healthier than we were last year,
and we're certainly not getting any younger. But health care stocks--
the darlings of Wall Street two years ago because of an aging
demographic--have moved so far out of favor over fears of President
Clinton's impending health care reform that many are now shunned."
(Health Care Stocks Rebound from Scare, Linda Stern, WT, 7/28/93)

"The health care crisis hit home the other day. We received a packet
in the mail from our local health maintenance organization urging us
to approve its takeover by Humana, a national health care company. A
'no' vote, we were warned, might jeopardize 'the security of your
health coverage and your doctor relationship.' This was put in bold
type, just in case we missed the point. Agree or face the
consequences. Pow, right in the kisser." (The Day the Health Care
Crisis Hit Home, Robert Samuelson, op ed, Washington Post, 7/28/93)

The Oregon state legislature approves a 10-cent-a-pack cigarette tax
to provide Medicaid coverage to 120,000 and gave businesses until
March 1997 to provide health coverage to 280,000 uninsured employees.
Business with 25 or less workers have until January 1998. (Oregon
Legislature Approves Health Plan, Washington Times, 8/6/93)

"Not too many months ago there was great hope, indeed optimism, in the
mental health community that health care reform would enable us
finally to eliminate one of the major forms of discrimination against
persons with mental illness--the historic lack of decent, equitable,
and comprehensive health insurance. There was hope that people with
mental illnesses would be included on a par with physical illnesses in
the proposal. This courage and determination shown by the Clinton
administration has recently encountered opposition. Hope has begun to
fade, and optimism has given way to apprehension." --former First Lady
Rosalynn Carter, chair, Mental Health Task Force, Carter Center,
Atlanta, GA. (Don't Slight Mental Health Benefits, Carter, op ed,
Washington Post, 8/9/93)

"Unless we reform the health care system of this country, we can never
take the deficit down to zero. We cannot have very great issue of the
day...scheduled around the next trip to New Hampshire for a primary
still four years away." --Pres. Bill Clinton, in Charleston, WV.
"Maybe he doesn't want cooperation--at least not with me. Rightly or
wrongly, this big vote on the economic package is going to make it
tougher on health care, because somehow you've got to pay for it, and
you have to go either taxes or mandates." --Sen. Robert Dole (R-KS),
who is planning a NH vacation. (Clinton Begins Health-Care Push, Judi
Hasson and Judy Keen, USA Today, 8/10/93)

Lamenting that "positive arrangements...with your neighbors and even
your competitors" are being chilled by fear of antitrust laws, Hillary
Clinton promises 4,000 hospital execs attending the American Hospital
Association convention: "We not only heard you. We're going to do
something about that." But AHA president, David Dickson, advised
reporters that proposals to force people to buy their insurance
through huge purchasing cooperatives "starts to look like what we call
a single-payer system in drag, meaning there's some single power body
that has probably inordinate influence over the marketplace. The
alliances should start small. having companies with 50 employees or
less. Let's see if we can make that work." (Hillary Gives Hospital
Executives Reason to Back Health Reforms, Washington Times, 8/10/93)

"There's a monster on the lose in America. It is big. It is
unpredictable. And it is eating everything in sight--our security, our
economy, our future. No, I'm not talking about something from Jurassic
Park. The dinosaur I'm talking about is our nearly fossilized health
care system." __--Donna Shalala, Secretary, Health & Humans Services
(HHS). (People Want Health Security, Shalala, op ed, USAT, 8/10/93)

"The Democratic Congressional Campaign Committee...gave House members
a district-by-district battle plan for selling the president's health
care legislation, a sign that a coordinated grass-roots campaign on
the issue has begun. Called 'Running a Campaign for Health Care in
Your District,' the plan includes a time line of upcoming events,
advice on how to identify supporters, and a step-by-step guide that
amounts to a 'how to' campaign manual. According to the DCCC's
campaign packet,...members should...visit a hospital during shift
change...Let elderly constituents (and their families) know you are
committed to them by visiting...home and community based agencies."
CURE Comment: To call this highly orchestrated partisan campaign
"grass-roots" is Orwellian. Frankly, we'd be more impressed by long-
term commitment to improving the quality of health care health than by
such drive-by (camera) shootings victimizing the American public.
(House Democrats Get Battle Plan for Selling Health Care Reform Back
Home, Dana Priest, Washington Post, 8/11/93)

"The treatment of mental illness should be given parity--the respect
it deserves--with all other medical and surgical conditions in the
Clinton administration's proposed health care system. Unfortunately,
the Administration seems likely to offer too few days of inpatient and
outpatient treatment at too high a cost. Unless it is considered
natural and acceptable for people to visit a mental health
professional when they feel emotionally ill, many of those in Mr.
Foster's situation will continue to go without care." (Politics Didn't
Kill Foster, Drs. Elizabeth Hersh and Susan Lazar, op ed, NYT, 8/12/93)

"Some 30 million Americans work for employers who give them no health
benefits. Those employers are getting a free ride, much of it at the
expense of other employers who provide health insurance...Two-thirds
of all Americans currently have health insurance through their jobs or
the jobs of someone in their family...The tradition of providing
health insurance through employers is now firmly established in this
country. That creates a dilemma. Most of the jobs with no health
protection are at the lower end of the wage scale. The average
spending on health care...for a person working full-time...comes out
to about something like $1.70 an hour...That's a pretty substantial
addition to the minimum wage of $4.25 an hour and would inevitably
mean fewer jobs for unskilled workers. The administration might want
to think about that before it pushes ahead with its proposal to
increase the minimum wage...One possible way to ameliorate the
effects...might be to subsidize health insurance with public funds at
the low end of the wage ladder. But that's expensive, and subsidizing
low-wage employment raises other questions of fairness...The reform
plans need to be judged not only by their impact on health care but
also by their broader impact on the way the whole economy operates."
(Health Care's Free Riders, editorial, Washington Post, 8/13/93)

"Hans Konig believes that removing personal responsibility from
important decisions will relieve us from life's burdens and reduce the
sharpness of life ('A Different Kind of National Sharing,' op-ed, Aug.
3). Mr. Konig desires a society with unlimited health care, guaranteed
financial independence in retirement, and unrestricted access to
unemployment payments equal to the average wage. The economic lunacy
of Mr. Konig's argument is obvious. But his theory that government can
male life more pleasant for everyone through central control...has
taken root in the American culture recently...There are arguable
reasons why the United States should create a national health plan or
a national retirement plan--some based on natural rights, some...on
correcting past injustices. But Mr. Konig's idea that we need national
controls in order to create a complacent and passive society is the
most dangerous and the most damnable of all." --Todd Kice, Washington,
DC. (The Cost of Central Control, Kice, letter-editor, WP, 8/16/93)

"Health care reform as most define it involves two contradictory
goals. One is controlling costs, the other expanding access to cover
the uninsured. Both will likely require some increase in the federal
role. A lot of the complication in the apparent administration plan
stems from an effort to exercise the necessary federal influence
obliquely at one remove. In effect, it's a form of political
disguise...The debate needs above all to be clear. No trivializing of
the subject, no demonizing of the health care industry or the
government, either one." (The Health Care Debate, ed, WP, 8/16/93)

"Pres. Clinton came before the National Governor's Association today
to offer his broad vision for reforming the nation's health care
system, but instead found himself defending his plan against charges
that it would crush small businesses...Sounding beleaguered from the
partisan battle he fought to pass his economic program, Clinton said
health care reform will only succeed if it has bipartisan
support...Minutes earlier, one of the most formidable critics of his
emerging plan, National Federation of Independent Business Vice
President John Motley, described the lack of specifics as
'frightening.' He said the 'untried, untested' proposal'...will be
like 'tying small businesses to a sled and pushing them down a
mountain, hoping they'll remain upright.'" (Clinton Defends His Health
Plan Before Governors, Ruth Marcus and William Claiborne, WP, 8/17/93)

"Daniel Patrick Moynihan, that rare member of Congress who isn't
embarrassed to be called an intellectual, has a new passion. It's
called Baumol disease, and it could be devastating to Pres. Clinton's
health plan. Baumol's disease is not a deadly virus like TB or AIDS.
It's an economic theory, named for its discoverer, William J. Baumol
of New York University. The theory holds that, while productivity has
increased dramatically in most parts of the economy, it has languished
in professions such as the arts, teaching, and health care, 'which
require a high level of personal input.' As a result, the costs of
these activities just keep going up and up. In fact, Baumol himself
believes that within less than two generations, health care and
education alone will consume more than 60 percent of America's gross
domestic product." (Why Getting a Handle on Health Care May Be
Impossible, James Glassman, Washington Post, 8/20/93)

According to a study by the consulting firm Lewin-VHI, the net cost to
the taxpayer of providing health insurance to the uninsured under
Pres. Clinton's health care plan would be $42.7 billion a year.
John Schiels, who conducted the study, said that costs to employers
would be another $24 billion annually. He warned that these estimates
do not include the cost of provisions the administration has hinted it
will propose but not committed itself to. (Study Cites Cost to Cover
Uninsured, Spencer Rich, Washington Post, 8/20/93)

"Even with further cuts...health reform could wind up costing the
federal government an additional $75 billion a year. The biggest
political question of 1993--if not of Clinton's presidency--is where
that money will come from. Taxes that are actually called taxes will
have to be part of the equation. (Ira) Magaziner, First Lady Hillary
Rodham Clinton, and their advisers considered--and rejected--a long
list of new taxes: on sales, on alcohol, on firearms, on lavish
corporate health benefits, on pollution...For the moment, all of these
options have been rejected. The only certain one is a hefty new tax on
cigarettes; a $2-a-pack levy would raise perhaps $20 billion a year.
The administration is still considering taxing the 'windfall' profits
that doctors and hospitals could make if they are paid for care now
donated to the poor." CURE Comment: Consider the logic of this last
proposal. Does it really make more sense to pay someone to do a good
deed and tax the money you pay him? Only at the White House and on
Capitol Hill. (Another Taxing Dilemma, Howard Fineman, Nwk, 8/23/93)

"As Washington prepares to...reform the health care system--policy
makers should keep in mind a modest proposal from the University of
Wisconsin's Donald Kettl. In...'Improving Government Performance: An
Owner's Manual,' Kettl...suggest(s) that no federal program be enacted
without a detailed 'management impact statement'...lay(ing) out
whether states, counties, employers, or anybody else could
realistically carry out the byzantine laws crafted in the nation's
capital...Such statements could...end up being the  government's
answer to roach motels: Bad ideas might check in, but they won't check
out....A management impact statement...might be enough to send Clinton
and his health team back to the drawing board. The president's top
advisers are thoughtful people, and some are already privately voicing
fears that their intricate plan might only make matters worse. They
won't need a political impact statement to know what that could mean
for 1996." (Health Reform's Bitter Honey Pot, Susan Dentzer, op ed, US
News & World Report, 8/23/93)

"Marsha Romano, like many of the nation's 5.7 million small-business
owners, fears Pres. Clinton's health-care reform plan is taking dead
aim at her livelihood...Says Romano, a print shop owner who doesn't
provide health coverage for her five workers. 'I'm afraid...I think
everybody should have health insurance,...but I don't know if I can
afford to foot the bill.'" (Small Businesses Sound Alarm Over Health
Insurance, Judy Keen, USA Today, 8/26/93)

Under the Clinton health plan, illegal aliens will receive limited
benefits, but Secretary of Health and Human Services Donna Shalala
stresses they will not be eligible for the full benefit package.
(Health Care for Illegal Immigrants?, NCR, 8/29/93)

"I'm not interested in taxes, but it seems to me we can't say. 'Well,
never are you going to touch the so-called sin taxes,'" says Senate
Minority Leader Bob Dole (R-KS) echoing the conciliatory tone adopted
earlier this month at the national governors conference. "We may be
able to compromise. If it's a give-and-take thing, if the presidents
willing to give and take, and we're willing to give and take, we could
end up with a pretty good health package." Sen. Dole challenged Pres.
Clinton's intention to exclude illegal aliens from medical coverage,
claiming it may be necessary for American taxpayers to pay for health
care for aliens entering the country illegally in order to protect
legal immigrants and even U.S. natives who work beside them. Gov. Pete
Wilson (R-CA) seeks a constitutional amendment barring such benefits
for illegal aliens. (Dole Oks Sin Taxes to Cover Health Care, Major
Garrett, Washington Times, 8/30/93) Stay 'Tooned: Vacation time for
Senator Dole: Dole at podium on water skis, being pulled by boat: The
president says he wants "bipartisanship." I'm for that too...I just
happen to disagree with his definition of the word...Because a
successful effort on health care would give me nothing for the '96
presidential race...The president would get all the benefit for his
leadership. When he says "bipartisanship," he means cornering and
coopting me politically...When I say it, I mean humiliating him and
emerging perceived as the REAL leader...A high stakes cat-and-mouse
game...in the true spirit of bipartisanship. (Stamaty, 1993)

"Everyone can get into the fraud game. Doctors and lawyers often work
in tandem to alter medical records, fake injury reports, and file
claims for services never rendered. At hospitals, billing clerks
discretely boost the prices of low-ticket items, charging, say $4.15
for an aspirin that costs 11 cents. 'A lot of the billing frauds seem
insignificant,' says Ed Lueckenhoff, chief of the FBI's health-care-
fraud unit. 'But if you multiply that times thousands, it adds up to a
lot of money. And this is a systematic scheme that is taking place
with thousands of patients and thousands of procedures.' While
fraudulent claims are a top priority in the FBI's white-collar-crime
division, the White House has yet to target such scams to lower the
cost of national health. Perhaps it should. According to the National
Health Care Anti-Fraud Association, bogus claims account for between
3% and 10% of the nation's $9 billion health bill...Many health
experts wonder why the First Lady's task force is overlooking the
potential windfall that would result from a crackdown on fraud."
(Healthy, Wealthy, and Fraudulent, Jill Smolowe, Time, 8/30/93)

Administration sources say most health plans will be "managed care"
arrangements. Many experts believe most Americans would get their
health care from mega-organizations resembling existing health
maintenance organizations (HMOs). CURE Comment: Managed care and HMOs
are not the best health care deliverers for persons with disabilities
or others who have or will have significant--read "expensive"--
physical or mental health needs. On the other hand, they are ideally
suited to rationing and other forms of checkbook euthanasia. (Clinton
Sets 1988 for Health Reform, Dana Priest, Washington Post, 9/2/93)

Huddling with Hillary and 15 top aides for the third time in as many
days, Pres. Clinton hammers out details of his massive health care
plan, which he'll reveal in a nationally televised speech to a joint
session of Congress the week of September 20.  According to the White
House, the plan will contain mechanisms to restrain health care costs,
but the president says mandatory price controls will not be one. State
monitoring and prosecution of those Hillary has dubbed "profit-
gougers" will be included in the plan, as will a ceiling on total
health care spending (a.k.a. global budgeting), and Medicare and
Medicaid limitations. While the financing is undecided, it will likely
include a steep cigarette tax, says White House press secretary Dee
Myers, who adds, "We'd like to get as much of it done this year as we
can. We're going to move as quickly as we can. But it's complicated,
and I think we're painfully aware of that." (Clinton Says Health
Reform Won't Employ Price Controls, Karen Riley, WT, 9/3/93)

Buoyed by reports that the White House will not impose short-term
price controls when it unveils its health care reform plans later this
month, drug company and other medical stocks rallied sharply. But the
enthusiasm of health industry business leaders is tempered by the
threat of long-term price controls, likely by limiting annual
increases in insurance premiums to the overall rate of inflation.
(Health, Drug Stocks Up on Price Control News, Kathleen Day,
Washington Post, 9/3/93)

After considering cigarette taxes from 50 cents to $2 a pack, Pres.
Clinton tells staff he 's leaning toward the low-end of the scale
so that tobacco won't have to shoulder the entire financial burden of
his health plan. Administration officials and members of Congress say
the development is easy to explain: Clinton needs congressional votes
from tobacco-producing states. Anti-smoking advocates are highly
critical of a cigarette tax in the 50 to 75 cents range. To impose
that level of tax "would be a great mistake, " says former surgeon
general C. Everett Koop." (President Leaning Toward Smaller Cigarette
Tax Increase, Dana Priest, Washington Post, 9/3/93)

Meanwhile, as the Clinton administration ponders its cigarette tax
increase, Maryland officials announce a sharp rise in their state
tobacco tax has persuaded thousands to stop smoking. Gov. William
Schaefer (D), who championed the higher tax, said he was pleased to
see it "has had an immediate effect in reducing cigarette smoking in
this state. This will help us a great deal in our fight against
cancer." (Tax Increase Cut Smoking, Maryland Finds, Charles Babington,
Washington Post, 9/3/93)

"Small business claims the proposed payroll tax to pay for health care
coverage will cost American jobs. The issue must be seen in a social
and economic context. At the start of 1989 only three industrial
nations did not have national health insurance. South Korea was the
first of the nations to take action...Only two nations now lack
national health insurance--South Africa and the United States. It is
time we break company with South Africa. Affordable basic health care
is a basic human right." --Steven Eastaugh, Washington, DC. (Universal
Health Care Won't Hurt Small Firms. Eastaugh, let-ed, WP, 9/3/93)

Announcing his opposition to an increase in the liquor excise tax on
NBC's Meet the Press, Senate Majority Leader George Mitchell (D-ME)
forecasts, "I don't think there will be any increase in the tax on
alcohol in any form." Meanwhile White House officials say the
administration will tax employees and employers on health benefits
exceeding Clinton's "basic benefits" package. CURE Comment: We oppose
taxing the health insurance benefits of American workers and their
families as a regressive and repressive social policy designed to
force all save the rich into care-cutting managed care schemes.
(Senate Democratic Leader Predicts No Tax Hike on Liquor, MJ, 9/7/93)

"Health care is no exception to the rule that 21st Century complexity
overwhelms big bureaucracy, whether in government or IBM. Indeed,
health will prove the most difficult, for every poll shows Americans
value health above every other private good, and will be unlikely to
relinquish control over such a valued goal." --Donald Devine,
chairman, Citizens Against Rationing Health (CARH). (Economic
Colossus, Devine, op ed, Washington Times, 9/8/93)

"Like scholars guarding the Dead Sea Scrolls, White House advisers
yesterday traveled to the Capitol to give a handful of congressional
aides a peek at their master plan for health care reform. So closely
held were the writing that aides had to give back a give-page summary
before they left the briefing room...'You can come, look, and read,'
one staff worker said, citing administration ground rules for looking
at the document. 'But you can't make copies or notes.'" CURE Comment:
Do you think we--the American people--might get to see it a few days
before the politicians impose it on us? Or is that too democratic?
(Hill Aides Get a Peek at Health Plan as Critics Start to Peel Off
Gloves, Dana Priest, Washington Post, 9/8/93)

"Economic regulation of health care is hazardous business and
regularly proves iatrogenic. Japan's system of universal health care,
including free care for the elderly provides sobering evidence. "
(Regulatory Hazards, Bruce Fein, Washington Times, 9/8/93)

"The Clinton administration estimates a cost of $419 billion over six
years to fulfill its promise of guaranteed health coverage for all
Americans government officials said Wednesday. It is counting on
massive savings from Medicare and Medicaid and so-called sin taxes to
pay for many of the reforms...The size of the Medicare and Medicaid
savings--$238 billion form 1996-2000--has made some Democratic
lawmakers apprehensive that Clinton may be coming down to hard on
government health programs." CURE Comment: We share that apprehension.
(Health Care Reform Could Cost $419 Billion, Morning Herald, 9/9/93)

"Taking $238 billion out of Medicare and Medicaid is a very bad joke.
If we say, 'it's all or nothing,' I say it's nothing until '95 or
'97." --Gail Wilensky, former health care adviser to President Bush.
(Moderate Health Plan Predicted, Teresa Novellino, MJ, 9/9/93)

Trying to deflect criticism by health care specialists that Pres.
Clinton's health care plan will force Americans to choose between cuts
in medical services or higher costs, Vice President Al Gore tells
NBC's "Meet the Press," "We have a good plan that is going to...bring
down cost while expanding coverage." But on ABC's "This Week," Sen.
John Chafee (R-RI), counters, "Clearly the costs are going to up under
this plan," while Dr. Nancy Dickey, of the American Medical
Association, conveys her concern about the administration's proposed
spending caps "because they put the dollar in front of the patient's
care." (Gore Lists Benefits of Health Reforms, WT, 9/13/93)

While other special interest groups are cutting back on their
political contributions, the health care industry is sharply
increasing its donations to members of Congress, particularly those
who serve on the Senate and House Committees that will handle the
president's health care plan. "Special interests want to influence the
debate and prevent Americans from obtaining real reform of the health
care system," charges Michael Podhozer of the Citizen Action lobby.
(Health Lobby Ups Political Donations, Washington Times, 9/13/93)

"The health care plan involves the possible restructuring not of a
list of government programs but of a seventh of the economy. The
administration has lately seemed to be saying in its zeal that it will
be possible to achieve great gains in health care reform at minimal
cost. At the federal level, the background briefers suggest, reform
will not require a major tax increase and, indeed, will help to
produce a major spending cut. The cut in existing health costs will be
so large that it will help not only to finance universal health care
coverage but also to reduce the deficit--and all without a reduction
in existing health care benefits. Will it really be that easy?" (The
Cost of Health Care Reform, editorial, Washington Post, 9/13/93)

"What makes health care reform a truly unique enterprise for
government is that it touches on the deepest economic, civic, and
private concerns of the American people. These range from the
consternation the public shows when it is confronted with the
relentless rise in the GDP [gross domestic product] that is consumed
by health care, to the unease (and guilt) people feel when they
finally focus on the plight of the millions of Americans who have no
health insurance and most indifferent health care. Most personally,
the prospect of reform is deeply troubling to the majority of citizens
who are satisfied with their own medical care and fear that it will
change for the worse under a new system." (Between the Acts, Then on
to Health Care, Kermit Lasner, op-ed, Financial World, 9/14/93)

Some Democrat loyalists say the Democratic National Committee (DNC)
dropped the ball when National Health Care Awareness Day, scheduled
for September 13, was canceled for lack of planning. The event was to
have been the opening salvo in the DNC's $30-million campaign to push
Pres. Clinton's health care plan.  An earlier attempt to establish a
nonprofit organization to lead a bipartisan effort was abandoned after
critics charged its nonprofit status enabled it to avoid federal
campaign finance reporting requirements and challenged the DNC-funded
group's bipartisan nature. (DNC Cancels Event Set to Push Health
Reform, Dana Priest, Washington Post, 9/14/93)

Most of the 9 million enrollees in the Federal Employees Health
Benefits Program (FEHBP) would be forced to move into the
administration's health care plan, congressional leaders were advised
in an off-the-record briefing yesterday. In his daily feature, "The
Federal Diary," Mike Causey concludes, "It remains unclear whether
they or federal workers would be better or worse off." (Health Care
Horizon, Mike Causey, Washington Post, 9/14/93)

Those who employ nannies, housekeepers, cooks, and other domestic
workers--many of whom claim to have just learned of their obligation
to pay Social Security taxes on their employees in the wake of
"Nannygate"--would have to pay a share of their workers health
insurance premiums under the administration's health plan. (Premium
Planned for Housekeepers, Albert Crenshaw, Washington Post, 9/14/93)

"Treasury Secretary Lloyd Bentsen talked up health care reform
yesterday to some of the staunchest opponents of the plan Pres.
Clinton expects to unveil next week: small-business owners. And they
weren't buying it. 'We cannot absorb the cost of providing health
care,' said Stephen E. Elmont, chairman of the National Restaurant
Association, whose members gathered at a conference in downtown
Washington where Bentsen spoke." (The Reformer Meets the
Restaurateurs, Kathleen Day, Washington Post, 9/14/93)

"To justify their attempt to completely overhaul a highly complex
system, the president and Mrs. Clinton have pointed to polls showing
more than 80% of Americans think this country faces a health care
crisis. But, I caution the president to look beyond the first poll
number: Those same polls find those same Americans are satisfied with
the quality of care they receive and almost the same number are
satisfied with their insurance coverage. I have serious reservations
about embarking on a course of action that will completely change how
every American receives health care and how every health care
professional provides that care. Should we engage in a national social
experiment with our current lack of practical knowledge about what
will and will not work? Does it make sense to impose on Americans a
new system that is purely theoretical? The answer to both questions is
'no.'" --Rep. Thomas J. Bliley Jr. (R-VA), ranking minority member,
House health and environment subcommittee. (The GOP Health
Alternative, Bliley, op ed, Washington Times, 9/16/93)

"A famous painting (worth a thousand words) by Norman Rockwell from
the cover of the Saturday Evening Post of March 15, 1958 illustrates
with mellow remembrance and good humor the longing for a good
physician. A young boy stands on a chair, his trousers down, his
backside exposed to the doctor, waiting for an injection. To alleviate
the anxiety and embarrassment and to seek reassurance that he's in
good hands, the boy studies the small print of the doctor's degree
hanging on the wall just above him. What he wants is what all little
boys (and the rest of us) want from the doctor--care and trust." ('We
the People' and the Debate on Health Care, Suzanne Fields, op ed,
Washington Times, 9/16/93) Stay 'Tooned: A man, labeled Special
Interests, is in a position similar to the boy's above towards a
doctor who looks like Bill Clinton, with a syringe labeled Health
Care. The man, pulling his hair out, screams: Aaarrrgghhh!!! The
Pain!! Stoppit, pleeeasstoppit! You're killin' me doc!! Oooooch! Ouch!
Ach! Eech! To which the doctor replies: Cool it, I haven't even
touched you yet... (Stephanos, USA Today, 1993)

Small businesses owners convey their concerns to Pres. Clinton during
his photo op visit to a northeast Washington hardware store. Daryl
Routzahn, whose family runs a furniture store in Frederick, MD, was
direct: "We cannot finance your proposed 7.9% payroll tax on the backs
of small business without job loss. A mandate will hurt our struggling
economy," he said, concluding, "Mr. President, small business cannot
afford this plan. Eliminating jobs and tripling my costs will not work
in today's economy." In response to a late question, the president
acknowledged, "Some will pay more, I don't want to minimize that."
(Clinton Hears Tales of Health Care Woes, Ann Devroy, WP, 9/17/93)

"The Federal Employee Health Benefits Program (FEHBP), is probably the
best health insurance system in America today and the best model for
the future. The reason, ironically, is that it's based on the same
principles as American business: competition and consumer choice.
Unfortunately, the incredibly complicated plan the Clinton
administration will unveil on Wednesday will bear only superficial
resemblance to the FEHBP, which holds down costs and provides good
service for 9 million federal employees, retirees, and their
families." (Uncle Sam's a Smart Buyer in One Area: Health Care, James
Glassman, Washington Post, 9/17/23)

"Pres. Clinton's prescription for the nation's health care system is a
big leap into the unknown: a revolutionary, untested, controversial
blueprint for changing the way every American gets health care. It's a
huge gamble for Clinton, who is staking so much of his presidency on
an issue about which the country is apprehensive and divided. It's a
tremendous challenge for Congress, disdained by many Americans as the
gridlocked captive of cash-rich lobbyists and special interest groups.
And it's a lot to ask of everyday people who distrust government's
ability to do anything right." (Betting the Presidency on Health Care
Plan, Terence Hunt, op ed, Martinsburg Journal, 9/20/93)

On NBC's Meet the Press, Sen. Daniel Moynihan (D-NY) describes the
financial assumptions underlying the administration's health care plan
as "fantasy." "They've showed the cost of Medicaid dropping to zero
growth by the end of this decade. To say you're going to reverse that
rate down to zero growth...is to have lost touch with reality."
(Bottom-Line Details Remain Fuzzy, William Welch, USA Today, 9/20/93)

"Will the plan work? Politically, the blueprint sounds a starting gun
for a Congress under pressure to address a growing source of
insecurity for many Americans. But few outside experts think the
Clintonites can slam the brakes on the health industry without
economic and political whiplash. Economists worry that requiring all
employers to pay for insurance will squeeze some 500,000 low-wage
workers out of their jobs. The potent elderly lobby is gearing up to
fight the $100-billion Medicare cut that results from the plan's
spending caps. Insurers warn that cost controls will cut into care."
(Business Can't Hide Its Doubts, Mike McNamee and Susan Garland,
Business Week, 9/20/93)

"A funny thing happened to the Clinton health care reform plan on
its way to Congress. The more conservative economic advisers in
the Administration, wary of the weak economy, were able to knock
out the heavy taxes that were originally proposed to finance the
program. But [they] couldn't face down the more liberal members
of the Administration and failed to whittle the hefty benefits
package down to size. So the most sweeping health care reform
plan ever seen in this country is heading down Pennsylvania
Avenue to Congress basically on a wing and a prayer that somehow
billions will be squeezed out of the current medical system and
be used to pay for everything. Right now, the health reforms do
not pay for themselves. (Clinton's Health Reforms: Just a Start,
editorial, Business Week, 9/20/93)

"I'm perplexed by the Medicare savings. I don't know how much cutting
you can really do" of growth without cutting services. --an outside
actuary asked by the White House to review its figures. Critics charge
the administration has overestimated the speed at which it can cut
health care spending without jeopardizing patient treatment. (Health
Care Financing Questioned, Dana Priest, Washington Post, 9/20/93)

"The first question Pres. Clinton was asked when he created his health
care task force last January was how could he deliver medical coverage
to all Americans without driving up the deficit. It may be the last
question he answers about the plan...'We are still concerned about the
adequacy of the proposed financing,' said John Rother of the American
Association of Retired Persons." (Health Plan Questions Remain, Nancy
Benac, Martinsburg Journal 9/20/93)

"While other practices may be struggling as times change, health care
reform is going to make health law a growth industry." --Sanford
Teplitzsky, president, National Health Lawyers Association. (Health
Plan to Have Major Legal Impact, Rorie Sherman, National Law Journal,
9/20/93)

"Most Americans are personally satisfied with their health care. But
most know somebody who has lost their benefits, and with good reason,
most fear a similar fate. That insecurity is what is driving lawmakers
to debate the most sweeping reform in 100 years. In the process
lawmakers expect to change the way America thinks about health care.
If you're not impressed, consider this: Someday, you may way up
without a health care worry in the world." CURE Comment: Perhaps, but
it is likely not to be this world. (Nibbling at Edges Won't Fix Health
Care Problem, editorial, USA Today, 9/20/93)

"The true test of how good the nationalized medicine and health plan
being developed really is will be to see if our senators and
representatives exempt themselves from its provisions. After all this
is something they have done with 16 other pieces of legislation that
affect us all, including Social Security...Will our elected royalty
give itself superior health care, too?" --Raymond Miliauskas, Herndon,
VA. (Reform's Ultimate Test, Miliauskas, letter-editor, USAT, 9/20/93)

A 30-second spot by the Health Insurance Association of America shows
a worried couple poring over claims forms at a kitchen table as a
voice warns, "Things are going to change, and not all for the better."
An ad by the Democratic National Committee was quick to counter:
"After years of denying people coverage and jacking up prices, the
insurance industry is scared that change is coming." (Special
Interests Make First Strikes on Airwaves, Richard Wolf, USAT, 9/20/93)

"White Lie #1: Everyone will be able to chose their own doctor. White
Lie #2: The plan excludes price controls. White Lie #3: Market
competition will keep prices down." (Three Fibs That Won't Help Health
Reform, Mike McNamee, Business Week, 9/20/93)

Far from the public eye of tv cameras, Hillary Clinton made her pitch
on her husband's health care plan to media moguls and reporters from
three major networks, including NBC's Tom Brokaw, CBS' Connie Chung,
and ABC's Peter Jennings, Ted Koppel, and David Brinkley. The
background briefings restricted media mention of the First Lady to the
nondescript "senior administration official." As Mundy Grunwald, a
Clinton campaign consultant, puts it, "People on the press corps are
on a learning curve here, and it's our job to help them." (White House
Dispatches Trauma Team on Health, Howard Kurtz, WP, 9/20/93) Stay
'Tooned: President Clinton, wearing t-shirt labeled Arkansas, sitting
in row boat as sharks circle it, on cellular phone: Gergen, I thought
you promised NO media on my vacation. (Marguiles, The Record)

"Q: What do you think about the Clinton plan to save money from
Medicare and Medicaid to help finance broader coverage? A: The cuts in
Medicare and Medicaid will never take place at the level the president
is proposing; simply won't happen. They'll be destructive to both the
quality of care for old people and the excellence of our hospitals. I
think that's pie in the sky." --Joseph Califano, former Secretary,
Health, Education, and Welfare (HEW). (Califano Recalls Earlier Health
Reform Battles, Califano, interview, Washington Post Health, 9/21/93)

Hillary Clinton directs a congressional seminar--originally billed as
a "Health Care University"--for more than 300 legislators on Capitol
Hill, while at a White House breakfast meeting with physicians, former
Surgeon General C. Everett Koop gushes that Pres. Clinton has
"accomplished more in health care reform in the past four months than
all of his living predecessors put together." ABLEnews Editor's Note:
Chick was always one for hyperbole. (Congress Briefed on Health Plan,
Dana Priest and Kenneth Cooper, Washington Post, 9/21/93)

"Rough Rider Teddy Roosevelt campaigned for it. Franklin Roosevelt
considered it. Harry Truman pushed it. Lyndon Johnson stopped short of
it. Richard Nixon championed it. Jimmy Carter espoused it. All of them
failed to enact a comprehensive national plan that would guarantee
health care coverage to every American. Now, Pres. Clinton is
venturing on this historical landscape, which is marked like a
graveyard with buried efforts to change the country's medical system."
(Opening Night for Clinton's Health Plan, Abigail Trafford and
Christine Russell, Washington Post Health, 9/21/93)

"The greatest impact would be felt in the low-wage expanse of the
small business sector. That's where most of the jobs without insurance
are. People who operate small businesses have protested that many such
employers would be forced to buy insurance they can't afford. A lot of
congressional Republicans and moderate-to-conservative Democrats whose
votes the administration will need agree, and say they can't support a
mandate either." (Small Business and Health Care, ed, WP, 9/21/93)

"You might call it the first day of the rest of Hillary Rodham
Clinton's political life. Never before has a First Lady been so
involved in an issue affecting the lives of the American people, or
had so much personally at stake...The American Health Security Act is
seen by some as the last great missing piece of Franklin Roosevelt's
sweeping New Deal reforms of the 1930s, which included Social
Security. It was Roosevelt's wife, Eleanor, more than any other First
Lady, who paved the way for Hillary Clinton to reach the plateau of
involvement that she has with Bill Clinton's presidency...It is,
however, that sort of implied authority to speak and act for her
husband that makes some Hillary-watchers warying, remembering Bill
Clinton's campaign promise of two-for-the-price-of-one--which
opponents interpreted as a co-presidency." (The Capitol Climb of the
First Lady, Donnie Radcliffe, Washington Post, 9/21/93)

"We should resolve now that the health of this nation is a national
concern; that financial barriers in the way of attaining health shall
be removed; that the health of all its citizens deserves the help of
all its citizens." --Pres. Harry S. Truman (Nov. 19, 1945). "I ask
that our Social Security system--proven and tested by three decades of
operation--be extended to finance the cost of basic health services.
In this way, the specter of catastrophic hospital bills can be lifted
from the lives of our older citizens." --Pres. Lyndon B. Johnson (Jan.
7, 1965) "We should avoid holding the whole of our health care system
responsible for failures in some of its parts. There is a natural
temptation in dealing with any complex problem to say: 'Let us wipe
the slate clean and start from scratch.' But to do this--to dismantle
our entire health insurance system, for example--would be to ignore
those important parts of the system which have provided useful
service. While it would be wrong to ignore any weakness in the present
system, it would be equally wrong to sacrifice its strengths." --Pres,
Richard M. Nixon (Feb. 18, 1971) ('The Health of This Nation Is a
National Concern' Washington Post Health, 9/21/93)

"Some members of Congress were more than a little ticked off yesterday
when they were left cooling their heels for 30 minutes because Hillary
Clinton was running late to her Capitol Hill briefing on health care
reform." (The Reliable Source, Lois Romano, Washington Post, 9/21/93)

"American politicians tend to overuse the word 'crisis.' Not every
problem, not even every serious one, deserves that label. But the
problems of our health care system do add up to a crisis--and we need
to tend to it with urgency, and the willingness to put aside
partisanship, that a real crisis warrants." --Jimmy Carter and Gerald
Ford, honorary co-chairmen, National Leadership Coalition for Health
Care Reform. ABLEnews Editor's Note: I see Jimmy and Jerry are still
in their NAFTA-mode. (This One Can't Wait, Carter and Ford, op-ed,
Washington Post, 9/21/93)

Before Clinton's health care guru Ira Magaziner addressed the National
Association of Manufacturers, big business types thought the 80%
taxpayer bailout of their retiree health care benefits bill so liberal
it had to be the result of a typo. As one exec, who asked to remain
nameless, puts it, "We're thinking they transposed the numbers and
really meant the government will pick up 20 percent of the cost."  But
no, Magaziner advises the mega-corporate execs, the administration
wants the government to pay 80% of the cost of health care coverage
for early retirees. While Michele Amouyel, senior benefits analyst for
Chevron, confesses, "If this is true, it would be a dream come true,"
she remains incredulous. "It would be a great relief for employers
like us. But I think the White House has made a mistake. I think they
don't realize the cost involved." CURE Comment: We think they made a
mistake, too, although I can see why a friend who works for a trade
association describes the administration's health reform plan as a
bail out for big business. (US May Pay Up to 80% of Retiree Benefit
Costs, Kathleen Day, Washington Post, 9/21/93)

According to the Congressional Research Service, more the 14% of the
US population, or 34.5 million people lack health insurance at any
given time. As a result of Medicare and Medicaid, only one percent of
persons 65 and older lack insurance. Of America's uninsured, 16.3
million work full-time and year-round. Most of the others are part-
time workers and their dependents. (Who Are the Uninsured? Spencer
Rich, Washington Post Health, 9/21/93)

"America is ready for health care reform and so are we. We're just
sorry the president didn't spell out the details of his plan...As we
begin this national debate, we hope you'll remember these
words--choice, quality, jobs, and cost." --Gov. Caroll Campbell (R-SC).
"We are concerned about the president's Washington-mandated,
one-size-fits all approach. Should government really force most
Americans to change plans and buy health insurance through state-run
monopolies? Like many of you, I am more than a little reluctant to
create dozens of new bureaucracies with unprecedented power over my
health care." --Rep. Nancy Johnson (R-CT). "My wife, our daughter, my
mother, and I are all cancer survivors. My brother Michael died of
cancer in 1979. Along with our doctors, we chose the treatment that
was best for us during our illnesses. And we had a choice. And so
should you. But you may not under the president's plan--and it's
frightening." --Rep. Connie Mack (R-FL). (One-Size Plan Just Won't Fit
All (op-ed, Campbell, Johnson, and Mack, USA Today, 9/23)

"Tonight I want to talk to you about the principles that I believe
must embody our efforts to reform the American health care system:
security, simplicity, savings, choice, quality, and simplicity."
--Pres. Clinton. ('The System Is Badly Broken; It Is Time to Fix It,"
Clinton, address, USA Today, 9/23/93)

"When Pres. Clinton goes before a joint session of Congress to launch
his health care plan September 22, his audacity is sure to win
applause. But that may not be enough to drown out the continuing
dissension within the administration over the shape and cost of the
plan. For months, White House economic and health advisers have
battled over the proposal. Clinton's health and political aides
insisted on sticking with the President's campaign promise to provide
health care coverage to all Americans without a broad tax increase.
But the economists fear that the cost to employers of workers'
coverage will kill jobs. They worry that the plan, based on what they
call overly optimistic cost projections, will swell the deficit." (How
Clinton's Health Plan Got that Way, Susan Garland and Paul Magnusson,
Business Week, 9/27/93)

"To hear the Clinton administration tell it everyone wins with health
care reform. The mantra on the Potomac: We'll all pay less and get
more. But on Wall Street and among health care executives, there's a
touch more skepticism about what reform will bring. Says one not-so-
sanguine analyst, Kenneth S. Abramowitz of Stanford C. Bernstein &
Co.: 'I don't think there'll be any winners--just various gradations
of losers.'" (Who Will Come Out on Top After Reform? Joseph Weber,
Business Week, 9/27/93)

"In historic testimony before two House committees, First Lady Hillary
Rodham Clinton yesterday presented a skillful explanation and defense
of the White House's health care plan to members clearly concerned
about whether it is workable...She is the third First Lady, preceded
only by Eleanor Roosevelt and Rosalyn Carter, to testify before a
congressional committee. But Hillary is the first to take the role of
leadoff witness on an issue as pivotal to the success of her husband's
presidency as health care reform.' (Health Care Testimony From the
Top, Dana Priest, Washington Post, 9/29/93)

"Let us be clear about what the Clinton Health Care Rationing Plan
does. It does not simply set limits on government-financed health
care, such as Medicaid or Medicare. It reaches out to limit the health
insurance coverage people buy with their own money. Apart from the few
who are so wealthy they can essentially self insure themselves, it
effectively prevents anyone from spending their own money to purchase
coverage that is secure from rationing." --David O'Steen, PhD,
executive director, National Right to Life Committee. (Clinton Tries
to Hide Rationing, Burke Balch, JD, NRL News, 9/30/93)

"If forcing your child or mother or grandmother to die against her
will, by effectively making it impossible for you to buy health
insurance that will prevent her death doesn't qualify as involuntary
euthanasia, what would?" (The Clinton Rationing Plan, Burke Balch, JD,
NRL News, 9/30/93)

"Another aspect...that bodes ill for pioneering medicine is its sharp
limitations on the number of doctors who could be legally trained as
specialists...Virtually all medical research is undertaken by
specialists. The Clinton Rationing Plan would dramatically decrease
the pool of those qualified to pursue breakthroughs at the frontiers
of medicine, even as it decreased the number of those available and
competent to treat people with the sort of life-threatening conditions
that require the care of a specialist." (Research and Development of
Lifesaving Treatments: The Impact of the Clinton Rationing Plan, Burke
Balch, JD, NRL News, 9/30/93)

"The Clinton plan is a good starting point on reform," says American
Association of Retired Persons (AARP) legislative director John
Rother, "but there are also some concerns." "The key question for
older Americans," adds Robert Blendon, MD, Harvard School of Public
Health analyst, "is whether or not the reductions in government
payments for Medicare and Medicaid are seen to have affected the care
that older Americans receive from doctors and hospitals." (Clinton
Unveils Health Plan, Robert Hey, AARP Bulletin, 10/93)

"The AMA is ready, willing, and able to work with the White House and
Congress to construct a new health system, even to the extent of
doctors sharing in the financial sacrifices...The issue for the
doctors is really autonomous decision-making with their patients."
--James Todd, MD, executive vice president, AMA. (AMA Seems to Be Here
and There in Appraising Clinton Plan, Spencer Rich, WP, 10/1/93)

"I'm all for it." First Lady Hillary Rodham Clinton on Sen. Bill
Bradley (D-NJ)'s proposal to tax the sale of handguns 25% to raise
revenue for Pres. Clinton's health care plan and "tax directly the
purveyors of violence." (Health-Violence Tie Prompts Gun Tax Talk,
Dana Priest, Washington Post, 10/1/93)

"'We think they would actually save money,' [Mrs. Clinton] told the
[congressional] committee...The fiercest battles in the coming
legislation are likely to be fought over these claims, for in both
parties there is deep skepticism that new benefits can actually bring
net savings." (Questions About the Health Plan, ed, WP, 10/1/93)

"So much praise was bestowed on First Lady Hillary Rodham Clinton for
the testimony she gave in her precedent-breaking round of appearances
before congressional committees last week that the questions she was
asked were overlooked. Now that the glamour phase of the health reform
battle is over, those questions become more important, because they
illuminate where some of the problems lie in converting this
exceedingly ambitious design into law." (The First Lady's Finesse,
David Broder, op-ed, Washington Post, 10/6/93)

"It was a mean scene. Spectators may have thought they had blundered
into a huge family quarrel, as the secretary of Health and Human
Services ducked brickbats from a committee controlled by her own
party...The hectoring, badgering, interrupting, contradicting, and
sheer ill temper that pervaded the hearing room of the House Ways and
Means Committee had a hung-over quality to it. It was as if the
members hated themselves for having been dazzled by a smart woman who
had soothed them into a noncritical mode and made them look moonstruck
to the watching country. Shalala did not have Hillary Clinton's cock-
headed alertness, her desire to please, and her First Lady aura...Her
presentation was trite, her answers dispirited...Rep. Fortney 'Pete'
Stark (D-CA)...heckled and harassed Shalala in a way worthy of Rep.
Newt Gingrich (GA) or some Republican militant...Another California
congressman, Republican Bill Archer railed at Shalala about 'the
continued discussion in a general touchy-feely context'..The Clinton
Cabinet is learning the hard way that a Democratic Congress...will
take winging witnesses only from the top." (A Hangover in Ways and
Means, Mary McGrory, op-ed, Washington Post, 10/7/93)

Led by Rep. Jim Cooper (D-TN) and Rep. Fred Gandy (R-IA), 46
conservative Democrats and moderate Republicans propose legislation to
expand coverage by offering tax deductions for insurance premiums and
increased subsidies for the poor, but which stops short of immediate
universal coverage. "Our bill is squarely in the middle and the only
one with significant bipartisan support," Cooper claims. The White
House and liberal supporters of a government-financed health care
system were critical. The bipartisan bill "in a clever twist of words
provides universal access but not universal coverage," Rep. John
Conyers (D-MI) charges. "We already have universal access-but 37
million Americans can't afford it." (House Group Pushing Compromise
Health Care Bill, Kenneth Cooper, Washington Post, 10/7/93)

A special hotline has been established by the Washington Post to
answer questions on the administration's health care plan. The answers
are supplied by Marilyn Moon, a health economist with the Urban
Institute under a grant from the Kaiser Family Foundation. To pose a
question call POSTHASTE (202-334-9000) and select category 8500. (The
Health Care Proposal: Questions from Readers, WP Health, 10/12/93)

"It's more important to do it right than to do it quick. It could come
as soon as next week. It could be a little later than that." --Dee Dee
Meyers, White House press secretary. "The president has run a
tremendous public relations campaign since presenting the broad
outlines of his health care reform plan on September 22. However, all
the PR in the world is no substitute for specifics about an issue that
will have such an immense impact on our lives." --Haley Barbour,
Republican National Chairman. (Clinton Health Bill Due in Week--or
Two, Washington Post, 10/13/93)

"Under Pres. Clinton's health care proposals, the states--and the
District of Columbia--are going to have to make many important
decisions for themselves. The District's commissioner of public
health, Mohammad Akhter, has usefully begun to raise some of the
questions that lie ahead. Would the city be better served, for
example, by a variety of health plans in competition with each other,
or by a Canadian-style single-payer system in which everyone belongs
to the same plan? Dr. Akhter is concerned that if there's a variety of
plans, they will begin to segregate themselves by income-level with
the well-to-do in some and the poor in others." (Health Choices for
the City, editorial, Washington Post, 10/13/93)

"During her Congressional testimony, Hillary Rodham Clinton used a
Pennsylvania hospital survey to explain how it was possible to get
more health care for less money. One hospital, she noted, charged
$21,000 for a heart bypass and its patients did better than another
hospital that charged $84,000...The real lesson, hospital records
show, is that hospital charges, like a car's sticker price--are
fictitious indicators of what patient and insurers actually pay for
procedures. A such they are a hollow basis f or supporting the more-
for-less theory." ABLEnews Editor's Note: Hollow, indeed. The actual
difference is not the $63,000 imputed by Mrs. Clinton but--as Dana
Priest reports--"closer to $5,700...And the hospitals spent an
estimated $28 million to collect the data for the survey, a cost
Clinton failed to add to her equation." (Hospital Bills Can Prove
Hollow Basis for Health Care Comparisons, Dana Priest, WP, 10/13/93)

"As administration officials watched their opponents seize the
initiative, one official conceded yesterday that 'the follow-through
[to the president's speech] has not been what it should have been.'
But there is no agreement on how serious or lasting the loss of
momentum has been...The health care bill may be 1,600 pages long,
according to White House officials. In comparison, President Ronald
Reagan's 1986 tax bill was 461 pages long when submitted to Congress
and the Social Security Act of 1935 was 32 pages long when Congress
passed it." (As Momentum Slows, Clintons Said to Be Eager to Submit
Health Care Bill, David Broder and Dana Priest, WP, 10/14/93)

"West Virginians, on the whole, are lukewarm about the Clinton
proposal. A poll taken by the Associated Press found only 49% of West
Virginians support the Clinton plan. 'It will be such a fun year,
arguing and fighting,'(Sen. John D. "Jay") Rockefeller (D-WV) said
with a big grin as he toured West Virginia hoping to score support for
the Clinton plan." (Curing Health Care, Scott McCaffrey, Sunday AM,
10/17/93)

"Advocates for AIDS coverage have qualms--worries that budget concerns
would limit care for people whose lives can't be saved, fears that
experimental treatments common to AIDS patients won't be covered. But
to (David) Lewis (diagnosed with AIDS five years ago), the bottom line
is that the Clinton plan would protect others from the nightmare he
went through. When his insurance company halved his benefits and
quadrupled his premiums to $500 a month. Lewis faced premiums and
unreimbursed medical costs exceeding $12,000 a year. That forced him
to quit his job as library director in Plymouth, Massachusetts, and do
what 47% of all HIV patients do--turn to public assistance. (AIDS Camp
Plea: Pass Reform Plan, Richard Price, USA Today, c. 10/18/93)

"Pres. Clinton's health care reform plan is creating anxiety among
many area medical students and educators, who fear that its emphasis
on family medicine and competitive pricing would limit doctors' career
choices and threaten both the role and funding of teaching
hospitals... Medical students and residents said they are concerned
that they may not get to pursue their chosen fields or earn enough
money to repay their medical school loans--some as high as $130,000--
and support families at the same time. And educators say forcing
teaching hospitals to compete for patients--at the same Medicare
reimbursement rate as other hospitals, instead of the higher rate they
now receive--could drive away patients at the expense of students'
educations." (Clinton Makes Them Wince at Medical School, Brooke
Masters, Washington Post, 10/18/93)

"There is an incentive to avoid excessive expense and for people who
have a disease that is considered incurable, the temptation will be to
undertreat...Physicians may well adopt the attitude that treatment of
people with conditions like this is a waste of money." --Mathilde
Krim, chairwoman, American Foundation for AIDS Research. CURE Comment:
CURE fully shares AFAR's concerns about the nontreatment dangers the
Clinton health plan poses for person's whose "quality-of-life" or
prognosis fails the TAB test. (Experts Fear a 'Temptation to
Undertreat,' Richard Price, USA Today, c. 10/18/93)

"Hospitals are going to become much more critical-care units...(and)
more and more emphasis is going to be placed on home care. For people
that want to be a traditional nurse who works on a medical-surgical
floor, (the job) is going to be there." --Mary Miller, assistant
professor of nursing, Marymount University. CURE Comment: Translation:
all but the sickest of the sickest patients will be dumped. PS: And
those will be culled through checkbook euthanasia. (Overdose of
Applicants for Nursing Programs, Brooke Masters, WP, 10/18/93)

"The semantics become important politically. If this thing become
labeled a tax plan, rather than a health plan, we won't be able to
pass it." --Sen. John Breaux (D-LA). (Richard Wolf, The 'T' Word Could
Bedevil Clinton.USA Today, c. 10/18/93)

"The Clinton numbers just don't add up and would create more
bureaucracy. The Republican proposals were just a Band-Aid on a
hemorrhaging wound...The Wellstone plan offers just one bureaucracy,
the federal government. Tax it, pay it, and get it over with."
--Judith Thrane, RN, Louisiana, member of the Citizens Jury that
rejected the Clinton health plan 19 to 5. (The Single-Payer Decision,
op ed, William Raspberry, Washington Post, 10/19/93)

"Nothing will daunt us. No legislation, no threats will ever stop our
apostolic activity and our prayers in the cause of every human life at
every stage of existence."  Cardinal John O'Connor, preaching in St.
Patrick's Cathedral on Respect Life Sunday, October 3. (Cardinal
O'Connor Exhorts Congress to "Drop" Abortion From Health Care Plan,
Henry King, Wanderer, 10/21/93)

"Pres. Clinton readied a second launch of his health care plan Monday
After a marathon drafting session over the weekend, Clinton's health
advisers finished the voluminous plan Monday morning. Clinton and his
wife hillary were to deliver the 1,600-plus page Health Security Act
to Health Security Act to Democratic congressional leaders Wednesday.
Clinton's bill faces stiff competition from both the left and right.
Liberal Democrats favor letting the government pay all medical bills;
conservative Republicans are backing tax-free savings accounts for
health care." (Clinton Tries Again With Changes, MJ, 10/25/93)

"Congress and the American people are being asked to take a big dose
of untested medicine by a president betting more on conviction than
previous experience that his prescription will bring health and
happiness. Pres. Clinton's gamble is that he can simultaneously
provide health care for all, maintain quality of care, and reduce
federal deficits, all through a fundamental restructuring of the US
health care system. Moreover, he proposes to do it by increasing
rather than reducing government control of economic life, at a time
when public opinion favors the opposite." (Health Care Plan: Subject
to Change, Ted Van Dyk, Finance World, 10/26/93)

"Psychologists and psychiatrists are fighting so hard they may need
some time on the couch. Chiropractors, osteopaths, and orthopedists
are vying for supremacy over the world of lower back pain. And
opticians do not see eye to eye with optometrists and
ophthalmologists. Normally, rivals, many medical specialties have a
new reason to fight: the standard benefits package on Pres. Clinton's
health care plan." (It's Specialist Against Specialist in Battle to Be
Part of Clinton 's Health Package, Michael Weisskopf, WP, 10/26/93)

On the eve of its unveiling, the Clinton health reform proposal is
acknowledged to postpone universal coverage until 1998, according to
White House officials, and promises subsidies for small businesses and
low-income workers will be curtailed. (Health Plan Won't Have Full
Coverage Until 1998, Martinsburg Journal, 10/27/93)

As the White House readies the Clinton health plan for presentation to
Congress, an administration official concedes its budget savings will
be $33 billion less than the White House had predicted. (Health Reform
Savings Will Fall Short, Morning Herald, 10/27/93)

"The Future Diner could become a thing of the past under Bill
Clinton's health care reform, the owners of this mirrored-and-formica
enclave say 'Within a year's time we'll have to close and I'll have to
go to work for someone else,' said Socrates Fokas, one owner (of the
Fresh Meadows restaurant a two-time campaign stop for Clinton and a
favorite haunt in Queens). It's frustrating to admit, especially for a
man who is pictured on a wall smiling jauntily, his arm around the
president, who visited in September to talk about health care."
(Bill's Plan Would Ax His Diner, Sez Owner, Suzanne Sataline, New York
Post, 10/28/93)

"President and Mrs. Clinton delivered their new and, they hope,
improved version of their health care plan to Congressional spin
doctors, who quickly vowed to give it a 'new diagnosis and a second
opinion.' In a fist-pounding speech in the Capitol's ornate Statuary
Hall, Clinton agreed his proposal, with its 'managed competition'
formula mixing health maintenance organizations and government
oversight, 'seems bewildering and complex, but look at what we have
now.'" (Coming Debate to Test Us All, Richard Sisk, NY Post, 10/28/93)

"If I had to vote on this today, I would vote against it. It's just
not fair." --Rep Charles Rangel (D-NY) on Clinton's Health Security
Act. Regarding the plan's denial of health care coverage to illegal
immigrants, Rangel observed: "They are nor covered under the Clinton
plan and that's supposed to discourage them from coming. But what
about the ones already here? Are we just going to kick them out of
hospital emergency rooms or, if we're not, shouldn't everyone bear the
costs and not just New Yorkers?" (Health Plan Not Playing Well Here,
Timothy Clifford and Susan Milligan, New York Post, 10/28/93)

"The most Clintonesque part of it is the apparent belief that an army
of policy wonks can predict what would happen under a program that
would change one seventh of the economy, which 30 years of experience
tells us we can't do." --former Health, Education, and Welfare (HEW)
Secretary Joseph Califano, Jr. (In Scope and Vision, Health Plan
Defines Clinton Presidency, Steven Pearlstein and Dana Priest, op-ed,
Washington Post, 10/28/93)

"The time for cheap talk is over. We're either going to have to
produce or find other means of livelihood." --Sen. John D. "Jay"
Rockefeller (D-WV). "The operational confusion of the administration
is wearing people out. Had they had their bill ready on the next day
after the president's (September 22) speech, they would have had great
momentum. But now the weight of energy in this country is clearly
against his bill." --House Minority Whip Newt Gingrich (R-GA). Several
polls, including the latest taken by the Washington Post show growing
opposition to the Clinton health plan. (On Divided Hill, Expectations
of Action Are High, David Broder, Washington Post, 10/28/93)

"At one extreme in Congress is the so-called single-payer plan you
might call it Medicare for the entire population in which the
government would raise, through taxes, enough money to pay for basic
health care for everyone. At the other end of the spectrum are plans
that mostly tinker with the present system. Mainly backed by
conservative Republicans, these tend to involve such steps as tax
subsidies to help the poor buy more insurance, paid for in part by
cuts in Medicare and Medicaid, and some insurance market reform to
make it easier for those who find it hard to get insurance now. The
conservatives make the usual point that the system isn't all that
broke and doesn't need all the fining the Democrats propose." (The
President's Health Care Plan, editorial, Washington Post, 10/28/93)

"We face the prospect that about half the population will find itself
paying more in health premiums. That's about right, isn't it?"  Sen.
Daniel Patrick Moynihan (D-NY), chairman Senate Finance Committee, to
Secretary of Health & Humans Services Donna Shalala, who testified
that the increased premium could mount as high as $1,000 a year. (40%
Will Pay More for Care, J. Jennings Moss, Washington Times, 10/29/93)

"If 40 percent of insured Americans are going to pay more, we're going
to have to persuade some of those that they're going to get more and
others that, on balance, it's their civic duty. We're not very good at
that."  Sen. Moynihan. CURE Comment: That may be a tough sell since
more than a third of those paying higher premiums "mostly young
people" will get at best the same level of care as they did before
Clinton's Health Security Act. (Health Plan Costly for Many, Dana
Priest and Fern Shen, Washington Post, 10/29/93)

"William Raspberry is right. We had better consider the single-payer
health care option before it is too late. ('The Single-Payer
Decision,' op-ed, October 19).) Conventional wisdom says that whatever
its merits, this proposal can't get through Congress. But its
advantages make it the only workable reform. Consider the evidence.
Canada is one of several countries with single-payer systems affording
universal access. Some Americans assume that any government-run system
would be highly bureaucratic and inefficient. But is largely because
such a system is less bureaucratic (cutting out eh wasteful insurance
component) that it is more efficient. What about the long waits for
services, which drive some Canadians to the United States? These much
overplayed waits are generally for elective services."  David
DeGrazia, Washington, DC. (Health Care:, The Single Payer..., DeGrazia,
letter-editor, Washington Post, 10/29/93)

"In the '1993 Survey of Small and Mid-Sized Businesses,' cosponsored
by National Small Business United and Arthur Anderson's Enterprise
Group, more than 80 percent of the owners of small and mid-sized
businesses indicated that increasing payroll taxes to fund health care
reform would have a major negative impact on their businesses. Higher
payroll taxes add to the cost of employees, increasing incentives to
lower wages and to reduce the number of employees. A payroll tax of
this magnitude raises a huge hurdle for starting a new business or
hiring an additional employee. A payroll tax of this magnitude raises
a huge hurdle for starting a new business or hiring an additional
employee. Ultimately payroll taxes are likely to increase the number
of failures while making start-ups more difficult and costly."  John
Paul Galles, executive vice president, National Small Business United.
(...And the Burden on Small Businesses, Galles, let-ed, WP, 10/29/93)

"If 40 percent of insured Americans are going to pay more, we're going
to have to persuade some of those that they're going to get more and
others that, on balance, it's their civic duty. We're not always very
good at that." --Sen. Daniel Moynihan (D-NY). CURE Comment: With
Health and Human Services Secretary Donna Shalala's confession that
half of those who will pay more will get the same or LESS care then
they do now that could prove to be a hard sell. (Many Will Pay More
Under Health Plan, John Fairhall, Baltimore Sun, 10/29/93)

"Our industry can't take another 'back-door, for-a-good-cause, this-
is-the-last-time tax." --Stephen Elmont, president, National
Restaurant Association. A 1993 study reports that 67% of all food
service companies have sales of less than $500,000 a year, and 67% of
these smaller companies don't offer employees coverage because they
can't afford it. (Clinton Faces Tough Sell on Health Care Plan, Jane
Applegate, Washington Post Business, 11/1/93)

"A look at the history of health insurance in the United States
reveals not the competitive marketplace that most believe exists but
an industry filled with anti-competitive efforts of medical societies
and hospitals to suppress alternatives, guarantee their own income,
and use government intervention to further their own objectives."
Terree Wasley, author, What Has Government Done to Our Health Care?
(Creating the "Crisis," Robert Lee, New American, 11/1/93)

"Over 800 federal and state laws (some hundreds of pages long) govern
all health providers and institutions. According to some estimates,
for every man-hour of health services provided by doctors, two hours
are spent filling our government paperwork." --Vincent Miller and
Jarret Wollstein, International Society for Individual Liberty.
(Freeing the Consumer, William Grigg, New American, 11/1/93)

"You are right now looking only at legislative blueprints and graph-
paper projections and inspired guesses and wishful premises. Together
they amount to a construct of life that takes into account everything
but life itself, that is, everything but the way incorrigible, flawed
humankind and the institutions it creates behave and have tended to
behave for the past several thousand years. Ideology is a totally
unreliable guide as to how various individuals and institutions will
behave under a new law. So is whatever palaver they were putting out
with so much seeming passion during the argument about enacting it."
(Health Care: An All-Points Alert, Meg Greenfield, WP, 11/1/93)

Before the Nazis directed their murderous attention to the
extermination of the Jews and other minorities, they regimented
Germany according to a "quality-of-life" ethic developed over decades.
In The Nazi Doctors, Robert Lifton describes the process through which
the medical profession became subservient to the Nazi "politics of
meaning." "There was one area in which the Nazis did insist upon a
clear break with medical tradition. They mounted a consistent attack
upon what they viewed as exaggerated Christian compassion for the weak
individual instead of tending to the health of the group, the volk."
One of the first products of revised medical attitudes was the
euthanasia program. The Hillary Clinton task force commissioned "a
panel of outside experts to lay out a value framework to guide health
care reform." The identities of most panelists were kept secret. Noted
the Los Angeles Times, "White House Task Force officials refused to
discuss the work of the ethics panel and said they had prohibited its
members from talking publicly about their deliberations." (Echoes of
Auschwitz, William Grigg, New American, 11/1/93)

"Support for Pres. Clinton's health care plan has fallen since it was
unveiled five weeks ago, a new USA Today/CNN/Gallup Poll shows. The
poll finds the  public split 45%-45% down from 59% support Clinton
enjoyed after he outlined the plan to Congress." (Health Plan Support
Slips, Richard Benedetto and William Welch, USA Today, 11/1/93)

"Pres. Clinton wants to make all Americans 'equal' in the quality of
health care they receive. As in Orwell's Animal Farm, however, some
people are 'more equal than others.' We know, for example, that the
super-wealthy in Britain have their own private physicians and
hospitals and receive whatever 'Rolls Royce; care they can afford. It
will be no different here. You may be sure that while standing in
interminable lines, you will never rub shoulders with the Clintons,
the Rockefellers, Teddy Kennedy, or Tom Foley. These folks wish to
experiment with your health, not their own." (Is Health Care a Right?
Fr. James Thornton, op-ed, New American, 11/1/93)

"Rank-and-file citizens are becoming increasingly skeptical of the
Clinton plan's effect on them, and may wind up the tougher sell as
details get clearer and bargaining unfolds on Capitol Hill. The
public's biggest worries: 56% says costs will go up. 53% fear too much
government involvement. 31% expect quality to decline. 42% expect
fewer choices among doctors." CURE Comment: As we analyze the bill,
they are all apt to be right. (Skepticism Grows Over Quality, Cost,
and Choice, Richard Benedetto, USA Today, 11/1/93)

"Its chokepoint on a free economy is the insurance premium. Put that
in Washington's hands, and the Feds dictate everything from the price
of by-passes to the price of aspirin. Most people like the idea of
price controls until they are faced with the shortages and black
markets and rationing and wage controls that always follow." --former
presidential aide, William Safire. (The Clinton Cure-All, William
Hoar, New American, 11/1/93)

"The 35 (or) 37 million figure comes from the Current Population
Survey (CPS) administered annually by the Census Bureau to about
60,000 households. But studies by the General Accounting Office,
Congressional Budget Office, the Employee Benefit Research Institute,
the Urban Institute, and others have pointed out that the widespread
use of the raw CPS data is grossly misleading for a number of reasons.
To begin with, researchers have noted that the CPS questionnaire
results fail to account for all health care coverage and greatly
overstate the number of uninsured." (The Mythical 37,000,000, William
Jasper, New American, 11/1/93)

A Blue Cross-Blue Shield Association study reports that charging
everyone in a community the same health insurance rate generally
produces some savings for those small businesses that already cover
their workers. Meanwhile, a Senator whose support is  critical to
winning liberal support for Clinton's Health Security Act, Sen. Paul
Wellstone (D-MN) registers public concern about the bill's limits on
mental health care coverage. CURE Comment: CURE supports equal
treatment in health care coverage for all disabilities. (Community
Insurance Rates Less Costly for Small Business, MJ, 11/9/93).

                        Medicaid/care

"Congress is going after elderly Americans who 'spend down' so they
can go on Medicaid...Critics of the current setup argue the tougher
Medicaid rules are overdue. Those critics include the nursing home
industry, which makes less money from patients on Medicaid than
patients who pay their own money...Advocates for the elderly say the
tighter rules raise a public policy question: Should people who have
saved all their lives have to spend their last dollar on costly
nursing home care than can run $3,000 a month?" (Plan Reworks Medicaid
Nursing Rules, Martinsburg Journal, 7/15/93)

"The settlement is the first of its kind against a Medicare claims
administrator and represents a substantial victory in our efforts to
fight abuse in the Medicare program." --Frank Hunger, Assistant
Attorney General, Civil Division, Department of Justice. (Florida
Blues to Pay $10 Million to Settle Medicare Case, Jerry Seper,
Washington Post, 8/6/93)

Medicare has been cheated out of $14 million by a ring of doctors and
health care companies issuing phoney billings for nutritional
supplement and feeding tubes. "The recruiters would go to community
centers and apartment buildings where large numbers of senior citizens
were present to solicit new patients," the indictment charges. "The
recruiters would tell the senior citizens they were eligible to
receive 'milk' free of charge from the government." (Billing Fraud Got
Millions from Medicare, Martinsburg Journal, 8/10/93)

"We and the Office of Management and Budget [OMB] would rather not
spend the money. But we are really obligated to do so if we are to
apply the law fairly." --Bruce Vladeck, administrator, Health Care
Finance Administration (HCFA). "My view is that the entire DSH
[disproportionate share hospital] program is a sham, and to allow more
money to seep out of it is a shame." --Tom Scully, former associate
director, OMB. The new Medicaid regulations could cost $1.3 billion in
1993 alone. (New Medicaid Rules Could Take Bite Out of Projected
Savings, Dan Morgan, Washington Post, 8/13/93)

Processing up to 400 cases a day, insurance companies employees who
are high-school graduates without medical training make nine out of
ten decisions on whether or not to reject Medicare physician fees as
"medically unnecessary." Only 10% of such reviews ever involve a nurse
or doctor. (Lower-Level Workers Make Key Medicare Rulings, GAO Says,
Spencer Rich, Washington Post, 8/19/93)

"In its new role as medical Robin Hood...Medicare sought to
redistribute the medical wealth...by setting up a new fee
schedule...based on the so-called resource-based relative value scale,
or RBRVS..developed by William Hsiao of Harvard School of Public
Health...[which] established the amount of labor for everything from
removing a bunion to performing a triple coronary bypass....Hsiao
figured that family doctors would get a sixty percent raise from
Medicare, while such high-paid specialists as heart surgeons would see
their income cut in half."  CURE Comment: Is that who you want doing
open-heart surgery on your Mom or Dad, a cut-rate surgeon? (Doctors
Unhappy with Medicare Effort, Morning Herald, 8/26/93)

Proposed changes in Maryland Medicaid regulations aimed at cutting
costs for patients who rely on breathing assistance by transferring
them to nursing homes from hospitals may threaten the closure of the
state-run Western Maryland Center and private long-term care hospitals
in the state. More than 60 ventilator patients are currently cared for
in such facilities. There have been repeated efforts to close the
Center and last year state health officials tried unsuccessfully to
privatize it. Joyce Brown, chairman of the Center's advisory board
warns allowing nursing homes to care for ventilator patients could
undermine the need for chronic care hospitals like the one on
Hagerstown. (MD Rewriting Medicaid Rules for Ventilator Patients, Deb
Reichmann, Morning Herald, 9/1/93)

                              Oh, Oh, HMO

"We were simply the victim of our own 56 years of success. None of our
major competitors have existed for more than 10 or 12 years in this
area. The mix of patients they all serve is a younger, healthier mix."
--Robert Pfotenhauer, chief executive, Group Health Association, Inc.,
announcing its sale to the corporate giant, Humana, Inc. (Humana Buys
GHA, Oldest HMO in Area, Albert Crenshaw, Washington Post, 7/13/93)

"Humana is not a health institution; it's a for-profit corporation
that's making money in health. Group Health is entirely from the
opposite end of the spectrum." --John Silard, retired civil rights
attorney, one of a number of Group Health Association (GHA) members
who successfully opposed the health maintenance organization (HMO)'s
conversion to a for-profit corporation last year, who are opposing the
proposed sale of GHA to Humana. David Greenberg, GHA chairman,
retorts: "They are looking at the situation through rose-colored
glasses. Their position appears to be based on emotion rather than
logic, and lacks relevance to the critical issues." (GHA Groups Aims
to Block Humana Deal, Albert Crenshaw, Washington Post, 7/15/93)

"Several months ago, a 39-year-old magazine editor in northern
Virginia decided she needed mental health counseling. Her marriage was
foundering; she was having problems at work, and she couldn't shake
the depression that had descended six months earlier after a
miscarriage. Summoning her courage, she called her health maintenance
organization (HMO), the Georgetown University Health Plan, for help.
First, she was told she needed a referral from her primary care
doctor. After waiting a week to see him, she was referred to the
Metropolitan Psychiatric Group and given an appointment with a
'liaison' nurse. 'I thought, well, I'd see her and she would assign me
to a therapist and I'd start my 20 sessions'...covered by [my] HMO
plan. 'One of the first things she said was that she'd never heard of
anyone getting 20 visits...The nurse began her evaluation reading
aloud from a checklist. 'The questions were things like, 'Do the
patient's shoes match?' 'Does she know where she is?''...'I told her
what my problems were but she just dismissed them...The whole
experience was devastating. I never went back.'...The debate over the
quality of care in HMOs has assumed new urgency because of the health
care reform plan being formulated by the Clinton administration. The
plan is likely to force many Americans into HMOs and other large plans
that are tightly managed to control costs." (The White House Is
Banking on HMOs as a Way to Reform Health Care--But Many HMOs Today
Skimp on Mental Health Benefits, Sandra Boodman, WP Health, 8/3/93)

Members of Group Health Association (GHA), the District of Columbia's
oldest [HMO] vote 12 to 1 to sell the nonprofit HMO to Humana, Inc.,
the nation's largest for-profit HMO operator. Matthew Watson, attorney
for GHA dissidents, who lost the vote after successfully defeating a
past management bid to turn GHA into a for-profit HMO, comments, "The
vote is not surprising. The management of Group Health has learned
lessons from public politics, unfortunately, that money can buy
elections." Watson estimates GHA spent a million dollars in support of
Humana's takeover bid. A letter from GHA physicians urging a yes vote
failed to disclose the financial benefits the doctors stood to gain
from the deal. For such reasons, Watson's clients will continue their
battle in the courts. (GHA Members Back Takeover by Humana, Kathleen
Day, Washington Post, 8/11/93)

"Patients were more satisfied with doctors who practiced by themselves
or in a small specialty group and charged on a fee-for-service basis
than with any other type of medical practice, according to a study in
today's Journal of the American Medical Association. The patients--
17,671 were surveyed in three cities--were far less happy with visits
to prepaid group practices commonly called health maintenance
organizations (HMOs), a type of practice that Pres. Clinton's
forthcoming health plan will seek to encourage." (Patients Rate Small-
Scale, Fee-Based Services Superior to HMOs, Spencer Rich, WP, 8/18/93)

                            The Bottom Line

As drug manufacturers and hospital suppliers scramble to meet mounting
pressures on prices they fear will increase under any health reform
plan coming out of Washington, Johnson & Johnson announces plans to
eliminate 3,000 jobs. (Johnson Trimming 3,000 Jobs, Milt Freudenheim,
New York Times, 8/12/93)

                        Wish We'd Said That...

         It's been said that when Malthusian don't have enough hats
         to cover all the heads, they solve the problem by cutting
         off a few heads. That's not dissimilar to what's happening
         in Washington today with the proliferation of prescriptions
         for health reform....Washington's neo-Matlhusians, no matter
         what their camp, find that the supply of hats is
         disappearing fast, and they're out to chop off a few million
         heads. (Linda Everett)

     Had President Clinton been honest about the deep
     dislocations and de facto rationing that must come when
     demand explodes and budgets decline, his plan never would
     have had a chance. (Charles Krauthammer)

     We're afraid to have our hands tied. You're obligated and
     expected to rein in costs...But you feel you are doing that
     at the expense of your patient. (Joseph Vinetz, third-year
      medical student, John Hopkins University)

                           ...Glad We Didn't

     What these people are going to be involved in is very
     controversial you've got people in this group who've
     written on such things as when to pull the plug and I'm
     not going to talk about that they are doing, or what
     they will do. (Robert Boorstin, spokesman White House
     Health Care Task Force, on its covert ethics panel.)

     As the debate here about health care reform begins in
     earnest, Americans would do well to keep in mind that...to
     create a health care system that os minimally decent to all,
     you have to be willing to say no to some very expensive
     things that might benefit a few. (Arthur Caplan, PhD)

         There should be a way of telling people they cannot have the
         medical care they want for themselves or their family.
                                                                 (Sen. John Danforth, R-MO)

     I want to implore all of you to get this and read it...and
     create a climate in this country where we have an honest,
     nonpartisan debate. (Pres. Clinton, addressing John Hopkins
     University medical students)

                               We Did Say It...

     Then why do the American people have to pay $40.00 to buy a
     copy of the actual Health Security Act from the GPO
     (Government Printing Office)? And why did Hillary's Task
     Force meet behind closed doors? (Earl Appleby, Jr., CURE)

                        A Word From Our Sponsor

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Special Editions include Abled, AIDS, Cancer, Family, Health Care,
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