Media Share 9/MEDIASHARE_09.ISO/mag&info/anr9302.zip/9302HLTH.ANR

Text File | 1993-04-04 | 21KB | 409 lines

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(22)   Wed 3 Feb 93  6:07p   Rcvd: Mon 8 Feb  6:17p
By: Mike Adams
To: Earl Appleby
Re: Medications
St: Rcvd
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EA>                         Medicine Chest

EA> "Medications. They cure, relieve suffering, and prolong life. As
    a nurse, I have a deep respect for medication. But a recent
    conversation with a friend reminded me of how often they are
    misused. My friend had heart problems and had ben feeling
    progressively worse. Each time she went to her doctor she was
    given new prescriptions that didn't seem to help. At one point,
    she was taking 16 pills a day, at a cost of $300 per month. To use
    her own words, 'I was taking so much medication, it almost killed
    me.'" (Medicines That Don't Mix, Ana Maria Catanzaro, R.N.,
    Catholic Digest, 2/93)

Years ago when I was starting out as a social worker, this was a
problem I recognized with many of the elderly clients I worked with,
and I made a habit of taking down the names of their medications,
dosages, and doctors' names so I could check to see if the medications
were still necessary or if they might be compounding the problems.  We
had an RN at the office who'd look over the list and make suggestions
as to which doctors might need to be notified to double-check the
prescriptions.  I often found few doctors would ask what other
medications a patient took when they made a prescription, and most
didn't acknowledge the patient might be seeing other doctors.  There
were many cases in which drastic changes needed to be made.

It doesn't surprise me this is still the case.

* Origin: Majik Shoppe Point 1 (1:19/10.1)

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(23)   Wed 3 Feb 93  1:00p
By: Gordon Gillesby
To: All
Re: health care reform st 1/3
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                   UNDERSTANDING HEALTH CARE PROPOSALS

         COALITION ON HEALTH CARE FOR PERSONS WITH DISABILITIES
                        STUDIES THE ALTERNATIVES

                              By Tom Brick

The Coalition on Health Care Issues for Persons With Disabilities was
formed in 1990 under the leadership of the Minnesota State Council on
Disability. Originally formed to develop a position on health care
issues for input to the Minnesota Health Care Access Commission, the
mission has now expanded to include developing legislative positions
and advocating for persons with disabilities on National health care
issues as well as Minnesota specific issues.  Many organizations and
disability advocates are represented within the Coalition.

In 1991, the Coalition supported the Health Care Access Commission
report as introduced in House File 2; at the same time we fought
against the limitations on various therapies and the lack of provision
of durable medical equipment for adults. In 1992, the Coalition
supported the HealthRight legislation but opposed the Small Employer
Plan's limited benefit package and worked for inclusion of better
mental health benefits in HealthRight/Minnesota Care. Also, in 1992,
the Coalition opposed new rules proposed for HMOs which allowed them
to not offer supplemental benefits (Various therapies and medical
supplies).

Recently, the Coalition has worked with other health care reform
groups, composed of consumer advocates on health care. That group has
adopted our position calling for elimination of preexisting condition
limitations; a definition of medical necessity similar to the Medicaid
definition, a set of mandates that would provide health care at the
level of a persons need, and a proposal to provide Minnesota
Comprehensive Health Association benefits to those who would have
inadequate coverage on the Small Employer Plan. Also, along with
other health care reform advocates we are calling for increased
consumer involvement on the Health Care Commission.

Mission Statement:  The Coalition on Health Care Issues for Persons
With Disabilities envisions health care provided in the context of
integrated human care services coordinated to allow all citizens to
achieve independence and quality of life in the community of their
choice. Services will be affordable, efficient, and comprehensive.
Sources of funding will be established which place no undue burden on
any individual or group and resources will be allocated cost
effectively without discrimination and with full community involvement
in setting rational priorities for allocation.

The Coalition's legislative goals include: Support of efforts to
provide equal coverage for mental health conditions; make the
Minnesota Comprehensive Health Association plan available (when
necessary) to persons who have a Small Employer Plan through their
work; oppose any reduction in funding of personal care services;
support efforts to gain reimbursement for nutritional supplements as
well as nutritional replacements; support legislation which works to
increase coverage for medical supplies; support appropriate
legislation to provide communication accessibility; and legislation to
gain reimbursement for management level medications.

On a national level, we will support appropriate legislation that
suggests a non competitive health plan; a comprehensive health care
plan which includes preventive care, acute care, chronic care,
rehabilitative services and long term care that is universally
accessible and affordable, with emphasis on community based programs
within an integrated system that emphasizes personal independence.  A
National health care plan must have universal access, community rating
(the same rate for everyone), no preexisting condition limitations,
and benefits provided at the level of a persons need, without
impoverishing the individual who has special health care needs.

Discussion on National health care reform now is centered on two types
of systems: managed competition and single payor. There are
disability related concerns which should be discussed regarding health
care reform.

Employment Disincentives Related to Health Care Coverage. A number of
studies indicate that there is a profound problem for persons with
disabilities in an employer based insurance system.

Persons with disabilities are disproportionately unemployed and poor.
In a Louis Harris survey in 1986, conducted for the International
Center for the Disabled (ICD) only 25 percent of persons with
disabilities were employed full time and only 33 percent full time and
part time combined. Persons with disabilities were twice as likely as
their counterparts without disabilities to have 1984 household incomes
of $15,000 or less.

As a minority, the ICD study concluded that people with disabilities
are much less likely to be working than any other demographic group.
The Health Insurance Task Force of the Ohio Developmental Disabilities
Planning Council concludes, "these patterns are ironic when studies
show that people with disabilities want to work, further benefiting
employers and society. From the individual perspective, work is
linked with independence, productivity, and mainstream integration.
In a society where work and identity often merge, jobs provide
purpose, material choices, security, peer interaction and recognition,
and a release from the stigmas of joblessness and public assistance.
The ICD survey's most important message may have been that only 26
percent of respondents with work perceived themselves as 'disabled"'.

National research conducted by the Developmental Evaluation Clinic of
Boston Children's Hospital revealed the economic benefits afforded a
society employing those with even severe disabilities. Looking at
part-time and full time employees in supported, transitional, and
competitive work - often at sub- minimum wage - total earnings neared
a quarter of a billion dollars, generating scores of millions in
federal and state tax contributions, industry paid unemployment
contributions, and both individual and industry Social Security
contributions. Concurrently, public expenditures were lessened by
well over $100 million through reductions in transfer payments
(reduced SSI payments to those who exceeded earnings thresholds) and
alternate program costs, such as savings on day settings and sheltered
employment supervision.  Earnings produced additional sales and user
taxes, while further reducing public responsibilities such as housing
subsidies.

In 1987 Ohio Developmental Disabilities Planning Council funded
investigation of disincentives to employment facing persons with
developmental disabilities identified health care concerns as the most
prevalent barrier to work. Risks in working can be too great for
those with public program benefits. Earnings may exceed allowable
income thresholds, causing forfeiture of Medicaid benefits that are
not replaced by the employer and cannot be bought individually because
of preexisting conditions.

The Ohio Developmental Disability Planning Council's Health Care
Position Paper concludes, "Statistics reveal insurance-related
employment disincentives that are profound. The 1986 ICD survey found
a 15 percent prevalence of disability (27,000,000 persons) among
Americans aged 16 and over, while noting that two-thirds of these were
unemployed. With 18 percent of unemployed respondents noting "loss of
benefits, such as government health insurance" as an important reason
why they were not working, over 3 million persons with disabilities
could be expected to explain that health coverage fears play a
significant role in deterring employment perspectives."

From these various studies it seems that a health care system based on
a mix of employment based health care plans and public programs is not
in the best interest of persons with disabilities.

Health care insurance was created, as other lines of insurance, to
spread the risk (of the cost of health care) among the entire
community. Each person paid essentially the same amount; in other
words, there was "community rating".  In order to gain a larger share
of the market, health care insurers began "experience rating" for a
particular employer based groups. This lead to "distinctions" made on
the basis of occupation, medical history or even a relatives medical
history. So now health care insurers make a profit for the "service'
of determining which people not to insure - leaving government
programs to provide for health care for those that they reject; this
shifts the cost of care to the public so they can insure the
healthiest people at the lowest price.

Another way private insurers reduce their costs is by restricting
benefits. According to an analysis of Health Care Financing
Administration data by Bob Griss, Senior Health Policy Analyst for the
United Cerebral Palsy Associations, private insurance covers only 13.8
percent of non-durable medical supplies and drugs and 11.3 percent of
durable medical equipment.

Various Small Employer Plans would further restrict benefits paid.
The Congressional Research Service reported in 1988 that private
insurance company administrative expenses for companies with less than
5 employees averaged 40 percent - including 9.3 percent for claims
administration, 12.5 percent for general administration, 8.5 percent
for risk and profit, and 8.4 percent for commissions. In contrast,
administrative expenses for companies with over 10,000 employees
consume only 5.5 percent of premiums. Yet, proposals for small
employers market reform concentrate on a reduction in benefits,
co-payments and high deductibles to control costs. These reductions in
the scope of care merely shift the cost of care to individuals or to a
public program.

Single Payor System.  In Canada's single payor system, the government
negotiates with the medical association and sets fees for doctors
within a global budget; private doctors then provide care similar to
our Medicaid system. All people are in the same "pool", so persons
with disabilities do not have income and other restrictions of our
Medicaid system. The Canadian system is universal, portable (can move
between jobs or geographically), accessible, comprehensive (covers all
medically necessary treatment) and is publicly administered.

Managed Competition.  The model for managed competition is not so well
defined. A managed competition system would encourage the use of
managed care. The system would continue to rely on the present health
care plan companies (insurance companies and HMOS). The plan would
encourage employer based coverage ("play or pay" - the employer would
either pay a portion of the health care plan premium for employees or
would be assessed a special tax for the government to arrange for
their employees insurance); the Federal government would set a limit
on the amount of dollars which would be tax deductible for the
employer for health care coverage; this, probably, would encourage a
set of benefit coverages based on what the average person would likely
need in an acute care setting.

Managed competition would use co-payments and deductibles to make
consumers wise health care users. There would probably be some reform
of health plan companies underwriting practices and a continuation of
public programs such as Medicaid.

Other than managed care, there doesn't seem to be any overall cost
control mechanism in the managed competition system. Other countries
which have either a single payor system such as Canada or a multiple
payor system, such as Germany, control costs through an overall
(global) budget and uniform negotiated payment rates.

While any reform that creates universal coverage may be better than
the health care financing system we have now, persons with
disabilities and chronic conditions should beware of any plan that
narrows the scope of coverage. The definition of health should be
expanded, not narrowed. Any system that makes people pay extra for
more than a "basic" benefit package would be even more restricted to
acute care than is the case now.

Persons with disabilities and chronic conditions should not just focus
on their specific health care needs, but join together and support the
changes which are critical to he health care needs of all people with
disabilities and chronic conditions.

Health care should be a right for all Americans.

If you would like additional information about the Coalition on Health
Care Issues for Persons With Disabilities, call Tom Brick at
612-296-3478, Minnesota State Council on Disability.

                   -  -  -  - END ARTICLE -  -  -  -

   This article is a reprint from ACCESS PRESS newspaper.  Editorial
   content may be reprinted with attribution (and notification) to
   ACCESS PRESS.  Letters and editorial submissions are welcome.

                              ACCESS PRESS
                      3338 University Avenue S.E.
                     Minneapolis, Minnesota 55414.
                          612/379-0989 (voice)
                          612/379-2730 (FAX)

* Madness takes its toll; Please have correct change ready.

* Origin: DRAGnet - Disability Resources - [phone]
(1:282/1007)

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(44)   Tue 9 Feb 93  2:12p
By: Leon Lynch
To: Gordon Gillesby
Re: health care reform st 1/3
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On Feb 03 13:00, Gordon Gillesby of 1:262/4 wrote:

 GG>                    UNDERSTANDIN HEALTH CARE PROPOSALS

This set of messages is being posted as a Bulletin on The FamilyNet
News Center (sm) at 1:262/3. Up to nine ABLEnews related
notices/bulletins at one time can be brought online here through a
special bulletin program now being used at 1:262/3, with more
categories possible.

If signing on to 1:262/3 you are now taken to our general bulletin
menu first instead of the main menu. When one chooses "Important
Bulletins" he/she is given a submenu that includes the ABLEFILE
bulletin area. All are welcome to log on any time they can get through
and new bulletins will be posted as they are received.  Articles,
etc., addressed to Earl Appleby will be passed on to 1:262/4.

With Respect,
Leon Lynch, International Coordinator,
ICCN,MXBBSNET & ZGATENET FTN Domains
Curator of The International Zonelist

* Origin: ZGATENET to/from FIDONET Domain (1:262/3)

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(56)   Sat 6 Feb 93  7:25p
By: Nikos Voulgaropoulos
To: all
Re: article from internet
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Statement of President Clinton on Health Care Reform Task Force
To: National Desk, Health Writer
Contact: White House Press Office, 202-456-2100

WASHINGTON, Jan. 25   -- Following is a statement of President
Clinton at the White House Monday, Jan. 25:

   Good afternoon.

   As I travelled across our country this past year, no stories
moved me more than the stories of those families struggling to pay
for health care. I listened to Marie Kostos, a working mother in
Columbus, Ohio who had to quit work in order to get Medicaid
coverage for her infant, who is stricken with spina bifida....To
Mary Annie and Edward Davis, a New Hampshire couple who faced the
terrible choice of having only enough money to buy the food they
needed or the prescription drugs they had to have....And I listened
to a group of coal miners in Beckley, West Virginia -- some of whom
had worked the mines for more than 30 years but were at risk of
losing their health benefits.

   Their message to me -- and to the Congress -- was simple: it's
time to make America's health care system make sense. It's time to
bring costs under control -- so that every family can be secure in
the thought that a medical emergency or a long illness will not
mean bankruptcy. And it's time to bring quality coverage to every
American -- to cut back on the paperwork and the excuses and make
health care a right, not a privilege.

   As a first step in responding to the demands of millions of
Americans, today I am announcing the formation of the President's
Task Force on National Health Care Reform. Although the issue is
complex, the task force's mission is simple: to build on the work
of the campaign and transition, to listen to all parties, and to
prepare health care reform legislation that I will submit to
Congress this spring.

   The task force will be chaired by First Lady Hillary Rodham
Clinton and will include the Secretaries of Health and Human
Services, Treasury, Defense, Veterans Affairs, Commerce, and Labor,
as well as the director of the Office of Management and Budget and
senior White House staff members.

   I am grateful that Hillary has agreed to chair the task force --
and not only because it means she'll be sharing the heat.  As many
of you know, while I was Governor of Arkansas, Hillary chaired the
Arkansas Education Standards Committee, which created public school
accreditation standards that have since become a model for national
reform.  In 1984-85 Hillary served as my designee on the Southern
Regional Task Force on Infant Mortality.  She was the Chair of the
Arkansas Rural Health Committee in 1979-80.  And she has also
served on the Board of the Arkansas Children's Hospital, where she
helped establish Arkansas's first neo-natal unit.

   I am certain that, in the coming months, the American people
will learn -- as the people of Arkansas did -- just what a great
First Lady they have.

   Here in the White House, Hillary will work with my domestic
policy advisor, Carol Rasco, my senior policy advisor, Ira
Magaziner, and the head of my health care transition team, Judy
Feder. I have asked all of them to be as inclusive as possible and,
as part of that, we are inviting the American public to write us
here at the White House with their suggestions. All suggestions
should be sent to the Task Force on National Health Care Reform,
The White House, Washington, D.C. 20510.

   We will no doubt be criticized by some for undertaking something
much too ambitious.  But as I said in my inaugural address, we are
going to have to make some tough choices.  In the months ahead,
powerful lobbies and special interests will attempt to derail our
efforts.  We may make those people angry, but we're determined to
come up with the best possible solution for America.

   I know -- as you know -- that we must reform our system. We're
kidding ourselves if we think we can deal with the deficit unless
health costs come down. If things don't change, American workers
and exporters will remain one step behind in global competition.
And most importantly, unless we do it now, American families will
continue to face tremendous financial hardship. We must not delay.

* Origin: Disabled Hellas, 2 nodes HST,V32 & V32b,16.8k,ZYX
(2:410/6)