Cream of the Crop 3/Cream of the Crop 3.iso/educate/hlthcr.zip/HLTHCR.TXT

Text File | 1993-12-19 | 12KB | 244 lines

Area: ABLENEWS

Date : Dec 15 '93, 14:01
From : Bob Lantrip                                            1:19/131.0
To   : All                                                   1:275/429.0
Subj : Health Care Reform...
────────────────────────────────────────────────────────────────────────────────


EID:F0C4 860C0000
Reprinted, with permission, from:

THE DISABILITY REPORTER
Published by: OKLAHOMA OFFICE OF HANDICAPPED CONCERNS
4300 N. Lincoln, Suite 200, Oklahoma City, OK. 73105
405-521-3756 V/TDD and 1-800-522-8224 V/TDD
Jean Jones, Editor


For millions of Americans with disabilities, the issue of health care
access and affordability has been simmering on the burner for many
years.

In the last two decades citizens with disabilities have successfully
advocated for improvements in civil rights, education, rehabilitation
and accessibility.  But the issue of health care has remained an
unassailable giant, immune to the desperation so often felt and
expressed by disabled individuals and families whose lives have been
harmed by inability to obtain adequate, affordable health care.

An estimated 550,000 Oklahomans have disabilities, not counting those
who live in nursing homes and other institutions.  All have physical or
mental impairments or chronic health conditions which can, at any time,
be used by insurance companies as a reason for cancelling, limiting,
denying or raising the cost of their health insurance.  In 1986 an
estimated 30,000-50,000 Oklahomans were uninsured because they were
"medically uninsurable."  Signs are this group has grown significantly
in the last decade, as insurers have become more selective about what
"risks" they will cover.

Uninsurability is an integral feature in the structure of our current
health care system in America.  There are built-in incentives for health
insurers to limit or exclude coverage for persons who appear to be at
high risk of incurring significant medical expenses.  The greatest of
these incentives is the need for insurance companies to make a profit.
But an increasingly important incentive is the need for insurance plans
to remain financially solvent as medical costs soar, expensive medical
technology proliferates, and cost shifting (covering the cost of
uncompensated care by raising rates on the insured) spreads in response
to the growing population of the uninsured.

They include people whose medical conditions or disabilities prevent
them from getting or keeping health insurance, even prevent them from
working, but who are not eligible for benefits through Social Security,
Medicare or Medicaid.  Even those who are awarded Social Security
Disability benefits must wait two years before they are covered through
Medicare.  If they are not otherwise insured or sufficiently poor to
qualify for Medicaid, these individuals generally have no way to obtain
health coverage.

Other "medically uninsurable" persons include those who at one time in
their lives had cancer, heart disease or any of hundreds of other
illnesses.  They include healthy children who happen to have Down
Syndrome, cerebral palsy, or other disabilities.  In fact, many persons
who today are considered "medically uninsurable" are actrually very
healthy people with no background of exceptional medical expenses.

Increasingly, working people with disabilities or pre-existing
conditions are denied employer group coverage because they are
considered high risk.  Employers can be caught in a double bind: they
must provide disabled workers with equal benefits, but no insurance can
be found to cover such workers, or group insurance rates would rise
substantially if such workers were extended coverage.

Without the opportunity to buy insurance at any price, "medically
uninsurable" individuals and their families often face unmanageable
out-of-pocket medical expenses.  Their choices, when they cannot pay or
pay enough, include bankruptcy, going without needed care, or obtaining
care without paying for it.

A 1988 Office of Handicapped Concerns survey of 343 disabled individuals
and family members rated insurance affordability as their major barrier
to obtaining health coverage.  52% of respondents said they lacked
health insurance because any health insurance was too expensive for
them to buy.

While some uninsured persons with disabilities receive medical services
as "uncompensated care," most do not receive adequate health care this
way, and many receive none at all.  Especially unattainable for these
individuals are prevention and health maintenance services, including
prescription drugs or therapy, which help prevent health decline, lost
productivity and greater medical costs later on.

What can be done to make our health care system fair and affordable?
The issue is frustratingly complex.  If affects individual opportunities
for employment, social program capacity, and the cost of government to
the taxpayer, as well as our nation's economic survival and future
competitiveness.

The nation has finally recognized that today's costly and inequitable
health care system will devour our resources and darken our future if
nothing is done to stop it.  On both sides of the political aisle,
leaders agree that something must be done to fix the system.  Thus
serious health issue debate has begun on Capitol Hill and throughout the
nation.

Although there is heavy media focus on certain pieces of the various
health reform concepts--such as universality, cost and cost savings, and
employer participation--we have as yet seen little attention given to
the needs of persons with disabilities.  The issue has become the
property of the majority.  As the health reform action unfolds, it will
be critically important that people with disabilities express their
health needs and problems to lawmakers.  Consumers and disability
leaders must also formulate questions that probe the various plans being
offered for responsiveness to the real need for universal coverage,
affordability, and adequate scope of coverage.

 * SLMR 2.1a * Any time that is not spent loving others is wasted.


--- WM v2.04/92-0734
 * Origin: IRONSIDES BBS. [phone] (1:19/131)
SEEN-BY: 209/209 270/101 275/1 37 429 396/1 3615/50 51

PATH: 19/131 124/4115 1 396/1 3615/50 275/1


Area: ABLENEWS

Date : Dec 15 '93, 14:28
From : Bob Lantrip                                            1:19/131.0
To   : All                                                   1:275/429.0
Subj : The Clinton Plan...
────────────────────────────────────────────────────────────────────────────────


EID:1E48 860C0000
Reprinted, with permission, from:

THE DISABILITY REPORTER
Published by: OKLAHOMA OFFICE OF HANDICAPPED CONCERNS
4300 N. Lincoln, Suite 200, Oklahoma City, OK. 73105
405-521-3756 V/TDD and 1-800-522-8224 V/TDD
Jean Jones, Editor


President Clinton's health care reform proposal is, as the President
readily admits, not a static plan but rather one which can and will be
modified by compromise.  Already some elements of the Administration's
proposal have been adjusted in response to public reaction.  However,
the basic system structure proposed remains the same:

*** Universal health care coverage for all Americans.

*** In order to pay for universal coverage, the costs of providing
health care must be lowered or contained.  Clinton's plan would do this
by increasing the bargaining power of consumers (employers and
individuals) and promoting competition among providers (insurance and
medical industries).

*** Employers and consumers would band together into large purchasing
pools to strengthen their bargaining power in the marketplace.  Health
providers would be forced to compete for business, leading to lower
prices and better quality services.  The purchasing pools are called
health care alliances.

*** The cost of universal coverage would also be borne by making almost
everyone pay something.  Employers would be required to contribute 80%
of the cost of insurance for their employees.  Small businesses would be
subsidized by placing caps on the amount they would have to spend on
insurance premiums.  The smallest employers, whose employee's average
yearly pay is $12,000 or less, would not have to pay more than 3.5% of
payroll for employee insurance.  Large firms would not have to pay more
than 7.9% of their payroll on health benefits for employees.

*** Employees pay the difference between the employer contribution and
the cost of their chosen health plan.  They could thus pay up to 20% of
the premium.  Employers, however, could choose to make larger
contributions, which would lower the cost to the individual employee.

*** Self-employed persons pay the total premium for their health
insurance, but the cost would be 100% tax deductable.  Remember that if
the plan's consumer bargaining power and industry competition features
work as intended, the price of individual or family health insurance
should be lowered or at least have its growth slowed.

*** Low-income families would have their health insurance premiums
subsidized.

*** Workers' Compensation medical services would be covered under the
plan, thus reducing Workers' Comp medical premiums.

*** The health care alliances would negotiate with health insurance
plans, including HO's, PPO's and fee-for-service plans, to get the best
prices for consumers.  Any plans selected to offer to consumers must
meet certain requirements for scope of coverage and other features.
There would be no limit on the number of health plans which could be
offered to alliance participants (an earlier Clinton plan version had
limited alliance offerings to three).

*** Health coverage would have to include:  Hospital care; Doctor
visits; Clinical preventive services; Mental health services; Substance
abuse services; Lab and diagnostic services; Home health care; Hospice;
Family planning services; Extended care; Prescription drugs; Medical
equipment; Outpatient rehabilitation services; Vision & hearing care;
Some dental services for children.

*** Medicare recipients would have prescription drug coverage.

*** According to a plan summary prepared by the President's Committee
(PCEPD), Clinton proposes to "increase federal authority to provide home
and community based services to individuals with the most severe
disabilities."

The extent to which the Clinton plan would actually cover home and
community services, and the nature of 'encouragements' for states to
plan and implement systems of such services, and the extent to which
services might hinge on Medicaid eligibility, are all somewhat unclear
as yet.

However, the Clinton proposal does appear to require states to have Home
and Community Based Care (HCBC) plans which define services,
eligibility, the ways in which funding resources will be used, and other
program policies.

The HCBC offered through the state systems must include personal
assistance (help with activities of daily living), case management,
homemaker and chore assistance, home modifications, respite, assistive
technology and supported employment.  There would be copayments for such
services, with persons below 150% of poverty level paying a nominal fee,
and persons above 250% of poverty paying 25% of the cost of HCBC
services.

For employed individuals with disabilities, the plan would provide a tax
credit of 50% of the cost, up to $15,000, for assistance with
activities of daily living.

 * SLMR 2.1a * ...Guns cause crime...like flies cause garbage.


--- WM v2.04/92-0734
 * Origin: IRONSIDES BBS. [phone] (1:19/131)
SEEN-BY: 209/209 270/101 275/1 37 429 396/1 3615/50 51

PATH: 19/131 124/4115 1 396/1 3615/50 275/1