Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SATURDAY, March 26, 1994                   TAG: 9403260066
SECTION: VIRGINIA                    PAGE: C-1   EDITION: METRO 
SOURCE: LESLIE TAYLOR STAFF WRITER
DATELINE:                                 LENGTH: Medium

KEY TO HEALTH: `RESPONSIBILITY'

Truth is, "the secretary of health and human resources is out of shape," she said at Friday's annual meeting of the League of Older Americans in Roanoke.

"But that's not going to last long, because she's going to take some responsibility for her own health and practice what Personal responsibility is one of four principles that Kay Coles James says must be part of health care reform. she preaches."

What James preaches, as one major principle of a health care reform, is personal responsibility.

"We as Americans tend to be people who eat whatever we want to eat, drink whatever we want to drink and as much of it, smoke, engage in whatever kind of sex we want to engage in, don't exercise, don't wear seat belts, get sick or hurt and demand access to health care so we can go back out" and do it all over again, she said.

"But if you're going to bring some sense to the health care debate, we must recognize our own responsibility for our health."

Personal responsibility is one of four principles that James says must be part of health care reform.

The plan also must be accessible. If it does not give access to care for those who cannot afford it, then it is not a good plan, she said.

And it must be affordable. If it is accessible but people cannot afford to buy that access, then it is no good, James said.

"The final principle we must apply to anything that comes out of Washington is flexibility," she said. "Because the reality is states need flexibility to design a system that best meets the needs of its citizens. If they allow us flexibility to develop a program that we need here in Virginia without imposing mandates, particularly unfunded mandates, then we can get the job done here."

Virginia legislators exercised that kind of flexibility by taking the lead in a national issue and passing welfare reform legislation during the last General Assembly. The plan limits welfare benefits to two years in exchange for job-training, child care, transportation and health care.

"We intend to tackle it and ensure that we can, in fact, end welfare as we know it," James said, borrowing an often-used phrase from President Clinton.

Welfare will not be reformed through government programs alone or by "tweaking" with a few caps and waivers here and there, said James, who grew up in a Richmond public housing development.

The Allen administration intends to do it with involvement from all segments - by "bringing all of the appropriate people to the table to get the job done," James said.

"I've attended too many conferences where they talk about the fact that it takes an entire village to raise a child," she said. "But I have some very sad news for you. The village is gone. What we want to do is look at how we can build the entire village."

That will require ending business, education, housing and health care "as we know it," James said.