Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, October 21, 1994 TAG: 9410220064
SECTION: NATIONAL/INTERNATIONAL PAGE: A6 EDITION: METRO
SOURCE: COX NEWS SERVICE
DATELINE: WASHINGTON LENGTH: Medium
Instead of a huge bill with far-reaching reforms and a massive government structure for health insurance purchases, the administration plans a more modest agenda that will be offered as part of the budget process, Shalala said.
Goals for the new plan would be a reduction in the growth of health care costs and an expansion of coverage through Medicaid and voluntary insurance pools, Shalala said. The plan would be paid for through reductions in the Medicare program and by an increase in cigarette taxes.
Two key components of the president's plan that are likely to be left out of next year's proposal will be universal health insurance for all Americans and a requirement that employers help pay for their workers' coverage.
``Hopefully, we've learned some things over the last couple of years,'' Shalala said at a breakfast with reporters. ``This time, we're going to try to be shrewder and more strategic about what things need to be done first.''
Although there was strong public support for health reform, Shalala said, there also was public opposition to ``taking on the whole system.''
Democratic congressional leaders for the past several years have resisted efforts to adopt incremental changes in health care, arguing that minor alterations would merely reduce the pressure for major change without correcting the problems. But Shalala said she doesn't think a major overhaul is feasible.
``Large targets, huge plans, are very difficult to get through Congress,'' she said. ``It's an organization that is designed for small steps.''
Shalala, who has been campaigning heavily for Democratic candidates in recent days, said there is still a strong interest in health reform among voters, but there is also a strong ``anti-government feeling'' stemming from individuals' direct experiences with local, state or federal bureaucracies.
``With all our good intentions, we walked right into that with health care reform,'' she said.
The specifics of the plan are likely to be determined sometime in December when Cabinet officials present their plans to Clinton for inclusion in his fiscal 1996 budget, Shalala said.
Decisions on how many of the nearly 40 million uninsured Americans to cover and how deeply to cut Medicare will be made then, she said.
Last year, in his State of the Union message, Clinton held up a pen and threatened to veto any reform bill that did not include a plan for universal coverage. But lawmakers were unable to agree on how to provide coverage without forcing all employers to help pay for insurance.
Shalala indicated that the president's new plan would not call for the so-called employer mandate to provide insurance.
``I think that the public has spoken on that issue and we have to take their views into account,'' she said, adding that the mandate was viewed ``as a proxy for a government-run system. Whatever we propose in the future, it seems to me, can't have that handicap.''
Also not expected to be in the plan will be the mandatory insurance purchasing alliances under which every American would have had to purchase insurance.
by CNB