Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 6, 1995 TAG: 9503080027
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: Associated Press
DATELINE: WASHINGTON LENGTH: Medium
``Right now, health care is not very bright on anybody's radar screen,'' said Sen. Robert Bennett, R-Utah, the new head of a GOP Senate task force on health. But, he said, ``this issue will be back center stage. We're going to have to deal with it.''
Several GOP lawmakers have introduced bills to help small businesses pool and buy insurance on better terms, and to help individuals with medical problems get coverage.
Although health reform was conspicuously absent from the GOP's ``Contract With America,'' both House Speaker Newt Gingrich and Senate Majority Leader Bob Dole have called for a hard look at the $162 billion Medicare program.
Dole has said the Republicans may seek $146 billion in savings from Medicare over five years and half that much from Medicaid. Sen. Bob Packwood, R-Ore., the Finance Committee chairman, spoke of saving up to $400 billion over seven years.
Democrats, on the defensive last year over Clinton's plan to mandate health insurance for all, are raising alarms about GOP plans to tap Medicare and Medicaid to pay for tax cuts and deficit reduction.
A year ago, the White House had its own designs on Medicare. It was seeking big savings to help cover the uninsured and, eventually, bring down the deficit.
``I bit off more than I could chew,'' Clinton acknowledged Friday.
``I think I made a mistake, but I think [the Republicans] did, too,'' in killing any reforms, he said. Now, both parties should ``figure out a way to help Americans get more-affordable health care and to solve this problem. And if we do it in the right way, we will continue to substantially lower the cost of Medicare and Medicaid.''
The Republicans are framing the debate now and talking about moving Medicare, one of the last bastions of fee-for-service medicine, more rapidly into the managed-care arena.
Most working Americans have become accustomed to paying more if they want unrestricted choice of doctors - or less if they join a health maintenance organization or accept other restrictions.
Rep. Bill Thomas, R-Calif., chairman of the Ways and Means health subcommittee, calls Medicare a dinosaur that must change or go bankrupt after the turn of the century.
Thomas has offered a bare-bones insurance reform bill that would require insurers to accept every small employer in their market and limit exclusions for pre-existing conditions to six to 12 months.
The House already has voted to restore the 25 percent health premium deduction for the self-employed, and the Ways and Means Committee opted to expand Medicare Select, a managed-care option for seniors.
Sen. Judd Gregg, R-N.H., has proposed giving seniors a ``Choice Check'' for a fixed amount to enroll in a wide range of health plans, like the ones offered federal employees. Medicare now spends $4,400 per beneficiary.
But Bruce C. Vladeck, the Medicare chief, has urged Congress to be slow in pushing seniors into managed care. He fears private insurers might siphon off the healthiest customers and stick the government with the oldest and sickest.
Rep. Harris Fawell, R-Ill., has put forward a pair of bills to rewrite insurance rules and allow small businesses to avoid state mandates and regulation of their health plans, just as large companies do. Fawell says more Americans would be insured if states stopped mandating ``Cadillac coverage.''
Rep. Barney Frank, D-Mass., finds it ironic that Republicans want to shift scores of social welfare programs back to the states - but not the power to regulate all health plans. On that score, states' rights takes a back seat to business interests, he charges.
Some GOP leaders, including Bennett and Rep. Bill Archer of Texas, the chairman of Ways and Means, are enthusiasts for medical savings accounts - allowing people to control their own tax-free funds to pay out-of-pocket expenses, and encouraging them to buy insurance for catastrophic bills.
Absent from the batch of Republican proposals are any subsidies to help the uninsured buy coverage.
Lawmakers are wary of making changes that could drive premiums up and add to the ranks of the uninsured.
by CNB