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Health care reform - will this be the year?

President Bush has submitted his proposals for health care reform - and immediately encountered a volley of criticism. "Incremental," "Band-Aid," "Tinkering around the edges" typified the Democratic response. These were not the first shots fired, as the Administration has on numerous occasions denigrated Democratic proposals. Are we heading into a surefire deadlock, with nothing to emerge but hot political rhetoric?

There is every temptation to make health care a splendid political issue - and why not? - especially with a presidential election only nine months away.

What a chance - to talk about the ever escalating costs of health care; to ring the emotional chimes about 37 million Americans without health insurance; to deplore the fact that our nation's children are dying because we don't provide adequate immunizations - and then to blame the other party for lack of progress.

Contrary to the popular notion that the Congress discovered health care reform after the recent Pennsylvania senatorial election, many of on both sides of the aisle have actively worked on improving our nation's health care system for years. Our efforts have often been stymied by powerful interest groups, hesitant members, and weariness when no consensus could be reached on the appropriate approach.

But the scenario of gridlock need not recur. We can enact health care reform in this calendar year - if both parties will check their politics at the door.

Let us concentrate on the extraordinary similarities that exist among and between the proposals submitted by the President, the Senate Democratic leadership, Senate Finance Committee Chairman Sen. Lloyd Bentsen, and the Senate Republicans. Once these groups reach an agreement, we can move to reconcile the legislation that emerges with those bills pending in the House of Representatives.

Enactment of those common elements upon which there is agreement would significantly advance our objectives and slow the growth of health care expenditures, and ensure that more Americans have health care coverage. What are some of those common elements?

Expansion of Community Health Centers - With federal funds, community health centers have proven extremely effective in delivering excellent health services to residents of inner cities and in rural areas;

Tax Code Changes - No one can argue that changes to the Internal Revenue Code are not needed to correct the unfair treatment of people who, when purchasing their own health insurance, are only able to deduct little or nothing of its costs;

Promotion of Managed Care Programs - Managed care programs are proven innovative systems devised by insurers and business to establish coordinated care plans, such as health maintenance organizations;

Small Group Purchasing - We must encourage small business employers to join together, perhaps through their trade associations, to obtain cost effective health care benefits for their employees;

Insurance Market Reform - Insurance carriers should be prohibited from calculating premium rates in a manner that results in a denial of coverage to certain individuals, such as those with pre-existing health problems;

Federal Preemption of State Mandates - Currently each state has a variety of differing requirements for services that must be provided by insurers within that state. These state mandates - which can include such procedures as hair transplants - escalate the cost of health insurance. Federal preemption would ban these requirements and permit insurers to offer basic service plans;

Medical Liability Reform - In a majority of states, medical malpractice insurance adds greatly to the cost of health care, yet provides the insured patient with neither swift nor fair recovery - a single federal approach to medical malpractice insurance holds promise of greatly improving the situation.

These and other areas of agreement would not be insignificant reforms. Their enactment would greatly improve our health system. One year ago, this package would have been considered too ambitious, too hasty. But today, consensus is at hand. And if the various parties will come to the table, there is a possibility of finding agreement on additional points.

The American public is entitled to first rate health care at an affordable cost. The complete solution to our health problems may take several years. However, this should not be used as an excuse to do nothing in the short term. Eighteen months ago, I and twenty-two other Republican senators began working to produce legislation - the Health Equity and Access Improvement Act - which we introduced this past November. We are ready and willing to work with competing proposals to craft a reform package that is responsive to the needs of all Americans - this year.

Let us meet and see who wants a bill and who wants an issue.

Sen. John H. Chafee (R-RI) is chairman of the Senate Republican Health Care Task Force and a senior member of the Senate Finance Committee.
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Author:Chafee, John H.
Publication:Nation's Cities Weekly
Date:Mar 30, 1992
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