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SIGNIFICANT HEALTH CARE REFORM MORE LIKELY AT STATE -- NOT FEDERAL -- LEVEL IN THE NEAR TERM, SAYS CONGRESSMAN

SIGNIFICANT HEALTH CARE REFORM MORE LIKELY AT STATE -- NOT FEDERAL --
 LEVEL IN THE NEAR TERM, SAYS CONGRESSMAN
 WASHINGTON, Feb. 13 /PRNewswire/ -- Despite the high decibel level surrounding proposals for health care reform at the federal level, significant change in the near term may be more likely through multiple reforms at the state level, a leading congressional Republican health care expert said today.
 Rep. Willis D. Gradison Jr. (R-Ohio) added that he understood the message of many state governors to the federal government to be, "If you aren't going to do something, get out of our way."
 Gradison made these remarks at the Second Annual Leadership Forum, "Payment Options in an Era of Health Care Reform," held in Washington. The forum is sponsored by Lewin-ICF, Inc., a Fairfax, Va.-based management consultant group serving health care organizations for more than 20 years.
 Gradison told the forum he believed that, if many states did take action of a significant nature, it would slow or perhaps block subsequent proposed federal changes. He conceded that conventional wisdom is that many state actions would ultimately force federal action, but said that the probability was that the state programs would be various and that too few states would act, thus making it harder to get the federal government to deal with resultant dislocations.
 Gradison is the ranking member of the Health Subcommittee of the House Ways and Means Committee and of the House Budget Committee.
 His opposition to a single, federal, central solution to health care reform is based on the track record of government health care delivery programs, among other things, he said. Citing the experience of the care delivery programs of the Department of Veterans Affairs and the Indian Health Service, Gradison said that their inability to get fully adequate funding underscored the correctness of economist Milton Friedman's view that government funding of health care programs starts with an increase, but then recedes from the burden of continuing increases in the face of competing demands for dollars.
 Describing himself as a supporter of President Bush's health care reform proposals made public last week, Gradison nevertheless noted what he termed "ironies" in the plan.
 Such an irony arose, for example, with the fact that while the president's plan rests heavily on incremental reform of current systems as more supportive of freedom of choice, its push for managed care as a cost-containment measure would limit freedom of choice, and might allow less choice than available in some Canadian provinces under Canada's national health insurance program, which the president opposes. But, said the congressman, it "would be naive" to depend on a single, government solution to health care cost problems in the hope that "government would get it right."
 A gradual approach, building on current systems, would at least "diversify our risks" and give more players a better chance of coming up with better solutions. In any case, he said, whatever is going to happen, "isn't going to happen soon" at the federal level. The successful presidential candidate in this year's election may claim a mandate for one or another health care reform proposal, but that will not in itself guarantee speedy passage of such laws.
 Referring to recent polls, he said that the American people told pollsters that they are dissatisfied with the current state of affairs, but only a small fraction of them was strongly committed to any particular solution and its costs.
 -0- 2/13/92
 /CONTACT: Sara Brenner of ICF, 703-934-3004/ CO: ST: District of Columbia IN: HEA SU: LEG


TW-SB -- DC028 -- 9844 02/13/92 14:46 EST
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Date:Feb 13, 1992
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