Magazine article The Alcoholism Report

Is Administration's Health Care Package Terminally Ill?

Magazine article The Alcoholism Report

Is Administration's Health Care Package Terminally Ill?

Article excerpt


If the president's health care package were a living patient, the reciption garnered by last September's "official" release would have placed the proposal on the critically injured list. Based on developments in February and March, there are some who now believe the package is terminally ill.

Economic & Structural Diagnosis

Ironically, perhaps the most severe blow to the president's Health Security Act (H.R. 3600/S. 1757) may have been caused by the White House itself. The congressional Budget Office (CBO), a nonpartisan and widely respected policy analysis organization, was promoted by the administration as being the final word on cost estimates for their proposal. That final word sentshock waves through the White House and provided opponents of the president's bill with additional ammunition.

Testifying before the House Committee on Ways and Means on February 8, CBO suggested the Clinton plan would actually increase the deficit by $74 billion, not reduce it by $59 billion as the administration had estimated; this resulted in a $133 billion difference of opinion.

CBO cited premium costs as the primary reason for the difference in estimates.They also suggested the benefit package contained in the Clinton plan is more generous than most Americans receive today and about 3 percent to 5 percent more costly. Another difference is attributed to the base figures used as a starting point for projecting health expenditures.

In addition, certain portions of the president's plan could prove structurally difficult to implement. CBO warned that the proposed National Health Board and regional health alliances would be a "major undertaking for an existing agency with some experience, let alone for a new agency" that would have to perform all the functions required under Clinton's legislation.

Not all the news, however, from CBO was bad for the president and his proposal. CBO's report tried to downplay the complexity of the bill arguing that the plan "outlines in legislation the steps that would actually have to be taken to accomplish its goals. No other proposal has come close to attempting this."

CBO concluded their study of the Health Security Act by suggesting that as Congress "considers the administration's proposal and alternatives, both comprehensive and incremental, the inherent uncertainties of change must be weighted against the detrimental consequences of the current system; increasing numbers of people who lack the security of insurance coverage for health care and the rapidly rising costs of that care."

Alternative Proposals

While the CBO report may habe been in final nail in the coffin for the president's reform package, alternative reform packages--ranging from single payer to incremental reform--have been steadily eroding support for the president's bill.

One piece of legislation that initially enjoyed wide-ranging support is the Managed Competition Act of 1993 (H.R. 3222/S. 1579), introduced by Representative Jim Cooper (D-TN) and cosponsored by Senator John Breaux (D-LA). Cooper's legislation would not force employers to pay for their employees health insurance, it would not limit premium prices, and although it provides a "standard minimum benefits package," what constitutes "standard minimum" has yet to be defined. This bill however, may be known more for what it does not contain--universal coverage--than what it seeks to accomplish.

Evidence of just how hard Cooper hammered into the president's support came in early February when the Business Roundtable, after intense courting from the administration, decided to back the Cooper bill over the president's legislation, and the National Association of Manufacturers decided not to support any particular reform bill. Cooper has scored big not only with business, but within Congress as well, attracting at least 31 Democrats and 26 Republicans as cosponsors. …

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