Ronald Reagan's America - Vol. 1

By Eric J. Schmertz; Natalie Datlof et al. | Go to book overview

books, government documents, print media, and especially personal interviews with 60 current and former members of the Reagan administration and executive branch, congressional staff, and the Washington policy community.


NOTES
1.
Referred to by President Reagan as "that woman from Massachusetts," Heckler received the HHS position after her post-reapportionment defeat by liberal Barney Frank as a reward for loyalty in an overwhelmingly Republican state and as an opportunity to increase women's representation on the Cabinet. However, Mrs. Heckler was never actually intended to run the department, but to be the public façade for operations directed by the White House. Her unwillingness to cooperate with White House direction contributed to a perceived sense of disloyalty to the Reagan team. With the departure of Jim Baker, Heckler lost her primary support within the administration inner circle. After a full year of public dispute with his successor, Don Regan, during which he held up all departmental appointments, leaving HHS virtually operating with a temporary management team, Heckler finally resigned to accept an ambassadorship to Ireland.
2.
As configured, Medicare is effective for short-term illness. Patients with acute catastrophic health care needs, though few in number, are often left impoverished by increasing copayments required by Medicare and run the risk of total loss of benefits. As chairman of the quadrennially mandated Advisory Council on Society Security, Bowen gave full support to a proposal to expand Medicare to include acute catastrophic coverage, which was estimated to add approximately $5 to the Medicare Supplemental (Part B) monthly premium. This would have extended hospitalization benefits to one full year and put a cap on out-of-pocket copayments. It was designed to cover only acute care, not nursing-home or chronic long-term care.
3.
Political Affairs Advisor Mitch Daniels recalled that Bowen's interest in Medicare and catastrophic care was discussed within the administration prior to his appointment.
4.
The health insurance industry saw catastrophic coverage under Medicare as a threat to their $8 million annual sales of Medigap policies. Mutual of Omaha sent health insurance lobbyist and presidential confidante Robert Gray to intercept the catastrophic care proposal. He was successful in downgrading the expected announcement of forthcoming legislation for Medicare restructure to a request for a presidential study.
5.
Bowen had served for 20 years in Indiana legislative politics before he became governor in 1973 and served for two terms in that office. He was an enormously wellliked governor, whose personal style enabled him to achieve a broad-based coalition within his diverse state and to utilize the loyalty of others to build support for his own issues.
6.
A 12-person Executive Advisory Council, including the entire upper administrative staff at HHS, was the designated decision-making body. Additionally, the White House mandated a blue-ribbon panel of their own selection, which was expected to produce a private-sector initiative for catastrophic care that could be presented as a Reagan plan. However, conflict between the White House and HHS precluded any

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