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White House Defends Saving $124 Billion From Medicare : Health: Clinton's chief adviser on reform insists that care for elderly can be capped without hurting the quality of the program.


WASHINGTON — Brushing aside criticism from Congress and senior citizens' groups, President Clinton's chief health care adviser insisted Sunday that the Administration will not alter its proposal to save $124 billion from future Medicare spending to help finance national health coverage.

"Our cost and savings projections are solid, and we stand firmly behind them," Ira Magaziner told a White House news conference. "They are conservative and credible."

Critics of the President's reform proposal are fearful that doctors and hospitals, faced with tighter restrictions on government reimbursements, will start turning away Medicare beneficiaries.

But Magaziner said the Clinton plan will slow inflation while still providing quality care.

"We've had hundreds of experts working on this plan," said Magaziner, defending the Administration's insistence that it can cap the growth of Medicare outlays without hurting the quality of the program that serves 33 million Americans over the age of 65 and 3 million disabled individuals of all ages.

He acknowledged the criticism from Congress, while denying that it would change the plan that the President will formally announce next week.

"We have heard from numerous people on the Hill . . . about every one of the ideas" in the health reform plan, Magaziner said.

He emphasized that health care reform, in which large regional purchasing alliances negotiate with networks of doctors and hospitals on behalf of consumers, would drastically reduce the runaway cost of medical care.

"We all know there is tremendous waste in the system, we need to get (rid of) that waste," he said.

Medicare will spend a total of $1.4 trillion by the year 2000, and savings of $124 billion on that huge base are comparatively modest, Kenneth Thorpe, deputy assistant secretary for health policy, told the news conference.

The Administration "is ready and willing to consult with anybody," Magaziner said, but the thrust of his remarks was clear: The Administration won't make any major changes in the projection of savings from Medicare and Medicaid--the health program for the poor--to help finance health coverage for the 37 million Americans who are now uninsured.

The draft plan calls for Medicare and Medicaid--which is expected to save some $114 billion during the same period--to provide $238 billion of the $441 billion needed over the next six years for the reform program.

The final plan may vary the Medicare numbers slightly, as could the amount of revenue collected from "sin" taxes on alcohol and tobacco, Magaziner said. But the major thrust--big savings from Medicare and Medicaid--won't be changed, he insisted.

Magaziner also used the news conference to try out the rhetorical themes that the Administration will use in trying to sell its health plan to Congress and the American people.

"We are going to stand firm on what the American people need," he said, citing a litany of guaranteed benefits, insurance for everyone whether employed or not and high-quality medical care. "Your insurance will never be taken away, no matter what," he said.

Magaziner also unloaded a volley against the Administration's favorite political target in the health reform battle--the insurance industry.

"Today, there's no competition in the health care market. Insurance companies can charge whatever they want," Magaziner said.

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