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Clinton Appeals to Elderly on Health Plan : Reforms: In radio address, he points out positive aspects of proposal and promises to allow choice between Medicare and alternatives.

September 19, 1993|ELIZABETH SHOGREN | TIMES STAFF WRITER

WASHINGTON — President Clinton, in a bid to win support for his health care reforms from older Americans, promised Saturday that his plan would allow them to choose between Medicare and less expensive alternatives and would permit them to continue selecting their own doctors.

In his weekly radio address, Clinton also said that because his plan would include coverage for prescription drugs, elderly Americans on fixed incomes would not face the dilemma of having to choose between food and expensive medicines.

Older Americans with serious impairments would also be eligible for community-based care, allowing them to remain close to their families, Clinton said.

He added that the Administration has proposed tax incentives to make private insurance more affordable for older Americans seeking coverage for long-term care.

"Sixty years ago, in the midst of the Great Depression, America provided Social Security for all Americans so that a lifetime of work would be rewarded by a dignified retirement," Clinton said. "Now it's time to provide health security for all Americans so that people who work hard and take responsibility for their own lives can enjoy the peace of mind they deserve."

The talk was a prelude to the President's speech to a joint session of Congress on Wednesday, when he will lay out his strategy for reforming the nation's health care system.

It was also a clear effort to woo elderly Americans, whose support he needs to get congressional passage of the reforms.

The nation's powerful senior-citizen lobby has threatened to oppose the entire plan, largely because of the Administration's proposal to pay for most of its costs by restricting the growth of Medicare and Medicaid payments to doctors and hospitals.

Older Americans have complained that while they were Clinton's biggest supporters in last year's election, they are being asked to pay more than their share of the health care reform bill.

Attempting to reassure them about their Medicare coverage, Clinton said: "This is something I feel strongly about. We will maintain the Medicare program. If you're happy with Medicare, you can stay in it."

Under his proposal, Medicare would continue to operate separately. Eventually, states could fold it into regional health-purchasing alliances that other individuals and businesses would use to buy their coverage, but they would have to guarantee senior citizens benefits as good or better than standard Medicare.

Clearly aware that some older people are nervous that health reform could be a net loss for them, Clinton said: "I want to say this to those older Americans listening today: Our plan offers you more peace of mind."

The Administration's overall plan would offer a standard set of benefits to all Americans by 1997 and require employers to pay about 80% of average premium costs, with workers paying the rest. Small businesses and low-wage workers would get federal subsidies to help pay their premiums.

Clinton made a strong plea for cooperation across party lines for passage of health care reform.

"On Wednesday night, when I speak before a joint session of Congress, I will ask the Congress to provide every American with comprehensive health care benefits that cannot be taken away," he said. "I will ask Congress to work with me to reduce cost, increase choices, improve quality, cut paperwork and keep our health care the finest in the world. And I'll ask members of both parties to work together for this important purpose."

In a Republican response to the speech, Sen. John C. Danforth of Missouri said that while there are points of disagreement, Republicans are committed to bipartisan cooperation on health care reform.

"The Republican plan serves as an invitation to the President to work with us in building a consensus on this daunting issue," he said.

"We agree on the problems," he added. "Health care costs cannot continue to grow at three times the rate of inflation. Health insurance coverage should extend to all Americans. Insurance companies should not make money by avoiding people who are sick."

One of the points of contention between Republicans and the President, Danforth said, is that Republicans feel that mandating employers to pay for health coverage "would be another tax on small businesses."

In a related development Saturday, the Congressional Budget Office warned in a study that limiting increases on private health insurance premiums--a step proposed by the Administration to control rising health care costs--could be economically harmful to people covered by the policies.

"Benefits would be lower, out-of-pocket spending for health care would rise, high-risk individuals would find it harder to obtain coverage and technological progress in health care would probably occur more slowly," the report said.

The report was requested by a House subcommittee before announcement of Clinton's plan to control health costs by capping premium increases.

The CBO said the study is "not based on any specific legislative proposal under consideration nor on the Administration's health care proposal."

Under the Clinton plan, the government would restrict the growth of health spending in the private sector by limiting the amount that health insurance premiums could rise each year. The Administration theorizes that such a move would force insurers to economize.

But the study said many insurers might be unable to cut costs sufficiently and might attempt to "avoid insuring individuals and groups likely to be above-average risk, that is, people whose expected health care costs are above average."

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