National Emergency Medicine Assoc. (NEMA)



a special program of the National Emergency Medicine Association (NEMA) 

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Week: 609.6 Pt.1

Guests: President Clinton, Sen. Phil Gramm (R-TX), Ruth Kane, Richard Coorsh- Health Insurance Assn. of America, Rep. Pete Stark (D-CA)

Topic: Clinton announces new age for Medicare

Reporter: Aaron Cohen

Host/Producer: Steve Girard

NEMA: Thanks for joining us. A couple of stories for you, as usual. First up:

Much has changed since President Lyndon Johnson created Medicare over a quarter century ago...and if President Clinton succeeds, Medicare will be remade before the end of the century. Mr. Clinton proposed expanding the government health insurance program to include those too young for Medicare and not poor enough for Medicaid. Aaron Cohen has Health on the Hill....

COHEN: Three million people, America’s near-elderly, either can’t afford private insurance or can’t buy insurance to cover their preexisting conditions. None of them are old enough, or poor enough to receive guaranteed Federal health benefits. So with seemingly no where to turn, the President proposed an expansion of Medicare...

CLINTON: This is an entirely new way of adapting a program that has worked in the the needs of the future. It is a fiscally responsible plan that finances itself, by charging an affordable premium up front, and a small payment ensure this places no new burdens on Medicare. It will provide access to health care for hundreds of thousands of Americans, and it is clearly the right thing to do.

COHEN: Three groups in medical limbo could qualify if they’re willing to pay the premiums: 55 to 65 year olds who get fired or laid off and lose their health insurance, retirees whose old bosses renege on promises to provide coverage, and 62 to 64 year olds who want to opt into the system early. One couple who would be willing to buy into a Medicare plan are the Kains. Rufus retired in 1990, and his wife Ruth has heart problems...she needed a pacemaker and a stent. Her insurance covered everything but her heart condition, forcing the family to abandon their Northern California farm for a more austere life in Missouri...

KAIN: My insurance company doesn’t cover any of it. People like my husband and I, who work hard to make sure we could take care of ourselves in our retirement years, shouldn’t literally have to sell the farm to have access to health care.

COHEN: Administration officials say three million near elderly Americans in the 55 to 65 age bracket would be eligible, but they expect only 300 thousand to buy into a Medicare policy...its 3 or 400 dollar a month premiums may be too expensive for people on fixed incomes. The President’s latest attempt to expand health coverage drew fire from the insurance industry and congressional republicans. Richard Coorsh is a spokesman for the Health Insurance Association of America...

COORSH: On the whole, the President’s notion of extending coverage is certainly laudable...we have to be concerned, however, that he chooses to do so based upon a ‘big government’ type of this case by expanding the federal Medicare program.

COHEN: Coorsh says the industry is concerned particularly that, as Medicare insures younger people, companies may decide to drop retirement health benefits altogether. That concern was echoed by a prominent republican on Capitol Hill. Texas senator Phil Gramm also worries that workers may retire early to take advantage of the low-cost, or even free insurance. The near-bankrupt system, Gramm says, can hardly stand any more strain...

GRAMM: The last thing on earth you want to be preoccupied with is getting more passengers on the Titanic.

COHEN: Medicare hasn’t yet hit a financial iceberg, but alarms have been sounded...a bipartisan commission has been formed to recommend measures to prevent insolvency, but the panel has yet to meet. In the meantime, the President is responding to a growing need - 55 to 65 year olds have less insurance and more medical problems that others. And with baby-boomers reaching their 50’s in the next few years, the pressure on Medicare and Social Security will grow. Plus, Congressman Pete Stark of California, a top health subcommittee democrat, says the problem fills a niche market, and is self-supporting too...

STARK: There’s no question about it. It’s a very efficient system...Medicare has got a 2 % overhead, and this has been proposed before in a variety of forms, and the more people that use it, the better it gets. And the private insurance companies don’t really want that we’re playing into a market that needs what Medicare has to offer.

COHEN: Despite the administration’s assurances that the Medicare expansion plan won’t cost the treasury much money, congressional leaders are wary. Some are taking a ‘wait and see’ approach, but two influential committee chairmen in the House are predicting Congress will kill the bill. Medicare expansion for the near elderly is expected to be a hot topic in Washington this year...Congressman Pete Stark warns Republicans kill this plan at their peril....For Health on the Hill....I’m Aaron Cohen.