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  :database-name "Health-Security-Act"
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  :description "Server created with WAIS release 8 b5 on Oct 28 13:17:10 1993 by root@calypso

The Health Security Act of 1993 holds the promise of a new era
of security for every American -- an era in which our nation
finally guarantees its citizens comprehensive health care
benefits that can never be taken away.



Today, America boasts the world's best health care
professionals, the finest medical schools and hospitals, the
most advanced research and the most sophisticated technology. 
No other health care system in the world exceeds ours in the
level of scientific knowledge, skill and technical resources. 



And yet the American health care system is badly broken.  Its
hallmarks are insecurity and dangerously rising costs.



For most Americans the fear of losing health benefits at some
time has become very real.  Our current health insurance system
offers no protection for people who lose their jobs, move,
decide to change jobs, get sick, or have a family member with an
illness.  One out of four Americans is expected to lose
insurance coverage in the next two years, many never to be
protected again.  Altogether, more than 37 million Americans
have no insurance and another 25 million have inadequate health
coverage.  



Rising health care costs are threatening our standard of living.
 The average American worker would be making $1,000 a year more
today if health care accounted for the same proportion of wages
and benefits as in 1975.  Unless we act, health care costs will
lower real wages by almost $600 per year by the end of the
decade and nearly one in every five dollars Americans spend will
go to health care.


Small businesses create most of the new jobs in America and
while most want to cover their employees, more and more cannot. 
Under the current health care system, cost pressures are forcing
a growing number of small business owners to scale back or drop
health insurance for their employees.  Small businesses spend 40
cents of every health insurance dollar for administration --
eight times as much as large companies.  And only one in every
three companies with fewer than 500 workers today offers its
employees a choice of health plan.



Our health care system frustrates those who deliver care. 
Doctors and nurses are drowning in paperwork, and hospitals are
hiring administrators at four times the rate of health care
professionals.  The system places decisions that doctors should
be making in the hands of distant bureaucrats.  Its incentives
are upside down; it focuses on treating people only after they
get sick, and does not reward prevention. 



Clearly, our challenges are great.  This legislation is sweeping
in its ambition and simple in its intent:  to preserve and
strengthen what is right about our health care system, and fix
what is wrong.



Our needs are now urgent.  A nation blessed with so much should
not leave so many without health security.



This legislation draws upon history.  It reflects the best ideas
distilled from decades of debate and experience. 



It reflects the sense of responsibility that President Franklin
Roosevelt called for when he launched the Social Security
program in 1933 and recommended that health care be included.



It reflects the vision of President Harry Truman, who in 1946
became the first President to introduce a plan for national
health reform.



It reflects the pragmatism of President Richard Nixon, who in
1972 asked all American employers to take responsibility and
contribute to their workers' health care.



And it reflects the ideas and commitment of generations of
Congressional leaders who have fought to build a health care
system that honors our nation's commitments to all its citizens. 

Today America stands ready for reform.  For the first time,
members of both parties have agreed that every American must be
guaranteed health care.  An opportunity has been placed before
us.  We must not let it pass us by. 


This legislation builds on what's best about the American health
care system.  It maintains and strengthens America's private
health care.  It extends the current system of employer-based
coverage that works so well for so many.  It protects our
cherished right to choose how we are cared for and who provides
that care.  It invests in improving the quality of our care.



This legislation recognizes that America cannot, and need not,
adopt one model of health care reform.  It allows each state to
tailor health reform to its unique needs and characteristics, as
long as it meets national guarantees for comprehensive benefits,
affordability and quality standards.  It establishes a national
framework for reform, but leaves the decisions about care where
they belong -- between patients and the health care
professionals they trust.



Under this legislation, every citizen and legal resident will
receive a Health Security card that guarantees the comprehensive
benefits package.  People will be able to follow their doctor
into a traditional fee-for-service plan, join a network of
doctors and hospitals, or become members of a Health Maintenance
Organization.  Like today, almost everyone will be able to sign
up for a health plan where they work.  Unlike today, changes in
employment or family status will not necessarily force a change
in health coverage.



The self-employed and the unemployed will receive their health
coverage through the regional health alliance, a group run by
consumers and business leaders, that will contract with and pay
health plans, provide information to help consumers choose
plans, and collect premiums.  The largest corporations -- those
employing 5,000 workers or more -- will have the option of
continuing to self-insure their employees or joining a regional
alliance.

The legislation is financed by three sources:  requiring every
employer and individual to contribute to paying the cost of
health care; raising excise taxes on tobacco and requiring small
contributions from large corporations which form their own
health alliance; and slowing the growth in spending on federal
health care programs.  Enormous efforts have been made to ensure
that the financing is sound and responsible. 

The Health Security Act is based upon six principles:  security,
simplicity, savings, quality, choice and responsibility.  

Security.  First and foremost, this legislation guarantees
security by providing every American and legal resident with a
comprehensive package of health care benefits that can never be
taken away.  That package of benefits, defined by law, includes
a new emphasis on preventive care and offers all Americans
prescription drug benefits.

Under this legislation, insurers will no longer be able to deny
anyone coverage, impose lifetime limits, or charge people based
on their health status or age.  The legislation also limits
annual increases in health care premiums, and sets maximum
amounts that families will spend out-of-pocket each year,
regardless of how much or how often they receive medical care.

The legislation will preserve and strengthen Medicare, adding
new coverage for prescription drugs.  To meet the growing needs
of older Americans and people with disabilities, a new long-term
care initiative will expand coverage of home and community-based
care.

The legislation also provides residents of underserved rural and
urban areas with better access to quality care.  It also offers
incentives for health professionals to practice in these areas,
builds urban-rural health care networks, and protects those
doctors, hospitals, clinics and others who care for people in
underserved areas.

Simplicity.  To relieve consumers, business and health
professionals of the burdens of excess paperwork and
bureaucracy, this legislation simplifies our health care system.
 It requires all health plans to adopt a standard claim form;
creates a uniform, comprehensive benefits package; and
standardizes billing and coding procedures. 

Savings.  The legislation promotes true competition in the
health care marketplace.  It increases the buying power of
consumers and businesses by bringing them together in health
alliances.  Health plans will no longer succeed by trying to
pick only healthy people to insure; they will have to compete on
price and quality.  This competition will be backed up by
enforceable premium caps.

This legislation also criminalizes health fraud, imposing stiff
penalties on those who cheat the system.  And it takes steps to
reduce defensive medicine and discourage frivolous medical
malpractice lawsuits by requiring patients and doctors to try to
settle disputes before they end up in court, and by limiting
lawyers' fees.

Quality.  The legislation empowers consumers and health care
professionals by providing information on quality standards and
treatment results.  It calls for new investments in medical 
research, including heart disease, bone and joint disease,
Alzheimer's disease, cancer, AIDS, birth defects, mental
disorders, substance abuse and nutrition.  To help keep people
healthy, rather than only treating them after they get sick, the
legislation pays fully for a wide range of preventive services
and offers new incentives to educate primary care doctors,
nurses and other family practitioners.

Choice.  Through comprehensive reform, the legislation gives
Americans a new level of control over their health care choices.
 It ensures that people can follow their doctor and his or her
team into any plan they choose to join.  It transfers the choice
of health plan from the employer to the individual, and
guarantees a choice of health plans, including at least one
traditional fee-for-service plan.  Doctors and health
professionals may participate in multiple health plans if they
wish. 

Responsibility.  Under this legislation, every employer and
individual will be required to pay for health coverage, even if
that contribution is small.  It extends the current
employer-based system for financing health coverage -- a system
that now serves nine of every ten Americans who now have health
insurance.  To ensure affordability, small businesses, low-wage
employers and low-income individuals and families will get
substantial discounts.

This legislation will strengthen our economy.  Our current
system is so much more costly than any other system in the
world, and the American people should not be asked to pay huge
new taxes in order to afford health care reform.  This plan
raises no new broad-based taxes, but spends our health care
dollars more wisely.  It levels the playing field for small
businesses, making it possible for them to insure their families
and employees.  It eases the tremendous burden of rising health 
costs on big business, helping them to compete for global
markets.  And by bringing the explosive growth in health costs
under control, it sets us in the right direction of reducing our
national debt.

The legislation restores common sense to American health care. 
It borrows from what works today, letting us phase in change at
a reasonable pace and adjust our course if needed.  It builds on
what works best -- and makes it work for everyone.  Our task now
is to work together, to leave behind decades of false starts and
agree on health care reform that guarantees true security.  The
time for action is now.  I urge the prompt and favorable
consideration of this legislative proposal by the Congress.



					    Sincerely,


The Honorable Thomas S. Foley
Speaker of the
   House of Representatives
Washington, D.C.  20515



The Honorable George J. Mitchell
Majority Leader
United States Senate
Washington, D.C.  20510


   /pub/academic/political-science/Health-Security-Act/report
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   /pub/academic/political-science/Health-Security-Act/foley-mitchell-letter.txt
   /pub/academic/political-science/Health-Security-Act/exsum.d/10pgr.txt
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