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THE HEALTH SECURITY ACT OF 1993
Health Care That's Always There

Every American citizen will receive a Health Security Card that
guarantees you a comprehensive package of benefits that can never
be taken away.

Guaranteeing comprehensive benefits that can never be taken away.
Controlling health care costs for consumers, business and our nation.
Improving the quality of American health care. Increasing choices for
consumers. Reducing paperwork and simplifying the system. Making
everyone responsible for health care. These are the principles of the
Health Security Act of 1993 and they are not negotiable.

In America, rights and responsibilities go hand-in-hand. We will ask
everybody to pay something, even if your contribution is small.
Everyone must assume responsibility. No one should get a free ride.

Most important, we're going to offer new opportunities and new
incentives for people to stay healthy -- and to treat small problems
before they become big ones. Our goal should be to keep people
healthy, not treat them after they become sick.

What's Wrong With the Current System

The things that are wrong with our health care system are threatening
everything that's right with American health care.

* Over the next two years, one out of four of us will be without
health coverage at some point. Change jobs, lose your job, or
move -- and your insurance company is currently allowed to drop
you.

* Today's system is rigged against families and small businesses.
Insurance companies pick and choose whom they cover. Then they
drop you when you get sick. If you have a pre-existing condition,
you usually can't get any insurance at all.

* Insurance companies charge small businesses as much as 35% more than
the big guys.

* Only 3 of every 10 employers with fewer than 500 employees offer any
choice of health plan. Millions of Americans have almost no choice
today.

* Twenty-five cents out of every dollar on a hospital bill goes to
bureaucracy and paperwork -- not patient care.

* Fraud and abuse are exploding, costing us at least $80 billion a
year. That's a dime of every dollar we spend on health care.

* Our nation's health costs have nearly quadrupled since 1980.
Without reform, by the year 2000, one of every five dollars
we spend will go to health care.

The Health Security Plan

Every American citizen and legal resident will receive a Health
Security Card. Once you get your card, you can never lose your
health coverage -- no matter what. If you get sick, you're covered.
If you change jobs, you're covered. If you lose your job, you're
covered. If you move, you're covered. If you have the courage to
start a small business, you're covered.

Your Health Security card guarantees you a comprehensive package of
benefits that can never be taken away. The package is as comprehensive
as the ones that many Fortune 500 companies offer their employees. And
in critical ways -- like paying for preventive care and prescription
drugs -- the package gives you more than big companies provide today.

You will be able to choose your doctor. Everyone will have a choice of
health plans. You'll be able to follow your doctors and nurses into a
traditional fee-for-service plan, join a network of doctors and
hospitals, or join an HMO. Your boss or insurance company won't decide
how or where or from whom you get your care -- you will.

Almost everybody will be able to sign up for a health plan at work,
like you do today. You'll get brochures that give you
easy-to-understand information on several health plans -- which doctors
and hospitals are included, an evaluation of the quality of care, a
consumer satisfaction survey, and prices. If you're self-employed or
unemployed, you can sign up at your area health alliance, which will
be run by consumers and businesses and bargain for affordable health
care for you.

The federal government will set up a national health board -- a board
of directors to set standards and make sure you get the comprehensive
benefits and quality care you deserve. State governments will set up
health alliances give consumers and small businesses the power to buy
affordable care; and the businesses with 5,000 or more employees will
be allowed to operate as "corporate alliances."

Insurance companies will be required to use a single claim form to
replace the thousands of different forms they have today. So when you
get sick, you won't be buried in forms -- and neither will your
nurse, your doctor or your hospital.

* Security of guaranteed, comprehensive benefits.
* Health care costs that are under control.
* Improved quality of care.
* Increased choices for consumers.
* Less paperwork and a simpler system.
* Responsibility from everyone.

That's what the Health Security Act is all about.

Principle #1:
Security: Guaranteed, comprehensive benefits.

Over the next two years, one of every four of us will lose health
coverage for some time. The Clinton plan guarantees that you will
never lose your insurance -- no matter what. All Americans will
receive a Health Security card that guarantees you a benefits package
that is as comprehensive as those offered by most Fortune 500
companies...and then some. Here's how the plan guarantees security:

* Makes it illegal for insurance companies to deny you coverage
because of "pre-existing conditions." The Health Security Act also
makes it illegal for insurers to raise your premiums or drop you
because you get sick. All health plans will be required to accept
anyone who applies -- healthy or sick, young or old.

* Guarantees coverage if you lose your job. The proposal guarantees
that you will keep your health coverage even if you lose your job,
with the employer portion picked up by Federal revenues and
savings. Under the current system, if you lose your job, you lose
your health insurance.

* Guarantees coverage if you switch jobs, move or start a small
business. You will always be protected -- no matter what. Today,
if you switch jobs, move or start a small business, you can find
yourself without health insurance -- and risk bankruptcy.

* Emphasizes preventive care. The comprehensive benefits package
goes beyond virtually all current insurance plans by covering a
wide range of preventive services, including mammograms, Pap
smears, and immunizations -- at no charge to you. It puts a new
emphasis on helping you stay healthy, rather than waiting until
you get sick. Prevention saves money and improves people's
health.

* Includes prescription drugs. Many insurance companies and
Medicare have failed to cover prescription drugs. But drug costs
are breaking family budgets, forcing many older Americans to
choose between food and medicine. Health insurance should cover
prescription drugs. The Health Security plan does.

All Americans will be guaranteed coverage of:
* Preventive Care ( i.e., screenings, physicals, immunizations,
mammograms, prenatal care)
* Doctor Visits
* Prescription Drugs
* Hospital Services
* Emergency/Ambulance Services
* Laboratory and Diagnostic Services
* Mental Health and Substance Abuse Treatment
* Expanded Home Health Care
* Hospice Care/Outpatient Rehabilitation
* Vision and Hearing Care
* Children's Preventive Dental Care

Principle #2:
Savings: Controlling health care costs.

Here's how the Health Security Act will control health care costs:

* Limits how much insurance companies can raise your premium.
Insurance companies will no longer be able to raise your
premiums as they please. Today, insurance companies hike
your premiums -- sometimes at several times the rate of
inflation -- if you get sick, if someone in your family gets
sick, and for any other reason.

* Introduces competition to the health care marketplace. The Health
Security plan will release the chokehold that in today's system,
insurance companies have on all of us -- consumers, nurses,
doctors, and businesses. Reform will encourage competition --
forcing costs down as health plans compete by offering
high-quality care at an affordable price.

* Cracks down on fraud. The health security proposal makes
health-care fraud a crime and imposes stiff penalties on those
who cheat the system. It prohibits doctors from referring
patients to outside facilities, like labs, which they own a
piece of. It stops the kickbacks that some laboratories give
doctors in an effort to get their business.

* Asks the drug companies to hold down prescription drug prices.
The Health Security plan asks drug companies to take
responsibility for keeping prices down, without setting prices.
In today's system, overcharging runs rampant --certain
prescription drugs cost Americans three times more than people
pay in other industrialized countries.

* Reduces paperwork. All health plans will adopt a single, standard
claims form by Jan. 1, 1995. Along with other measures to
streamline the system and free nurses and doctors from excess
bureaucracy, this will reduce paperwork, cut red tape, and save
money.

* Squeezes the waste out of Medicare and Medicaid. By slowing the
growth of these government programs, the proposal uses funds
that have been wasted on excessive charges and funnels them into
comprehensive benefits. Under reform, Medicare will be expanded
to cover prescription drugs, and there will be a new long-term
care program to help cover home- and community-based care.
Today, Medicare and Medicaid spending keeps going up and up. But
the elderly and poor aren't getting any extra benefits. Health
security will change that.

Principle #3:
Quality: Making the world's best care better.

* Emphasizes preventive care. The Health Security plan puts a new
emphasis on preventing illness before it becomes a medical
crisis. Prevention will improve the quality of care by helping
people stay healthy rather than treating them after they get
sick. The benefits package fully pays for a wide range of
preventive services; the vast majority of today's insurance plans
don't cover a penny.

* Gives consumers the power to judge the quality of care.
Consumers will receive quality "report cards" that provide
information on the performance of health care plans and patient
satisfaction. These report cards will hold health plans
accountable for meeting high standards. The National Quality
Program will help states share information on health plan
performance.

* Reforms malpractice. The President's proposal will limit lawyers'
fees in order to discourage frivolous medical malpractice
lawsuits. It will also encourage patients and doctors to use
alternative forms of dispute resolution before they end up in
court. This will help eliminate the "defensive medicine" that
drives up costs and hurts quality -- doctors ordering extra tests
because they fear lawyers looking over their shoulders.

* Encourages cooperation in rural and urban areas. Rural residents
will have access to the latest technology and emergency services
through telecommunications links set up between local doctors and
advanced networks of specialists and hospitals. In urban areas,
the plan will increase investment in public hospitals and
community health centers.

* Provides incentives for more family doctors to practice in rural
and urban areas. The health security plan will give financial
breaks to doctors and nurses who work in underserved rural and
urban areas. It will expand the National Health Service Corps.
Two of three rural counties today do not have enough doctors and
111 rural counties have no physician at all.

* Increases funding for prevention research. The National Institutes
of Health (NIH) will expand research in areas like children's
health, and health and wellness promotion. Preventive care keeps
people healthier and saves money at the same time.

* Promotes research on the effectiveness of treatments. Today, a lack
of information about the most cost-effective methods of treatment
often leads to expensive defensive medicine and wide variation in
treatments and costs. The plan's investments in research into what
treatments really work will help improve the quality of care.

Principle #4:
Choice: Preserving and increasing what you have today .

* Preserves your right to choose your doctor. The proposal ensures
that you can follow your doctor and his or her team to any plan
they might join. Today, more and more employers are forcing
their employees into plans that restrict your choice of doctor.
After reform, your boss or insurance company won't choose your
doctor or health plan -- you will.

* Increases your choice of health plan. You will be able to choose
from among all the health plans offered in your area -- no matter
where you work. Only one of every three companies with fewer than
500 employees offer any choice of health plan. After reform,
every employee will be able to choose a health plan.

* Puts consumers in the driver's seat. The Health Security Act
brings competition to health care -- unleashing the market forces
that will lower costs and improve quality. Giving small
businesses and consumers the power to band together in alliances
will level the playing field and give them the same bargaining
strength as big businesses.

* Increases options for long-term care. The President's proposal
will make it possible for more Americans to continue to live in
their homes and communities while receiving care. Today too many
families are split apart when insurance or federal programs only
pay for hospital coverage. The plan will help put an end to this
situation and give families the options they deserve.

Principle #5:
Simplicity: Reducing paperwork and cutting red tape.

* Gives everyone a Health Security Card. The card -- with full
protection for privacy and confidentiality -- will allow for
electronic billing and the creation of health care information
networks. This will reduce paperwork and simplify the system.

* Requires insurance companies to use a single claim form. The
Health Security Act will reduce the insurance company red tape
that forces doctors and patients to spend their time filling out
forms and fighting bureaucrats. All health plans will adopt a
single, standard claims form by Jan. 1, 1995. It will enable
doctors and nurses to spend more time taking care of you -- and
less time wrestling with paper.

* Eliminates fine print. Everyone will get a comprehensive
benefits package -- and what you get will be spelled out in
easy-to understand language. If you get sick, insurance
companies won't be able to point to fine print and deny you the
coverage you've paid for.

* Streamlines billing reimbursement for doctors, nurses and
hospitals. The comprehensive benefits package, a standard rules
and codes for payment, and elimination of excessive government
regulations will reduce confusion. Doctors, nurses, and hospitals
will have more time to care for patients; and all of us will
benefit.

* Removes the burden on business of negotiating insurance. Groups
of businesses and consumers -- regional health alliances -- will
negotiate for high-quality care at affordable prices. This will
simplify today's system, where hundreds of thousands of
businesses negotiate with more than 1500 insurance companies. The
burden of finding insurance will be lifted -- and so will
administrative costs -- which can run as high as 40% of total
health costs for small business.

Principle #6:
Responsibility: Making everyone responsible for health care.

* Cracks down on fraud. The health security proposal makes
health-care fraud a crime and imposes stiff penalties on those
who cheat the system. It prohibits doctors from referring
patients to outside facilities, like labs, which they own a piece
of. It stops the kickbacks that some laboratories give doctors
in an effort to get their business.

* Asks the drug companies to hold down prescription drug prices.
The Health Security plan asks drug companies to take
responsibility for keeping prices down, without setting prices.
In today's system, overcharging runs rampant --certain
prescription drugs cost Americans three times more than people
pay in other industrialized countries.

* Emphasizes preventive care. The Health Security plan puts a new
emphasis on preventing illness before it becomes a medical
crisis. Prevention will improve the quality of care by helping
people stay healthy rather than treating them after they get
sick. It offers you full coverage of a wide range of
preventive services, but asks you to take responsibility for
keeping yourself healthy.

* Reforms malpractice. The President's proposal will limit
lawyers' fees in order to discourage frivolous medical
malpractice lawsuits. It will also encourage patients and doctors
to use alternative forms of dispute resolution before they end up
in court. This will help eliminate the "defensive medicine" that
drives up costs and hurts quality -- doctors ordering extra tests
because they fear lawyers looking over their shoulders.

* Everyone contributes, and no one gets a free ride. In America,
rights and responsibilities go hand-in-hand. Everyone will get a
Health Security card that guarantees you a comprehensive package
of benefits that can never be taken away. But we will ask
everybody to pay something, even if your contribution is small.
Small businesses and low-wage workers will get substantial
discounts on the cost of insurance, but everyone must take
responsibility.

HOW THE SYSTEM IS FINANCED

The financing proposal was developed under the most rigorous and
conservative forecasting standards. For the first time,
representatives from every federal agency involved in fiscal
accounting and financial projections have been brought together to
work out the numbers. Then teams of actuaries, health economists and
other financial analysts from outside the government served as
auditors and consultants, checking and rechecking.

The system is financed from five major sources:

1) Medicare savings -- The savings from reducing the growth of
Medicare are based on specific, scorable policy proposals. Every penny
of these savings will be channeled back into benefits -- prescription
drugs and long-term care -- for the people which these programs serve.

2) Medicaid savings -- The rate of growth of Medicaid can be reduced
primarily by folding the acute care portion of Medicaid into the
overall health care system. Since everyone will be insured, there
will be savings in "uncompensated care" -- the money that goes to
doctors and hospitals to compensate for caring for the uninsured.

3) Savings from federal employee health care costs -- As all federal
workers are integrated into the overall health care system, there
will be less expense to taxpayers to provide for their health care.

4) Reducing the benefits of tax-free compensation -- By reducing the
rate of growth for health insurance, the President's proposal lowers
the amount of compensation paid as tax-free health benefits, and
frees up money for higher wages, wages for new workers, or
profits -- all of which are taxable and thus bring in new federal
revenues.

5) Sin taxes -- There will be some new "sin taxes," the composition of
which is not yet decided.

In addition, there will be other savings. Reducing paperwork and
administration, cracking down on health care fraud, and emphasizing
prevention will save money in the long-run.

PAYMENT SCENARIOS

As a rule, most individuals and families in which at least one person
works will pay a maximum of 20% of the average health plan premium in
their area. Those who choose a lower cost plan -- from among those
offered in the area -- will pay a little less than the 20% average.
Those who choose a more expensive plan will pay a little more, as
they do today.Employers who currently pay 100% of health benefits may
continue to do so.

Two parent family with children: Two parent families with children --
whether one or both parents work -- pay a maximum of 20% of the family
premium offered by the average plan in their area. If both parents
work, they choose how to pay their family's share. They can have the
share deducted monthly out of either paycheck or write a check to the
local alliance.

Couple: Working married couples -- whether one or both spouses work --
pay a maximum of 20 percent of the average plan premium. They can have
the share deducted monthly from either paycheck or write a check to the
local alliance.

Single-parent family: Working single parents with children pay a maximum
of 20 % of the average plan premium for a single parent policy.

Individual: Working single people pay a maximum of 20% of the average
premium for an individual policy in their area.

Part-time worker with no unearned income: Part-time workers pay a
maximum of 20% of the average plan premium for their policy type
in their area.

EXCEPTIONS


Exceptions are provided for: (1) the self-employed and independent
contractors; (2) part-time workers who have unearned income; (3)
families with incomes below 150% of the poverty level; and (4)
seasonal workers.

Self-employed/independent contractors: The self-employed and
individual contractors can deduct from their taxes 100% of their
health care costs. As with any small business, they pay the employer
share. They also pay an individual share. If a firm earns less than
$24,000 a year, it is eligible for subsidies.

Part-time workers with unearned income: Part-time workers with
unearned income pay a maximum of 20% of the average plan premium
for their policy type -- individual, couple, two parent, or single
parent family.

The number of hours someone works determines how much of the premium
is paid by the employer and how much by the individual. For example,
an employer would pay 40% of the premium for someone who works
half-time. Payment of the remaining 40% of the premium depends on how
much a person makes in unearned income, with subsidies provided on a
sliding scale for those whose incomes are below 250% of the poverty
level.

Families with incomes below 150% of the poverty level: Families at
this level are eligible for discounted premiums and pay a maximum of
20% of the employee's share of the average plan premium. This applies
to individuals making $10,455 annually; couples with incomes of
$14,145; families of three earning $17,835; and families of four with
incomes of $21,525.

Seasonal workers: Seasonal workers pay a maximum of 20% of the average
plan premium in the area where they reside. Those whose incomes are
150% of the poverty level or below are eligible for discounted
premiums. If they have unearned income and are not working, seasonal
workers are treated the same as part-time workers.

Unemployed and non-working: Unemployed individuals and heads of
household who make less than 150% of the poverty level are eligible
for individual subsidies on a sliding scale. Those with unearned
income pay all or part of what would normally be the employer's share
of the premium.

Those whose incomes are 250% of the poverty level or less --
pensioners, for example -- are eligible for discounts on what would
be the employer's share. They are not eligible for individual
subsidies, and pay the normal individual share of the health premium.



  3 Responses to “Category : Various Text files
Archive   : HPLAN.ZIP
Filename : 10PGR.TXT

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