IssuesMatch

More Federal Funding For Health Coverage

POSITIONS

This question is looking for your views on how large a role the federal government should play in the health care industry.  However you answer the above question would be similar to your response to these statements:

 
BACKGROUND


HMOs & Managed Care

Comprehensive national health care reform died in Congress in 1994 (after a report by a commission run by Hillary Clinton). 16% of Americans (42 million people) have no health insurance (and hence must pay for health services in full, or receive hospital charity). 14% of Americans receive some form of public health care or health insurance (70% have private health insurance). 20% of Americans are members of Health Maintenance Organizations (HMOs).

Patient's Bill of Rights

Congress and the Presidential candidates are debating a ‘Patient’s Bill of Rights’ which would establish rules of dealing with HMO managed care. The buzzwords in this debate are: External Appeal: Patients cannot currently appeal an HMO’s decision to deny coverage, even if the HMO doctor agrees with the patient. The ‘Bill of Rights’ would establish some form of expert appeal board external to the HMO. Medical Necessity: At issue is whether the doctor or the HMO management determines what is necessary. Determination of ‘necessity’ may become subject to expert review as well, or it may become measured against established standards of ‘generally accepted practices.’ Legal Liability: Patients would be granted the right to sue HMOs for medical costs and damages, which is not a right under current law. Scope of Coverage: Some states regulate HMOs in ways similar to those described here; a ‘Bill of Rights’ could apply to them, to all HMOs, or to all patients.

Medicaid / Medicare

Medicare and Medicaid will become insolvent under current estimates by 2015 (1999 budget discussions may push that to 2025). There were 39 million Medicare beneficiaries in 1998; that number is expected to rise along with Social Security retirement figures. Senior Drug coverage is currently $24-$44 per month insurance premium to cover $1,000-$2,500 per year in drug costs. Medicare deductible on tax returns is currently $100 per year; also expected to rise in current negotiations.

 

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