UNINSURED: Clinton To Propose Local Grants
The Clinton Administration's fiscal 2000 budget proposal will include a $1 billion plan to increase access to medical care for the nation's uninsured by providing grants to local health clinics and hospitals to help them better coordinate and monitor care, the Washington Post reports. HHS Secretary Donna Shalala said the initiative "eventually would provide 100 U.S. communities with grants aimed at helping the nation's growing cadre of low-income workers who lack health insurance," and would also go to hire "more dentists, mental health workers, drug counselors and providers of other basic services that often are in short supply for adults who have trouble paying medical bills." Shalala said the move was intended as a stopgap measure, filling a desperate need while the White House pursued its goal of making sure all Americans have access to health insurance. "We are working to get (people) health care while we are working to get everybody health insurance," she said. The Post reports that the administration was "vague" about how the program would be funded, saying only that "the budget Clinton proposes would be in balance." The White House has announced proposals "that would cost about $10 billion in the next five years," including a long term care tax credit and Medicare and Medicaid buy-ins for the disabled.
A New Strategy
The Post reports that the initiative "represents a departure" from the thrust of the Clinton administration's previous health care policy efforts, as it "concentrates on strengthening the health care system, rather than on giving individuals the means to pay for their care." The first year of the program would disburse $25 million in "glue money" to "help 10 to 20 communities develop computer systems" in an effort to "overcome the inefficiency, delays and fragmentation that often characterize medical care for the uninsured." In subsequent years the government would spend $250 million per year for four years "to reach more communities and allow money to be spent on actual medical services."
Public hospitals and health departments voiced their support for the Clinton plan, with Association of American Medical Colleges President Jordan Cohen saying, "Obviously, that amount of money is not going to buy a lot more care, but it could provide a stronger, more coordinated safety net." Larry Gage, president of the National Association of Public Hospitals, added, "We're not going to see a return to (legislation calling for) universal coverage in the short term, so you've got to find more efficient ways to use the current system. We've got to seed the clouds any way we can" (Goldstein, 1/18). However, American Association of Health Plans President and CEO Karen Ignagni criticized the program for its scope and direction, advocating instead "a bigger, more aggressive program where the private sector and government work constructively to create more opportunities for people to access and maintain quality health insurance." She noted that the managed care group is running an ad in today's Roll Call calling on Congress and the administration to meet the "challenge of that broader debate" (AAHP release, 1/18).