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    "ocrText": "FOIA Number:\n2006-0810-F (2)\nFOIA\nMARKER\nThis is not a textual record. This is used as an\nadministrative marker by the William J. Clinton\nPresidential Library Staff.\nCollection/Record Group:\nClinton Presidential Records\nSubgroup/Office of Origin:\nFirst Lady's Office\nSeries/Staff Member:\nFirst Lady's Press Office\nSubseries:\nKaren Finney\nOA/ID Number:\n11140\nFolderID:\nFolder Title:\nHEALTH PROGRESS\nStack:\nRow:\nSection:\nShelf:\nPosition:\nS\n58\n6\n6\n2\nCLINTON LIBRARY PHOTOCOPY\nInterview with Health Progress\nFirst, let me say how grateful I am for this opportunity to\nanswer some of your questions. The Catholic Health Association\nhas been at the forefront of the call for meaningful health care\nreform. I look forward to working with all of you to further our\ncommon goals.\n#1:\nThe President has set universal coverage as his most\nimportant goal for health care reform. If every one of us does\nnot have real health security, none of us truly has it. The\nPresident has said that his bottom line is guaranteeing private\nhealth insurance to every American. And while most people agree\nthat every citizen deserves access to quality, affordable health\ncare, there has been considerable discussion about how such a\nsystem should be structured. We have looked very closely at\ndifferent ways and found that, as you mentioned, there are only\nthree ways to finance universal coverage.\nThe first way is to introduce a government sponsored,\ngovernment run system, as some countries have done. Often called\nthe single-payer approach, it would mean eliminating private\ninsurance and instead funding the health care system through a\nbroad-based tax. The President has rejected this approach. He\ndoes, however, agree with its goal of universal coverage, but he\nbelieves that we should build on what works in our system and fix\nwhat is broken. We therefore should not eliminate private\ninsurance, but rather extend it to everyone. The President's\napproach does provide an option for states to adopt the single\npayer system.\nAnother approach is often referred to as an \"individual\nmandate.' Like auto insurance, it puts the burden solely on the\nindividual to buy insurance. There are several problems with\nthis approach. First of all, it would be very difficult to\nimplement, as it would require careful monitoring of who is in\nthe system and who is out. It would mean tracking individuals as\nthey move in and out of jobs, and as they move in and out of the\ninsurance market. In fact, the only examples we have of\nindividual mandates are those, as I've mentioned, like auto\ninsurance requirements in many states. And in spite of the fact\nthat the states have access to all drivers through the licensing\nprocess, literally thousands of licensed drivers remain without\ninsurance.\nThe individual mandate could also have the unfortunate\nresult of encouraging employers who currently provide insurance\nto their employees to stop doing so. If we had a health care\nsystem which made insurance the sole responsibility of the\nindividual, employers might decide that they need not contribute\nanymore.\nThe President feels that we should build on what works in\nour own system. Today, nine out of ten Americans with private\ninsurance receive their health care benefits from the workplace.\nWe want to build on the employer/employee system that works for\nmost people today, by making sure that it covers all Americans.\nWe feel that we should extend health insurance to everyone\nthrough the workplace, with both employees and employers\ncontributing to the cost. The government will provide discounts\non insurance to small businesses and the unemployed.\n#2:\nWe believe that not-for-profit hospitals, such as our\nnation's Catholic hospitals, will prosper under the President's\nplan. As you know better than most, Catholic hospitals have a\nremarkable history of providing high quality health care, often\nunder very difficult financial conditions, and often in areas\nthat are greatly underserved. Catholic hospitals have\ndemonstrated an incredible commitment to providing health care to\nthose with nowhere else to turn. Catholic hospitals provide care\nin inner cities and rural areas where there is a very large\nuninsured base. Under the President's plan, Catholic hospitals\nwill begin to be reimbursed for care that has long been charity\ncare, enabling Catholic hospitals and other not-for-profit\nhospitals to become more viable and financially secure. As we\nmove toward universal coverage, health care providers such as\nCatholic hospitals will need to meet growing individual and\nfamily demands. I have no doubt that Catholic Hospitals and\nother not-for-profit health care institutions will continue to\nplay an essential role in a reformed health care delivery system.\n#3:\nThere is certainly a role for not-for-profit and for-profit\nhealth care providers to organize and operate health plans.\nUnder the President's plan, health plans must meet state\ncertification requirements. They must also provide comprehensive\nbenefits and enroll all consumers, regardless of their health\nstatus (if they have the capacity). Not-for-profit and for-\nprofit organizations that meet these requirements may form health\nplans. We would imagine that plans offering high quality care at\nreasonable prices will provide attractive choices for consumers.\n#4:\nYes. Under the President's approach, there is no change in\nthe tax exempt status of not-for-profit health care\norganizations.\n#5:\nThat is an important question, because today our nation's\nlong-term care system does not adequately meet the needs of older\nAmericans and people with disabilities. And the situation is\nonly getting worse -- as the population ages, the demand for\nservices increases and people's options remain limited. Families\nall too often must exhaust their savings in order to pay for\nneeded care by qualifying for public assistance.\nThe President's approach will expand and improve long-term\ncare options across the country, stressing home and community-\nbased services. The plan aims to provide more flexibility and\ngreater choices for Americans with disabilities who need support.\nThis program could enable up to 2.2 million older Americans to\nstay at home while receiving the long-term care they need. In\naddition, in order to free people from having to \"spend down\" all\ntheir assets in order to become eligible for Medicaid, states\nwill have the option to allow residents of nursing homes and\nintermediate care facilities to retain up to $12,000 in personal\nassets -- up from $2,000 today. New tax incentives will also\nhelp make private long-term care insurance more affordable.\nThe President is committed to addressing the needs of our\ndisabled and older population. The President's approach also\nprovides prescription drug coverage for all Americans, including\nMedicare beneficiaries. This, we believe, will dramatically\nreduce the financial and emotional strain of illness and improve\nthe health of older Americans.\n#6:\nHealth promotion, in the form of preventive health care, is\nthe cornerstone of the President's approach to health care\nreform. We know it makes sense, both in human and economic\nterms, to focus on prevention -- to keep people healthy rather\nthan treating them when they're sick. We also know that focusing\non preventive health care is one of the clearest commitments we\ncan make to getting costs under control. The average citizen of\nHawaii, for example, has more doctor visits for primary and\npreventive care than the average citizen of the other forty-nine\nstates. But because these are doctor visits for primary and\npreventive care, their overall health care costs are less.\nThe President's approach provides incentives for patients\nand doctors alike to focus on prevention. From free coverage for\na wide range of preventive services to wellness education,\ncounseling, and increased research funding, the President's\napproach offers an unprecedented focus on prevention. The\ncomprehensive benefits package includes a broad array of\npreventive services not covered by the vast majority of insurance\nplans today -- immunizations, mammograms, well-baby care, and\nother screenings that will detect or prevent health problems\nbefore they become serious illnesses. The plan covers all of\nthese at no cost to the individual. In addition, the President's\nplan includes support for prevention research and school health\nprograms to teach healthy behaviors, and reduce drug and alcohol\nuse. The President's approach to reform underscores the\nimportance of prevention through deliberate incentives geared to\nencourage the use of preventive health care services.\n#7:\nThe President's approach to health care reform is to contain\ncosts by using competition and incentives. We don't think that\nthe government or anyone else should decide how much this country\nshould spend on health care. We do believe, however, that the\nbusinesses and individuals we are asking to contribute deserve to\nknow that their premiums won't continue to skyrocket out of\ncontrol. We feel that increased bargaining power, good\ninformation and sound decision making on the part of consumers\nand providers will begin to move our health care system toward\nhigher quality care at a more affordable price. At the same\ntime, the President's approach sets a limit on the amount that\ninsurance premiums can rise each year. We view this budget is as\na disciplinary backstop.\n#8:\nWith universal coverage, uncompensated care will decrease\nsignificantly. However, the President's proposal maintains a\nvulnerable populations fund of $800 million each fiscal year to\ncover unreimbursed costs incurred by providers.\n#9:\nUnder the President's approach, we will not cut provider\npayments. Rather, we will slow the rate of growth in Medicare to\ntwice the rate of inflation.\n#10:\nCurrently, small businesses are discriminated against by\ninsurance companies and pay as much as 35 percent more than big\nbusinesses for the same health care insurance. Also,\nadministrative costs for health insurance currently account for\nas much as 40 percent of a small business's health costs,\ncompared to five percent for big businesses. The President's\napproach aims to make it easier for small businesses to provide\nhealth insurance for their employees. It will reduce health care\ncosts for small businesses that today provide insurance for their\nemployees by pooling the purchasing power of all businesses in a\nregion. We believe this will dramatically improve the bargaining\nposition and reduce the administrative costs of small businesses.\nIn addition, small, low-wage businesses will be eligible for\nsubstantial discounts. In many cases, contributions for health\ncoverage will be approximately a dollar a day for the small\nbusiness employer whose average worker earns minimum wage -- a\nsignificantly smaller impact for an employer than an increase in\nthe minimum wage. The President is committed to helping small\nbusinesses as a part of reform."
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