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Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001a. form
Routing and summary form for Thomas Badger letter [partial] (1 page)
5/12/94
b(6)
001b. letter
From: Thomas Badger, M.D., To: Hillary Rodham Clinton [partial] (1
5/12/94
b(6)
page)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Pam Cicetti
OA/Box Number: 13598
FOLDER TITLE:
HRC Health Care Correspondence 94 - B
2014-0159-S
sb284
RESTRICTION CODES
Presidential Records Act - [44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
PI National Security Classified Information [(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRAJ
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRAJ
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
HRC
HC CORR 94-B
PERSONAL
&
CONFIDENTIAL
DETERMINED TO BE AN
ADMINISTRATIVE MARKING
INITIALS: SAB DATE: 12-4-13
PHOTOCOPY
PRESERVATION
PRESERVATION
PHOTOCOPY
TUESDAY, SEPTEM SEPTEMBER 27 BER 27 1994
Thelvashington Post
18:00 on
RESS
THE
Fre
SECOND OPINION
PHOTOCOPY
BY ABIGAIL TRAFFORD
PRESERVATION
Barbara Bush's Memoir:
A Telling Omission
y uncle Peter is in love with
M
blocking career advancement or are hurt by the
Barbara Bush. Always has been. In
subtle forces of ageism as they try to find a job.
a world of chaotic social change,
Yet, overall, older women have a lower rate of
"Bar" in his eyes is the Rock of
depression than younger women.
Gibraltar. She reminds him of the school chums
Barbara Bush does not dwell on her depression.
of his sisters, of the girls he used to play tennis
It's a stiff-upper-lip attitude that my Uncle Peter
with. Barbara Bush is the public figure he feels
would find familiar and laudable. But I am left with
he knows. Plucky, lucky, Beloved Bar.
two lingering impressions. First is her fabled luck,
Her newly published book, "Barbara Bush-A
which she accepts with grateful aplomb, as though it
Memoir," fleshes out the details: lovable kids,
were her destiny. Her depression went away
disastrous dinner parties, interesting people,
without treatment; her marriage survived. As she
wonderful George, lots of travel. My uncle would
writes: "I was so lucky."
admire all this.
But even more, what strikes me is the gap
But to me the memoir should have been titled:
between personal experience and public policy.
"Oh Lucky Me!" It reminds me of a scratchy 78-rpm
Barbara Bush's take-home message is that her
record we used to get out as kids to remind our
depressive episode made her "much more
parents' generation of the old-old days: "Oh, boy,
sympathetic to people. with emotional problems."
I'm lucky. I'll say I'm lucky. This is my lucky day.
and she advises readers to seek help "when things
Doo-do-doo-do!"
go out of control."
But my flippancy stops at a brief passage in this
That may work well for people like the Bushes.
575-page "luckylog" that describes her bout with
But many people with "emotional problems" may
suicidal depression. Suddenly, the plucky-lucky
have difficulty getting help "when things go out of
facade cracks. "Sometimes the pain was SO great, I
control" because, well, they are just not as lucky as
felt the urge to drive into a tree or an oncoming
Bar. Perhaps their depression doesn't go away after
car," she writes. "When that happened, I would pull
six months, but worsens. Perhaps they have no
over to the side of the road until I felt okay."
health insurance that would cover treatment. (The
This is not your everyday homemaker blues or
Bushes had coverage paid largely by the
feeling a little down in the dumps. What Bar
government through George's job.) Perhaps they
describes sounds more like an episode of the
don't have a supportive family or friends. Perhaps,
nation's most common mental illness. Depression
they are "left" by their spouse and have no family.
affects about 13 million Americans, according to
no home at all.
national health statistics. It strikes women more
As an individual, Barbara Bush cares. She. too,
often than men. It is a leading cause of suicide, and
has suffered, as her memoir makes clear, and one of
in about 65 percent of suicides, experts say, the
the most moving chapters involves the loss of a
person is suffering from depression.
daughter to leukemia. She is someone who
As Bush describes it, her depression occurred in
sympathizes with those who suffer. But she never
1976 when she was 51. Her husband had taken
sees in the suffering of others a reason for the
over the CIA and the couple was living in
country to fashion public policy that would alleviate
Washington. The episode lasted about six months,
that suffering. It doesn't seem to occur to her that
which is fairly typical. "I was very depressed, lonely
the government may have a role in helping people
and unhappy," Bush writes. "I felt ashamed. I had a
who aren't as lucky as the Bushes.
husband whom I adored, the world's greatest
What a contrast to other First and Second Ladies,
children, more friends that I could see-and I was
especially on the issue of mental health: Rosalyn
severely depressed. I hid it from everyone, including
Carter and Betty Ford have long championed better
muclesest friends Everyone but Ceerga Buch
Barbara Bush's Memoir:
A Telling Omission
y uncle Peter is in love with
blocking career advancement or are hurt by the
M
Barbara Bush. Always has been. In
subtle forces of ageism as they try to find a job.
a world of chaotic social change,
Yet, overall, older women have a lower rate of
"Bar" in his eyes is the Rock of
depression than younger women.
Gibraltar. She reminds him of the school chums
Barbara Bush does not dwell on her depression.
of his sisters, of the girls he used to play tennis
It's a stiff-upper-lip attitude that my Uncle Peter
with. Barbara Bush is the public figure he feels
would find familiar and laudable. But I am left with
he knows. Plucky, lucky, Beloved Bar.
two lingering impressions. First is her fabled luck.
Her newly published book, "Barbara Bush-A
which she accepts with grateful aplomb, as though it
Memoir," fleshes out the details: lovable kids,
were her destiny. Her depression went away
disastrous dinner parties, interesting people,
without treatment; her marriage survived. As she
wonderful George, lots of travel. My uncle would
writes: "I was SO lucky."
PHOTOCOPY
admire all this.
But even more, what strikes me is the gap
PRESERVATION
But to me the memoir should have been titled:
between personal experience and public policy.
"Oh Lucky Me!" It reminds me of a scratchy 78-rpm
Barbara Bush's take-home message is that her
record we used to get out as kids to remind our
depressive episode made her "much more
parents' generation of the old-old days: "Oh, boy,
sympathetic to people with emotional problems."
I'm lucky. I'll say I'm lucky. This is my lucky day.
and she advises readers to seek help "when things
Doo-do-doo-do!"
go out of control."
But my flippancy stops at a brief passage in this
That may work well for people like the Bushes.
575-page "luckylog" that describes her bout with
But many people with "emotional problems" may
suicidal depression. Suddenly, the plucky-lucky
have difficulty getting help "when things go out of
facade cracks. "Sometimes the pain was SO great, I
control" because, well, they are just not as lucky as
felt the urge to drive into a tree or an oncoming
Bar. Perhaps their depression doesn't go away after
car," she writes. "When that happened, I would pull
six months, but worsens. Perhaps they have no
over to the side of the road until I felt okay."
health insurance that would cover treatment. (The
This is not your everyday homemaker blues or
Bushes had coverage paid largely by the
feeling a little down in the dumps. What Bar
government through George's job.) Perhaps they
describes sounds more like an episode of the
don't have a supportive family or friends. Perhaps,
nation's most common mental illness. Depression
they are "left" by their spouse and have no family,
affects about 13 million Americans, according to
no home at all.
national health statistics. It strikes women more
As an individual, Barbara Bush cares. She. too,
often than men. It is a leading cause of suicide, and
has suffered, as her memoir makes clear, and one of
in about 65 percent of suicides, experts say, the
the most moving chapters involves the loss of a
person is suffering from depression.
daughter to leukemia. She is someone who
As Bush describes it, her depression occurred in
sympathizes with those who suffer. But she never
1976 when she was 51. Her husband had taken
sees in the suffering of others a reason for the
over the CIA and the couple was living in
country to fashion public policy that would alleviate
Washington. The episode lasted about six months,
that suffering. It doesn't seem to occur to her that
which is fairly typical. "I was very depressed, lonely
the government may have a role in helping people
and unhappy," Bush writes. "I felt ashamed. I had a
who aren't as lucky as the Bushes.
husband whom I adored, the world's greatest
What a contrast to other First and Second Ladies.
children, more friends that I could see-and I was
especially on the issue of mental health: Rosalyn
severely depressed. I hid it from everyone, including
Carter and Betty Ford have long championed better
my closest friends. Everyone but George Bush
treatment of those who suffer mental problems and
Night after night, George held me weeping in his
addictions, better insurance coverage to enable
arms while I tried to explain my feelings. I almost
people to get care, better understanding of mental
wonder why he didn't leave me."
conditions and substance abuse to chip away at the
Like about three-quarters of people who become
stigma of being labeled "crazy."
depressed. she was never diagnosed and did not get
First Lady Hillary Rodham Clinton and Second
treatment. Her husband suggested she "get help,"
Lady Tipper Gore have rolled up their sleeves to
but that advice sent her "into deeper gloom."
get legislation that would help people who, like
Bush attributes her depression to menopause, but
Barbara Bush, are stricken with a problem such as
this common myth that menopause causes
depression. To Barbara Bush. people who are sick
depression is not backed up by the latest research.
and suffering deserve sympathy. To Hillary Clinton
Depression has many causes, including
and Tipper Gore, they deserve government action.
psychological and social stresses. Many women in
That is why this chatty memoir is an important
their fifties, for example, confront changes at home
political document. It documents how great is luck
as children leave the nest and marriages go through
for those who have it. But like the Bush
periods of adjustment. They also encounter stress
administration itself, it fails to bridge the gap for
on the job as they bump up against the glass ceiling
those who don't.
THE WHITE HOUSE
WASHINGTON
August 12, 1994
Dr. Thomas M. Badger
Arkansas Children's Hospital
Research Institute
800 Marshall Street
Little Rock, AR 72202
Dear Tom:
It was so nice to hear from you. I was
pleased to know you enjoyed the event at the
White House in May. Thank you so much for
sending the information so promptly on the
programs you and I discussed. I hope things
continue to progress well for the Arkansas
Children's Hospital Research Institute.
With best wishes, I remain
Sincerely yours,
Hillary Rodham Clinton
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001a. form
Routing and summary form for Thomas Badger letter [partial] (1 page)
5/12/94
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Pam Cicetti
OA/Box Number: 13598
FOLDER TITLE:
HRC Health Care Correspondence 94 - B
2014-0159-S
sb284
RESTRICTION CODES
Presidential Records Act - [44 U.S.C. 2204(a)]
Freedom of Information Act - [5 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRA|
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information ((b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRAJ
b(7) Release would disclose information compiled for law enforcement
purposes [(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
5/12/94 letter from Tom Badger of ACH Research Institute, thanking you
for seeing him. He appreciates your continued interest and
appreciated opportunity to attend Mothers Day Health Care for Women
event on WH lawn. He had interesting conversation with Morris and
Rita Pynoos.
He encloses summary of issues you discussed: USDA Human Nutrition
Center, Clinical Toxicology Center and Alcohol and Drug Abuse Center.
As you suggested, he will copy Carol Rasco.
(b)(6)
See
0019
Direct to Jennifer Klein for response
File; NRN
HRClogMCA
052494
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001b. letter
From: Thomas Badger, M.D., To: Hillary Rodham Clinton [partial] (1
5/12/94
b(6)
page)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Pam Cicetti
OA/Box Number: 13598
FOLDER TITLE:
HRC Health Care Correspondence 94 - B
2014-0159-S
sb284
RESTRICTION CODES
Presidential Records Act - [44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA|
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRA|
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRAJ
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information |(a)(4) of the PRA|
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRAJ
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRAJ
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA|
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
ARKANSAS
ARKANSAS
CHILDREN'S
HOSPITAL
HOSPITAL
RESEARCH
INSTITUTE
800 Marshall Street
Little Rock, AR 72202
501/320-3571
TDD 501/320-1184
May 12, 1994
Hillary Rodham Clinton
Office of the First Lady
The White House
1600 Pennsylvania Avenue
Washington DC 20500-2000
Dear Hillary:
Thank you for taking the time to see me last Friday. I enjoyed the time you
made in your busy schedule and appreciate your continued interest and support
for the ACH Research Institute. I also appreciated the opportunity to attend
the Mothers Day Health Care for Women event on the White House lawn. I sat
next to Morris and Rita Pynoos and had a very interesting conversation. Very
nice people.
The White House atmosphere is indeed exciting and everybody is so full of
energy. My wife Cheryl and son Mark were envious.
Attached is a summary of the issues you and I discussed: the USDA Human
Nutrition Center; the Clinical Toxicology Center; and the Alcohol and Drug
Abuse Center. Planning is much more advanced for the Nutrition Center than
the other two, with the current strategy calling for between $10-$13 million a
year at the ACH Research Institute within the next four years, so this is a
real big deal to us. If the opportunity arises, we could use some additional
help in these three areas. As you suggested, I will copy Carol Rasco.
(b)(6)
001b
Thank you again.
Sincerely,
om
Thomas M. Badger, Ph. D.
Director
TEL 501-686-5206
FAX 501-686-6702
Arkansas Children's Hospital is
A Major Teaching Affiliate of the University of Arkansas for Medical Sciences
ARKANSAS
ARKANSAS
CHILDREN'S
HOSPITAL
HOSPITAL
RESEARCH
INSTITUTE
800 Marshall Street
Little Rock, AR 72202
501/320-3571
TDD 501/320-1184
1. HUMAN NUTRITION CENTER
President Kennedy established a program for eight human nutrition
centers under the Agriculture Research Service of the USDA. Currently, there
are five funded centers and we are attempting to get the sixth one at ACH with
the help of Dale Bumpers, Ray Thornton and David Pryor. The current plan now
working its way through the process is to start with $2 million for Year 1, $5
million for Year 2, $8 million for Year 3, and $10-$13 million thereafter.
The Year 4 figure is the current level of funding for the Baylor Center.
Thus, this is a real big step and would be a needed shot in the arm for us.
The USDA has site-visited ACH Research Institute for the science, and found us
to be unique and better qualified for such a center than any other
institution. They also feel that the areas of emphasis, "Developmental
Nutrition" (brain development, development of obesity, development of the
immune system, long term effects of dietary factors, bone development, etc),
are needed areas of study. The only concern of the USDA relates to whether
there will be additional funds put into the USDA budget to support a new
center.
This Nutrition Center is absolutely the highest priority for the ACH
Research Institute. We are uniquely qualified for such a center and the base
funding that would accompany it will help establish us as a credible national
child research institution. Any additional help along the way will be greatly
appreciated.
2. CLINICAL TOXICOLOGY CENTER
Through Congressman Ray Thornton, $500,000 was appropriated for one year
to set up a clinical program to determine the effects of acute and chronic
pesticide exposures of children and their families. This is "Pass-Through" in
the EPA budget that is to start July 1, 1994. Ray Thornton is working to
continue this support for a full 5 years with the idea of eventually
developing more solid base support for a "Clinical Toxicology Center" at ACH.
This is, of course, now dependent upon yearly appropriations. The EPA has
opposed this research and we are still waiting for a reply to the grant we
submitted.
We could really use help in getting a more solid base funding for the
future. With all the resistance we have had with convincing the EPA of the
value of such a center, I was hoping that Vice President Al Gore's staff might
be of help to establish communications with higher levels of EPA officials
(perhaps even Ms. Browner). I was thinking that since Vice President Gore was
instrumental in the appointment of Ms. Browner and is apparently especially
interested in environmental issues of this type, we might get Mr. Gore's help
in this matter. There really is no research center to address the possible
long term effects of toxicants on developing children. Any help here would be
appreciated.
Arkansas Children's Hospital is
A Major Teaching Affiliate of the University of Arkansas for Medical Sciences
3. ALCOHOL AND DRUG ABUSE CENTER
As you probably remember, we have had NIAAA and NIDA funding to study
the effects of alcohol and drugs of abuse at ACH Research Institute and UAMS.
The ACH Research Institute is in the perfect position to establish a center
just for children and their families.
This center will focus on such issues as long term effects of in utero
alcohol and drug exposure, adolescent alcohol and alcohol use, etc. This is
closely related to the clinical toxicology center, because we really need to
understand the long term effects of toxicants (we consider alcohol, cocaine,
etc. as toxicants) on the developing fetus or child. We are now finding that
adult health is affected by events that occurred in early life. For example,
we suspect that in utero exposures to alcohol and other toxicants lead to the
increased use of the health care system later in life (ie increased infection
rates, etc). This may also be true of learning abilities. By understanding
these factors and being able to diagnose these conditions, we hope to develop
early intervention programs to prevent or reduce problems later in life.
These ideas fit nicely into the priorities of NIH and the Research Society on
Alcoholism (see the following pages).
There is a real need for a center dealing with alcohol and drugs on
children, especially since other programs aimed at preventing the use of these
drugs are not meeting with much success. This is an area in which ACH
Research Institute could make some significant progress. I really do not know
exactly what you can do for us here, except perhaps support funds going into
this area of research, or perhaps helping to get such funds ear marked for a
center at ACH.
In Summary, these are three areas in which we have the most to offer and
the most to gain. They are quality programs in need of base funding. Any
help you can give in these area would be wonderful. Thank you again for your
support.
Research Society on Alcoholism
Youth and Adolescent Initiative
Background
While alcohol misuse presents a major risk for health and well-being throughout the life span,
children and adolescents may be especially vulnerable to adverse effects both from direct
exposure to alcohol and from the consequences of others' alcohol abuse. Alcohol is the most
widely used substance (including legal drugs, illegal drugs, and tobacco) among all age
groups of youth. Attitudes and expectancies regarding alcohol use are established at a very
early age, and most persons first experiment with alcohol during childhood or adolescence.
Misuse of alcohol by youth can have immediate devasting effects, including traffic accidents
and acute alcohol poisoning and can be associated with other risky behaviors such as
engaging in unprotected sex. Alcohol abuse in youth can interfere with school performance
and contribute to a long-term pattern of poor social adjustment and failure, such problems can
lead to a lifetime pattern of alcohol abuse and dependence. Genetic, psychological and
environment factors may interact in determining risk for these adverse outcomes.
Research Opportunities
Researchers are faced with the challenge of identifying the mechanisms that underlie alcohols
multiple effect on children and adolescents and developing effective age-appropriate
prevention and treatment intervention. Research on youth is considered to encompass
childhood through early young adulthood, of approximately the ages of 6-21. A broad range
of research has been initiated by the National Institute on Alcohol Abuse and Alcoholism
(NIAAA) that includes biomedical neuroscience, behavioral, epidemiology, prevention, and
treatment studies. An additional $3 million in funding for NIAAA for fiscal year 1995 is
necessary to continue research dealing specifically with alcohol problems in youth. Some
potential areas for further exploration include:
Neurobiology of alcohol in youth and adolescence -Studies to determine biological
markers that identify young children who are at increased risk for developing
alcoholism. To study the specific actions of alcohol on the developing brain as well
as metabolism in the non-adult organism. Alcohol may be metabolized differentially
in youngsters. Alcohol may have unique effects on the developing brain, and result in
specific deleterious consequences.
Risk-taking behavior and decision-making - Studies on the development of attitudes
and expectancies regarding alcohol use and their relationship to behavior; on the role
of alcohol in decisions regarding risk-taking (e.g., sexual activity, driving after
drinking); and the development of interventions to impact adolescent decision-making
regarding alcohol use and other risk behaviors.
Alcohol - related violence and youth - The effects of alcohol abuse in domestic
violence on the witnessing offspring. The role of neuronal disinhibition in youths on
alcohol-induced violence and the development of prevention and treatments.
2
Development of appropriate interventions - Studies to determine whether behavioral
strategies developed with alcoholic adults work with adolescents who abuse alcohol.
Research topics include development of methodologies to detect and assess early onset
alcoholism in adolescence; identification of risk factors and the responsivity of these
factors to different intervention strategies; and the development and evaluation of
treatment interventions for alcohol-dependent youth.
Strategies to prevent or reduce access to alcohol by youth and change norms
regarding its use - Studies to examine possible changes in law enforcement,
regulations and policies (such as price changes, sales restrictions, and sanctions against
drunk driving) as they affect youth access to alcohol and the acceptability of alcohol
use with this population.
Research and Society on Alcoholism
Women and Alcohol Initiative
Background
Until quite recently alcoholism research was conducted primarily with male subjects, leaving
critical gaps in our knowledge of women's drinking patterns and problems. Women respond to
alcohol differently from men physiologically, psychologically and socially, creating a need for
expanded studies into the epidemiology, etiology, psychosocial and medical consequences,
treatment and prevention of female alcohol problems.
Recent studies involving women are revealing that prevalence, age at onset, clinical features, and
course and outcome of alcohol problems can differ dramatically between women and men. Death
rates for female alcoholics are 50 to 100 percent higher than for male alcoholics and a greater
percentage of women drinkers develop alcohol-related medical problems such as liver cirrhosis
and hemorrhagic stroke. Alcoholism research is now at the point where elucidation of gender
differences and their implications for prevention, intervention, and treatment is needed.
Research Opportunities
Through the National Institute on Alcohol Abuse and Alcoholism (NIAAA) an integrated
program of biomedical, behavioral, and epidemiologic research on alcoholism, alcohol abuse and
related problems is carried out. An additional $3 million in funding for FY 1995 will enable
NIAAA to further its research in alcohol related problems of women providing a basis for
the development of prevention and treatment interventions. Areas for further investigation
include:
Studies to elucidate important biological and psychological mechanisms which
differentiate alcohol metabolism in men and women.
Identification of genetic or biological markers that will be helpful in determining
increased vulnerability of alcohol dependence in women.
Studies to ascertain whether gender-specific alcohol interventions improve treatment
efficacy for women, determine barriers to identifying, diagnosing and treating women.
Studies on correlated diseases such as breast cancer, osteoporosis,and heart disease and
their association with alcoholism.
Development of prevention strategies targeted to particular groups of women identified
at high risk for alcohol problems.
Development of pharmacotherapies that provide more effective alcoholism treatment for
women.
United States Department of State
Foreign Service Institute
National Foreign Affairs Training Center
4000 Arlington Boulevard
Arlington, Virginia 22204-1500
January 7, 1994
Pam Barnett
Office of the First Lady
Second Floor, West Wing
The White House
1600 Pennsylvania Avenue
Washington, DC 20500
Dear Pam:
As I discussed with you on the phone, EPA selected me to
spend this year in the State Department's Senior Seminar. (I
have enclosed a brochure that describes the Seminar and this
year's class.) One requirement of the Seminar is that I develop
an independent work assignment for the month of February. I am
pursuing several opportunities to do useful things on
environmental issues, and have been offered the chance to go
overseas. However, it occurs to me that my prior experience in
the health field might be useful to the Administration's health
reform effort. I am willing to do anything that is helpful, from
policy analysis to making the coffee.
Earlier in my career, I worked on health care financing
issues as a partner in Lewin & Associates, predecessor to Lewin-
VHI, one of the most respected firms in the field. I am sure
that Larry Lewin will vouch for my capabilities. I have not
worked in on health issues for over ten years, SO I am no expert.
I am simply a career Federal executive who was once fairly
conversant with health care financing and who is willing to work
very hard during the month of February doing whatever will
contribute to health care reform. I am not seeking permanent
employment; I will return to EPA upon completion of the Senior
Seminar at the end of May, 1994.
A brief vita is enclosed to help you consider my request. I
greatly appreciate your help in this matter.
Sincerely
Edward J. Hanley
Sd Hanlay
THE SENIOR SEMINAR Tel. (703) 302-7178
Room E-4114
FAX: (703) 302-7181
EDWARD J. HANLEY
1965-68
-
U.S. Post Office Department: Management Intern,
Special Assist. to Lawrence F. O'Brien, Postmaster
General
1968-76
-
Various consulting positions, culminating in Vice
President/Partner, Lewin & Assoc., a small public
policy firm specializing in health care, child
care, and energy
1976-79
-
Managing Partner of HANCO, a limited partnership
created to purchase and operate a commercial
property and retail hardware business
1979-present - Senior executive at Environmental Protection
Agency in a variety of posts, most recently Deputy
Assistant Administrator for Management; currently
on assignment to The Senior Seminar, U.S. State
Department
References:
Lawrence S. Lewin, President
Lewin-VHI, Incorporated
703/218-5500
Jon Cannon
Assistant Administrator, Admin. & Resources Management
Environmental Protection Agency
202/260-4600
Ambassador Fred Rondon
Dean, The Senior Seminar
703/302-7174
PHONE:
OFFICE: 703/302-7178
HOME:
703/573-3020
January 25, 1994
TO:
Scott Johnson
FROM:
Pam Barnett, Exec. Assistant to the First Lady for
Pan
Domestic Policy
SUBJECT: Ed Hanley
I am attaching a copy of Ed's recent letter to me and his resume.
He is currently Deputy Assistant Administrator for Management at
EPA on assignment to the Senior Seminar, which is the most
advanced professional development program available to high-level
government officials. The month of February is devoted to an
independent work assignment.
As I mentioned, he was one of Larry Lewin's early partners and
has listed Lewin as a reference. He was a consultant on health
care financing at that time. Although it is not reflected in his
spare resume, I know that he has achieved some professional
acclaim for his work on computers and their intra-communication.
I know he has lectured abroad on this subject.
Ed is about 50, requires no baby-sitting, would be self-starting
and is completely trustworthy. He is not looking for a job. He
is a career civil servant, but he is a dyed-in-the-wool Democrat.
His wife, Kate Hanley, is an elected official, a Fairfax County
Supervisor.
We would be very lucky to have his assistance in February. If it
is not viable, please let me know as soon as you can so he can
look elsewhere.
Thanks
Scott
THE WHITE HOUSE
WASHINGTON
June 20, 1994
PERSONAL
&
CONFIDENTIAL
Ms. Margaret Batchelor-White
3501-14th Street, N.W.
DETERMINED TO BE AN ADMINSTRATIVE
Washington, D.C. 20010
MARKING Per E.O. 12958 as amended, Sec. 3.3 (c)
Initials: SDB Date 12-4-13
Dear Ms. Batchelor-White:
Thank you for your information concerning the
Black Women's Agenda, Inc. Reforming the nation's
health care system is one of the most important
challenges facing our country.
The enclosed copies of the "B.W.A. Report" have
provided me with a useful perspective on health care
reform. Your comments, and those of others are an
important source of information.
Thank you for taking the time to make your voice
count.
Sincerely yours,
Hillary Hillary Rodham Clinton
Black Women's Agenda, Inc.
3501-14th Street, N.W.
Washington, D.C. 20010
(202)387-4166
President
Fax (202)387-6659
Dr. Margaret Batchelor-White
7690 Northern Oaks Court
Springfield, VA 22153
703-440-9627
703-440-8547 Fax
VP for Administration
May 12, 1994
VP for Legislative Affairs
Ms. Sonia R. Jarvis, Esq.
send note from HRC
Diane
1631 MAY
Dr. Lorraine Williams
VP for Legal Affairs
Ms. June Jeffries, Esq.
Recording Secretary
Ms. Beverly Stripling
Ms. Alexis Herman
Treasurer
Director of Public Liaison
Ms. Delores L. Kennedy-Williams
/ Assistant to the President
Public Information Officer
Dr. Marcella Maxwell
Old Executive Office Building Room 122
News letter Editor
Washington, DC 20500
y
Thanks formewshty
Dr. Dolly D. Adams
Dr. Elizabeth Abramowitz
Dear Ms. Herman:
Dr. Dolly D. Adams
MAGY
Ms. Gloria T. Adams
Ms. Amy T. Billingsley
It is the mission of the Black Women's Agenda, Inc. to protect and
Ms. Etta Moten Barnett
advance the needs and rights of Black women and their families,
Dr. Bernadine Denning
exclusively through research, dissemination of information,
Ms. Maudine Cooper, Esq.
Dr. Helen Edmonds
advocacy, education and training. Therefore, we would be remiss
Ms. Gwainevere C. Hess
in our mission if we sat on the sidelines of the health care
Ms. Alexine C. Jackson
debate.
Dr. Jeffalyn Johnson
Ms. Dorothy On
Dr. Marjorie Parker
Enclosed are two copies of the B.W.A. Report, our organization's
Dr. Marcella Paterson
The Hon. Ersa H. Poston
quarterly newsletter. This newsletter reaches more than one
Dr. Elizabeth Stone
million households across the country. As you will see, the
Ms. Ruth Anita Sykes
thrust of this issue is health care reform. It would be greatly
Ms. Lynnette Taylor
The Hon. Maxine Waters
appreciated if you could pass on a copy to First Lady Hillary
Ms. Ethel James Williams
Rodham Clinton. We want her to see what we are doing to
Secretary to the President
disseminate information and we want her to know that we support
Ms. Vanessa Baxter
her efforts for health care reform.
Founding Members
Dr. Elizabeth Abramowitz
Ms. Amy T. Billingsley
Dr. Bernadine Denning
Sincerely, Margares Batchelor -white
Dr. Jeffalyn Johnson
The Hon. Ersa H. Poston
Margaret Batchelor-White
Ms. Audrey Rowe
President
Dr. Elizabeth Stone
Ms. Ruth Anita Sykes
Ms. Lynnette Taylor
Ms. Ethel James Williams
Honorary Members
Dr. Maya Angelou
The Honorable Lenore Alexander
The Honorable Yvonne B. Burke
The Honorable Shirley Chisholm
The Honorable Cardiss Collins
The Honorable Shirley Dennis
The Honorable Katie Hall
The Honorable Alexis Herman
The Honorable Barbara Jordan
Incorporated in the District of Columbia; Contributions are Tax Exempt
under Section 501(c)(3) of the Internal Revenue Code of 1954.
F
959 EIGHTH AVENUE, NEW YORK
Good
NEW YORK 10019 (212) 649-2000
FAX 212-265-3307
Housekeeping
June 1, 1994
Mrs. Hillary Rodham Clinton
The White House
1600 Pennsylvania Avenue N.W.
Washington, D.C. 20500
Dear Mrs. Clinton:
Thank you so much for taking time out of your
schedule to meet with me and other women's
magazine editors last week. It was truly a pleasure
meeting you and hearing your views on how health
care reform will improve women's health in this
country.
I know, from the many letters I receive every week,
how concerned our readers are about health care.
Our interview with you, which ran in the "Better
Way" section last October, was very well received,
and I am anxious to publish more news on health
care reform in future issues.
I look forward to our next meeting.
Best wishes,
Donna Behen
Donna Behen
Medical Editor
LIMITED WARRANTY TO CONSUMERS
Good Housekeeping
REPLACEMENT OR PROMISES REFUND " DEFECTIVE
A PUBLICATION OF HEARST MAGAZINES. A DIVISION OF THE HEARST CORPORATION
THE WHITE HOUSE
WASHINGTON
April 8, 1994
Thomas L. Blair
11610 Highland Farm Road
Potomac, Maryland 20854
Dear Tom:
Thank you for writing to express your support for health
care reform. Your letter highlights the inefficiencies and
inequities that plague the health care system. The President's
proposal for health care reform will make high quality,
affordable health care available to all Americans.
As you note in your letter, the Health Maintenance
Organization Act of 1973 gave federal guidance to the development
and expansion of health maintenance organizations. The Act
addressed some of the problems in the health care system that we
face today -- escalating costs, limited access, and decreasing
quality and choice. Like the HMO Act, the President's proposal
for health care reform removes financial barriers to health care
and ensures access to preventive services. However, the
President's plan goes further to guarantee universal coverage to
all Americans. After twenty years, the time has come once again
for federal reform to redirect and stimulate the delivery of
health care in this country.
Thank you again for your advice and support.
Sincerely yours,
Hillary Rodham Clinton
did I wer
THOMAS L. BLAIR
11610 HIGHLAND FARM ROAD
POTOMAC. MD 20854
Most
September 15, 1993
PHOTOCOPY
HRC HANDWRITING
Hillary Rodham Clinton
White House
1600 Pennsylvania Avenue
PAM OCT 4 1993
Washington, D.C.
Dear Mrs. Clinton:
Alice and I appreciate you hosting us at the White House last Saturday for dinner, a
movie and stimulating conversation. More important, as I stated at dinner, I appreciate
you grasping command of the Vietnam of Domestic Issues
health care reform.
During the past twenty years I succeeded in building national managed care companies
(HMOs and PPOs) and selling them to major insurance companies. I quickly add,
insurance companies that tend to consume more of their energies in sponsoring PGA
Tours than making difficult health care decisions.
I have a somewhat cynical view of health care. The Tooth Fairy and this Country's
health care system have similar qualities. They are both reassuring to believe in, but
there is neither a Fairy nor a system.
While I have no personal agendas in health care
I have sold all my companies, I do
have an interest in seeing constraints put on an inefficient industry that burdens those
with jobs and abandons those without jobs. I also have a historical perspective that
could be used to support your proposals. For example, the "Clinton Plan" is already
being criticized as applying a layer of Federal bureaucracy to the health care industry.
A stellar counter point to this criticism is the success of the Federal HMO Act of 1972.
Most participants in today's health care debate would acknowledge that HMOs have
been a positive influence in controlling health care expenditures. However, I'm not
certain that many would recognize that it was the Federal HMO Act that spawned,
financed, and now regulates most HMOs. For example, it was Federal grants and
technical assistance that developed U.S. Healthcare, which is second only to Kaiser in
HMO membership.
Again, thanks for an enjoyable evening. And, given that I live next door, if you or your
staff are seeking someone to assist in developing support for your programs, please let
me know how I might assist.
Sincerely,
Tom
Thomas L. Blair
Journal
100 Park Avenue New York, NY 10017 212 351.3579
Myrna Blyth
Publishing Director
Editor-in-Chief
May 27, 1994
Hillary Rodham Clinton
Office of The First Lady
The White House
Room 100, OEOB
Washington, D.C. 20500
Dear Mrs. Clinton:
Thank you so much for inviting me to tea last week. As always, it was
interesting and inspiring to be with you.
We write about women's health in every issue of Ladies' Home Journal, and I
will certainly give added coverage in our fall issues. I also know the Journal's
seventeen million readers would like to read another interview with you in the
magazine. Our research shows that the piece you wrote for our November
1993 issue was very well read and well received by our readers.
I once suggested to Lisa Caputo that it would be interesting to do a piece with
you that had a question-and-answer format with a group of selected Ladies'
Home Journal readers asking the questions.
We would bring the readers to the White House and record and photograph
your discussion. It would give you an additional opportunity to speak directly
with "real" women and address their specific concerns. And these women
would be an appropriate surrograte for our millions of readers, who, I know,
would find the discussion very interesting.
I hope you like this idea. I'll call Lisa in a couple of weeks to see if it can be
arranged.
All my best wishes,
Myrna Bly th
Myrna Blyth
MB/ah
A Meredith Publication
THE WHITE HOUSE
November 2, 1994
Ray Bourhis, Esq.
Ray Bourhis & Associates
1050 Battery Street
San Francisco, CA 94111
Dear Ray:
I am sorry that it has taken so long
for your letters to reach my desk. I very
much appreciate your taking the time --
several times -- to respond to my ques-
tions about insurance reform. Ironically,
though, as we continue our work on health
care reform, your comments are timely
again.
I have shared your letter with
Jennifer Klein on my staff and have asked
her to work with the Justice Department on
this issue. As part of their Civil Jus-
tice Reform Project, they are considering
studying unfair insurance trade practices.
I have also asked Jennifer to contact you
as this project continues.
With best wishes, I am
Sincerely yours,
PERSONAL
Hillary Hillary Rodham Rodban Clastin Clinton
&
CONFIDENTIAL
DETERMINED TO BE AN ADMINSTRATIVE
MARKING Per E.O. 12958 as amended, Sec. 3.3 (c)
Initials: ADB
Date 12-4-13
TO:
Hillary Rodham Clinton
FROM:
DATE:
Jennifer 10/28/94 Klein J.K.
RE:
Ray Bourhis
You had asked me to look into the series of letters from Ray
Bourhis to various people in the Administration. He has been
writing since last year, but has not yet received an appropriate
response. I would recommend sending the attached response. The
issues he raises -- federal regulation of insurance and the
creation of a Presidential Commission to study unfair insurance
practices -- are, according to the Justice and Labor Departments,
quite controversial, so I did not think you should take a
position in writing. I will follow up with Mr. Bourhis.
THE WHITE HOUSE
WASHINGTON
September 9, 1994
Mr. John Burry, Jr.
Blue Cross & Blue Shield of Ohio
2060 East 9th Street
Cleveland, OH 44115-1355
Dear Mr. Burry:
Thank you for writing to share your concerns about Medical
Savings Accounts. As you may know, the health care reform bill
introduced by Congressman Gephardt includes Medical Savings
Accounts as one of many avenues for small businesses and
individuals to purchase health insurance. The Gephardt bill
couples this option, however, with an emphasis on prevention. By
giving all Americans access to preventive care, people will be
able to seek medical attention before their illnesses are serious
and costly -- which will both improve health and save valuable
health care dollars.
The President is continuing to fight to guarantee private
health insurance to all American families. Without universal
coverage, the poor will continue to receive health care through
government programs and the wealthy will continue to be able to
afford to purchase coverage, while the middle class will remain
at risk. And without universal coverage, cost shifting and the
need of individuals without insurance to rely on costly emergency
care will persist, causing health care costs to continue to
skyrocket.
Thank you again for your thoughtful comments. The President
and I look forward to continuing to work with Congress to make
health security a reality for all Americans.
Sincerely yours,
Hillary Rodham Clinton Clinitor
BlueCross BlueShield
2060 East Ninth Street
Cleveland, Ohio 44115-1355
of Ohio
(R)
)
John Burry,
Jr.
Chairman &
Chief Executive Officer
May 13, 1994
Hillary Rodham Clinton
The First Lady
1600 Pennsylvania Avenue, N.W.
Washington, DC 20500
Dear Mrs. Clinton:
As Congress continues to consider various health care reform
proposals, the idea of Medical Savings Accounts appears to be
gaining in popularity among some members. I initially reacted
positively to this idea, but after careful scrutiny and analysis I
have concluded that, while well intended, if enacted into legisla-
tion Medical Savings Accounts will have devastating consequences to
our health care system.
The enclosed booklet explains how I reached my conclusions.
I hope you find it informative. Should you have any questions
about my views on this issue, please feel free to contact me.
Very truly yours,
John Burry John Burry, Jr.
Enclosure
MCA JUN 3 1994
BlueCross BlueShield
VELA
OSTAGE
of Ohio
MAY17'94
®
®
2060 East 9th Street
¥0.75
is
"UMETER
Cleveland, OH 44115-1355
OH
6765088
WHITE HOUSE MAIL
RECEPTION & SECURITY
MAY 20 1994
Processed by: 2
Hillary Rodham Clinton
The First Lady
1600 Pennsylvania Avenue, N.W.
Washington, DC 20500
INSPECTE
The White House
Health Care Delivery Room
Phone: 202/456-2566
FAX: 202/456-6485
TO: JESSELYN BROWN/JENNIFER
FAX: Medical Savings Account
PHONE:
FROM: ChRistiNE HEENAN
DATE:
6 2878
(Including PAGES: 5
This Page)
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"THE COMPREHENSIVE FAMILY HEALTH ACCESS
AND SAVINGS ACT" (GRAMM-MCCAIN):
SUMMARY
The Gramm/McCain bill attempts to make health care insurance more
portable and affordable by eliminating state requirements for minimum
insurance benefits to create a market for "bare bones" health plans which
would cover only major medical expenses. Tax incentives and government
assistance would encourage the purchase of such plans. The bill would also
create tax free "Medisave" accounts, much like Individual Retirement
Accounts, which individuals would use to pay small medical bills.
Individuals would pay for routine care and deductibles out of "Medisave"
accounts, only using insurance for serious or catastrophic care. All
"Medisave" funds not used for routine treatment would be retained by the
individual for future medical expenses, creating an incentive to keep
unnecessary health care use down.
In addition, employers who currently provide health insurance would
be required to offer the employee an option of a "Medisave" account, an HMO,
or continue their current coverage. The self-employed and uninsured would
be allowed to exclude from their income the percentage of medical insurance
coverage costs equal to the national average contributed by employers. This
would also create an incentive to choose lower cost "bare bones" or HMO
plans.
Under the Gramm/McCain bill, health care insurance companies
would be prohibited from excluding individuals with pre-existing conditions
from coverage but could charge a higher rate. There would be no limit
how much higher the premiums could be, but federal subsidies would be
available if the cost exceeded a percentage of family income. Insurance
discounts would be offered to individuals who engage in activities determined
to constitute a "healthy" lifestyle. Federal assistance would be reduced for
individuals who engage in "unhealthy" activities.
2 62878:#
The White House-
: Wd01:1 : 7-15-94 Affse IN3S
"THE COMPREHENSIVE FAMILY HEALTH ACCESS
AND SAVINGS ACT" (GRAMM-MCCAIN):
SOME CONCERNS
There are some components of even this proposal with which we can find
common ground. Like Senators Gramm and McCain, we believe that relying on
consumers to make informed choices should be the centerpiece of our health care
system. Like Senators Gramm and McCain, we believe that consumers should share
in the financial responsibility for purchasing their insurance coverage and paying for
their care in order to make these decisions sensitive to cost.
But we cannot support the Gramm-McCain bill because it does not provide
security for all Americans -- in fact it puts Americans at even greater risk than are
today. The sponsors of this plan believe comprehensive benefits are the problem, not
the solution, encouraging "bare bones" insurance policies. This plan leaves insurance
companies in the driver's seat free to drop people or raise their rates for any reason.
And it actually encourages them to jack up your rates if you have been sick or have a
pre-exisiting condition.
The Comprehensive Family Health Access and Savings Act is guilty of false
advertising. It is not comprehensive. It does not improve access. And it does not
provide any savings.
Encourages "Bare-Bones" Policies
We believe that all Americans should be guaranteed a comprehensive
package of benefits that can never be taken a away. Not only does this bill
not provide comprehensive benefits, it encourages everyone to purchase bare
bones policies which cover only catastrophic health care costs. Every time
you see your doctor means draining your savings. In fact, the only
comprehensive thing about this bill is the word in its title.
Does not Achieve Universal Coverage
The Gramm/McCain bill makes no promise of universal coverage. It does not
require that anyone businesses or individuals take responsiblity for
health care coverage. As a result millions of Americans will be left without
insurance, millions more will be underinsured with only bare bones
protection, and those who have good coverage will continue to pick up the tab
for those who don't.
E 62878:#
The White House-
SENT BY Intergovernmental Affs: 7-15-94 ; 1:11PM ;
Legalizes Discrimination Against Those with Pre-existing Conditions
The Gramm/McCain bill says that people with pre-existing health conditions
will be expected to pay at least 50 percent more than other people in their
area and it could be even higher.
Discourages Cost-Effective Preventive Care
We believe our health care system should encourage prevention to keep
people healthy rather than treating them when they get sick. By making
people pay for routine care, including preventive services, out of their own
pockets, this plan encourages them to avoid seeking care altogether in hopes
of saving this expenses. This will only lead to people waiting until they are
really sick before seeing their doctor when treatment will be much more
expensive.
Establishes a New Health Police?
Not only does the Gramm/McCain bill maintain insurance company and
government interference in the examining room, it wants to invite them into
your home. It says that insurance companies can charge a higher rate and
any government assistance will be reduced, if you engage in an unhealthy
lifestyle. To enforce this, perhaps we can expect insurance company spot
checks of our dinners to make sure we are eating our vegetables, surprise
government weigh-ins at work to make sure we haven't put on a few pounds,
or supermarket cashiers required to call for approval to ring up our groceries.
Tells Consumers to Go it Alone
We believe that by having individuals and small businesses join together
they will be able to bargain for good coverage at affordable rates just like
big companies do today. Under this plan its everyone for themselves
bargaining with doctors and hospitals for discounts. This plan expects that
everyone will have the medical knowledge of C. Everett Koop, the financial
sense of J.P. Morgan and the negotiating skill of Henry Kissinger.
Sacrifices Quality
This plan has no quality standards, eliminates basic protections for
insurance plans and provides no information to consumers on the quality of
plans or the effectiveness of treatments. It puts the burden on consumers to
make choices about their treatment but gives them no tools to do SO. This
plan is not the least bit concerned about people's health or the quality of care
received as long as it costs less.
1 92878:#
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SENT Y:Intergovernmental Affs; 7-15-94 ; 1:11PM ;
"The Bureaucracy and Paperwork Preservation Act"
We believe that health care reform should simplify the system for doctors and
patients by reducing paperwork and administrative redtape that are choking
our health care system. They believe that confusing insurance policy fine
print and mountains of forms are nothing we need to worry about. According
to them, its fine for us to spend our money, billions of dollars, on waste,
fraud, and other things which do nothing to make us healthier.
$ 92878:#
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SENT BY:Intergovernmental Affs: 7-15-94 ; 1:12PM ;
Clinton Presidential Records
Digital Records Marker
This is not a presidential record. This is used as an administrative
marker by the William J. Clinton Presidential Library Staff.
This marker identifies the place of a publication.
Publications have not been scanned in their entirety for the purpose
of digitization. To see the full publication please search online or
visit the Clinton Presidential Library's Research Room.
Medical Savings Accounts
Bad Medicine for the U.S.
Healthcare System
[Booklet] [19 pages]
MEDICAL
SAVINGS
ACCOUNTS
BAD MEDICINE
FOR THE U.S.
HEALTHCARE
SYSTEM
ST
By John Burry, Jr.
Chairman And Chief:
Executive Officer
Blue Cross &
Blue Shield Of Ohio
bec: ALEXIS HERMAN
MARILYN
9A6ER
THE WHITE HOUSE
WASHINGTON
February 24, 1994
Mr. August A. Busch III
Chairman of the Board and President
Anheuser-Busch Companies, Inc.
One Busch Place
St. Louis, MO 63118
Dear Mr. august Brisding
Thank you for meeting with us again to discuss health care
reform and for your continuing support. I appreciated receiving
your letter dated January 20 reiterating that Anheuser-Busch
agrees that universal coverage and a defined benefit package are
essential parts of national health care reform.
You noted in your letter that ERISA preemption is critical
to multi-state employers. The Administration agrees that multi-
state employers must not be forced to contend with multiple and
often inconsistent state requirements. As a result, under the
proposed Health Security Act, ERISA preemption will continue to
apply to corporate alliance plans. The only exception is in
states that form a single payer system, where employers eligible
to form corporate alliances may be required to join the single
payer system.
You also raised the possibility of allowing large employers
to move in and out of regional alliances. We are concerned about
risk selection within regional alliances, but are interested in
hearing alternatives to ensure that regional alliances maintain
steady risk pools.
Again, thank you for your thoughtful comments and ongoing
support. I look forward to continuing to work with you in the
coming months.
Sincerely yours,
Millary Hillary Rodham Clinton
Thanks for your advice and
support - -
Jra Magazinee
R
August A. Busch III
Chairman of the Board
ANHEUSER-BUSCH COMPANIES
and President
January 20, 1994
Ms. Hillary Rodham Clinton
PAM JAN 2 4 1994
The White House
Washington, D.C. 20500
Dear Ms. Clinton:
Thank you for the opportunity to participate in Wednesday's meeting.
As expected, it was a very informative session.
I hope some of the comments that were made during the meeting
regarding a cohesive effort to pass the health care bill will be
helpful in your deliberations.
We at Anheuser-Busch support your key principles of universal
care, a defined benefit package, and coverage for retirees. We
will communicate our support to our wholesaler family throughout
the country and will assist in any way possible as you work with
Congress on health care reform.
As I suggested at the meeting, it would be beneficial to your efforts
to keep the Washington offices of many of the larger U.S. corporations
fully informed as developments occur. In addition, I think it would
be very effective if you personally contacted some of the key people
in the Business Roundtable. I conveyed these thoughts to Alexis
Herman before I left Washington.
I would like to make two additional points, if I may. First, the
ERISA exemption is critical to multi-state employers. Having to
work under 50 different state plans VS. one U.S. government plan
would substantially increase cost and complicate administration.
Second, as I mentioned to Ira Magaziner the last time we were in
Washington and as you briefly discussed in your opening comments,
the once-in, never-out provision of the Regional Alliances is highly
restrictive. As we all well know, the world changes at an ever-
increasing rate, and nothing is forever.
Again, many thanks for the opportunity to participate. We stand
ready to help.
Sincerely,
hugust
August A. Busch III
CC: Alexis Herman
Anheuser-Busch Companies. Inc.
Executive Offices
One Busch Place
St. Louis. MO U.S.A. 63118-1852
Telex 447 117 ANBUSCH STL