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122243210
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Center on Disability and Health
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122243210
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Center on Disability and Health
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Records of the Office of the Public Liaison (Clinton Administration)
Jay Footlik's Files
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42-t-5757371-20070143F-Seg3-045-016-2018
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FOIA Number: 2007-0143-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Public Liaison
Series/Staff Member:
Jay Footlik
Subseries:
OA/ID Number:
12672
FolderID:
Folder Title:
Center on Disability and Health
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Section:
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Position:
S
31
1
7
1
06/12/1996 09:56 2028422402
CTR ON DIS & HEALTH
PAGE 01
CENTER ON DISABILITY AND HEALTH
1522 K Street, N.W., Suite 800
Washington, D.C. 20005
Telephone: (202) 842-4408
FAX: (202) 842-2402
Facsimile Transmittal Form
chns FYI.
June 12,1996
Date:
456-6218
Receiver's FAX#:
To:
Marilyn Yeager & Chio Jennings
White House
Company:
Department:
3
Number of pages:
(including cover sheet)
Bob Griss
From:
Description and Message:
Please show this intigue of MSAs
with China Jennary
06/12/1996 09:56 2028422402
CTR ON DIS & HEALTH
PAGE 02
CENTER ON DISABILITY AND HEALTH
1522 K Street, N.W., Suite 800
Washington, D.C. 20005
Telephone: (202) 842-4408
FAX: (202) 842-2402
June 12, 1996
STATEMENT OF BOB GRISS ON MSAs IN KASSEBAUM-KENNEDY BILL
Bob Griss is the Director of the Center on Disability and Health in Washington, D.C.,
and a Co-chair of the Health Task Force of the Consortium for Citizens with
Disabilities.
The disability community represents people with many different health care needs.
Some are low users of health care and others are high users, but all deserve the most
appropriate medically necessary care whether they can afford it or not. That's the
difference between comprehensive health care reforms and MSAs.
The disability community has many opinions about the Kassebaum-Kennedy bill.
A.
Many organizations support a clean version of the bill as the most likely political
strategy for incremental change with the current composition of Congress.
B.
Many organizations who focus on mental health needs would like to see a
significant move toward mental health parity in deductibles as well as
copayments and benefits.
C.
Some organizations in the disability community feel strongly that MSAs
represent a greater threat to the disability community than the pre-existing
condition exclusions which the Kassebaum-Kennedy bill was supposed to
eliminate:
1.
MSAs would undermine the capacity of the health care system for cross-
subsidization which is necessary to ensure that premiums are affordable
to high users of health care;
2.
MSAs would also undermine pressure for developing public policies that
would hold managed care plans publicly accountable for outcomes when
patients only go to the doctor when they decide that they can afford it.
This ensures that low income persons are less likely to go to the doctor
than rich people rather than that all people have equal access to health
care on the basis of their health care needs.
3.
MSAs would undermine support for standardization of benefits
encouraging people to reduce their health care premiums by signing up
06/12/1996 09:56
2028422402
CTR ON DIS & HEALTH
PAGE 03
only for the benefits which they think they will need. People who can
afford more expensive catastrophic plans will be able to get more
comprehensive coverage than persons with lower incomes.
4.
Rather than resort to MSAs to ensure consumer choice over health plans,
providers and treatments, we should demand that managed care be
regulated in ways that maximize consumer choice in publicly accountable
managed care.
5.
Although MSAs would appeal to wealthier low risk people who can
afford deductibles of $3000-$5000, and are more likely to have
employers willing to contribute to their MSA self-insurance fund, and
have greater financial Incentives to shelter their higher incomes from
taxes, MSAs will tend to segment the marketplace on the basis of health
risks and disrupt equal access to health care on the basis of health care
needs.
6.
It appears that the inability of Congress to support the scaled-back
incremental reforms for portability in the original Kassebaum-Kennedy bill
indicates that incremental reforms may in fact be more difficult to get
bipartisan support for than comprehensive health care reforms.
Interestingly, incremental reforms cannot capture the surplus in the
health care system and redirect it to reduce the uninsured. Even the
Kassebaum-Kennedy bill does not address the single pre-existing
condition which accounts for most of the uninsured, namely, the pre-
existing condition of poverty. The real challenge of health care reform
is not blaming the other party for blocking it but developing public
policies to ensure that everyone has equal access to medically necessary
services.
7.
Expecting the disability community to support an MSA demonstration as
a quid pro quo for passage of the Kassebaum-Kennedy bill would be like
asking the NAACP to endorse a study, before the Civil War, of the health
conditions for blacks on southern plantations compared to northern cities
in order to decide whether to oppose slavery.