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to employees of non-profit hospi-
tals. The House bill is similar to
the Senate-passed bill (S 3203) .

^ jH Hj

Although the House Health Sub-
committee completed hearings in
May on health planning legislation,
a finalized version in the form of
a bill was scheduled for sometime
in June at the earliest due to a
flood of other bills demanding the
attention of sub-committee mem-
bers.

Like Senate Health Sub-commit-
tee Hearings on similar legislation,
the House hearings were for the
most part rather mundane. The
general attitude pervailing among
the witnesses, sub-committee mem-
bers, and spectators was reported
to have been one of disinterest
stemming from the House panel's
decision to drop the idea of rate
regulation from the bill.

Chairman Senator Philip A.
— continued on page 11

Jacob Javits (R., N.Y.). The Sena-
tor who has put in his own NHI
bill in the past, announced his sup-
port for the bill in a speech before
Yeshiva University's Albert Ein-
stein College of Medicine in New
York.



National Health Insurance—

— continued from page 9
Health Insurance trust fund sep-
arate from the existing Medicare
trust fund.

Employees would pay into the
NHI fund no more than one per-
cent and employers at least three
percent payroll tax on the first
$20,000 of wages. The bill also
provides reduced cost sharing for
low-income individuals, the money
coming from federal revenues and
the states.

Long-Ribicoff Bill

(S. 2513, H.R. 14079)

Emphasis of this bill is catastro-
phic coverage and a revamped
Medicaid program to cover the
"working poor" in addition to low-
income individuals. Participation
is voluntary. Long-Ribicoff also
seeks to encourage the availability
of private health insurance policies
and establishment of insurance
pools.

Under the catastrophic plan, em-
ployers, employees and those self-
employed would pay into a sep-
arate trust fund 0.3% of earnings
for the first three years during
which time federal revenues
would be added to the fund. The
new medical assistance program
would bring in the so-called work-
ing poor, allowing them to become
eligible by deducting medical ex-
penses from income.

Griffiths-Kennedy Bill

(S. 3, H.R. 22)

The bill stresses a broad national
program of compulsory participa-
tion, financed by payroll taxes and
federal revenues. A new trust fund
would be created, with employers
paying 3.5% tax on entire payroll
and employees one percent on the
first $15,000 of earnings.

Other National Health Insurance
Bills

The American Hospital Associa-
tion's bill (H.R. 1) by Rep. Al Ull-
man (D. Oreg.) would require em-
ployers to pay at least 75% of
premiums with federal subsidies
for low-income workers and for
subscribers of new national health
care corporations. The "Medi-
credit" bill (S. 444), supported by
the American Medical Association,
is a voluntary system of income
tax credits for health insurance



premiums. The Health Insurance
Association of America supports a
bill (H.R. 5200) which offers incen-
tives for employers and individuals
to purchase private plans.

ADMINISTRATION AND
QUALITY ASSURANCE
Nixon Administration Bill

(S. 2970, H.R. 12684)

Private insurance companies
would offer the basic plan approv-
ed by the states, which would be
under regulations of HEW's Social
Security Administration. Reim-
bursement rates would be estab-
lished by states, according to fed-
eral criteria. The states would cer-
tify providers.
Long-Ribicoff Bill

(S. 2513)

Both the catastrophic insurance
and the medical assistance plan
would be administered by SSA's
Bureau of Health Insurance and
Medicare fiscal intermediaries. The
bill incorporates the quality assur-
ance and utilization review provi-
sions of the 1972 Social Security
Amendments.
Mills-Kennedy Bill

(S. 3, H.R. 22)

Administration would be by an
independent SSA headed by a
three-member board and fiscal in-
termediaries. Payments to institu-
tional providers would be on the
basis of a variety of prospective
payment systems with incentive
payments to better-performing pro-
viders.
Griffiths-Kennedy Bill

(S. 3, H.R. 22)

The President would name a
Health Security Board within
HEW, which would administer the
program and establish quality and
costs of services. The bill estab-
lishes at the federal level a Com-
mission on the Quality of Care, to
continually review the standards
and regulations for care paid by
the security board.

BENEFITS

After an individual paid $1,500
in cost sharing under the regular
plan or $750 under Medicare, cata-
strophic benefits would be provid-
ed by the Nixon Administration
bill. Also included is unlimited hos-
pital and physician care and mental
health and other medical care sub-
ject to deductables and copay-
ments.

Benefits are similar in the Mills-



comings/goings

With the advent of spring, there
comes also a change among the
faces of the Montana CHP scene.
Sandra Nicholson, Health Planner
for EDAEM, has left CHP reported-
ly because someone made her an
offer she could not refuse: matri-
mony. The Board of EDAEM has
selected Mr. Richard Eudy as
Sandy's replacement. Rich, who
holds a M.A. degree in counseling
and a B.A. in psychology from the
University of Montana, began work
in mid-March and will continue the
areawide organizational work and
health plan which Sandy had be-
gun. A native of Havre, Eudy will
be operating out of Sidney.

State CHP's environmental plan-
ner and most recent editor of the
MCHP NEWS, Dave Turner, has
also left CHP to pursue his interest
in the pastoral tranquility of eas-
tern Iowa. Replacing Dave is Jim
Jasper. Hailing originally from the
Chicago area, our new editor has
a B.A. in journalism and philosophy
from Marquette University, A for-
mer VISTA volunteer for the past
two years, Jasper's inheritance has
been one Underwood Typemaster
and a mobile which Dave couldn't
find room to pack.



The National Level—

— continued from page 10

Hart's (D., Mich.) Anti-trust Mon-
opoly Sub-committee heard hear-
ings in May on the existence of
competition among providers of
health care.

Intended to discover whether or
not increased competition in the
health care industry would work
to the benefit of consumers, the
hearings saw witnesses attempt to
show among other things that
Health Maintenance Organizations
could bring greater competition
while organized medicine can at
times stifle it.

Kennedy bill, except that a new
program would be created for a
long-term care. The Long-Ribicoff
bill would begin catastrophic cov-
erage after $2,000 was spent.

Under the Kennedy-Griffiths bill,
complete hospital and medical care
would be covered without deduct-
ables or copayments.

PAGE ELEVEN



Health Legislation—

^-continued from page 9
REGULATORY ACTIVITIES
H.R. 12053 — To review and ap-
prove or disapprove federal pro-
grams in Facilities Construction
for Mental Health and Retardation,
Alcohol Abuse and Treatment, and
assist in the 1122 program.

S. 2994 — Covers the provisions
found in H.R. 12053 and review
health services proposed to be of-
fered in the area.

P.L. 89-749 — Prohibits inter-
ference with the private practices
of medicine, dentistry and the re-
lated healing arts.

H.R. 13472 and S. 3166 — Ad-
dresses state regulatory activities
by providing a formula grant pro-
gram upon the participation in the
capital expenditures review pro-
gram. &"Recognizes that regula-
tion of the health care industry is
a governmental function and can-
not appropriately be transferred
to private hands."

S. 3139 — Requires each HPA to
review on a periodic basis the
health services offered or proposed
in the health area of the agency
providing recommendations to the
State Health commission. Where
such a service cannot be certified,
the health planning agency shall
work with the provider or proposed
provider (and other entities) for
improvement or elimination of the
service. After initial certification
by the State Health Commission,
the health service in the area shall
be reviewed at least every five
years by the HPA.

SPECIAL FEATURES
H.R. 12053—

(1) Establishes a National Coun-
cil for Health Policy within the
Executive Office of the President.

(2) Establishes State Health
Commissions, independent within
the state government and the
agency for performance of regu-
latory functions. Governing body
of 3, 5, or 7 fulltime members ap-
pointed by the governor for stag-



Moniana Slate Library




3 0864 1004 9691



S. 2994—

(1) Secretary would initiate
guidelines on national health policy
including a statement of national
health goals.

(2) Establishes State Health
Commission which is not an inde-
pendent agency within state gov-
ernment. Governor appoints ad-
visory council (budget and per-
formance advice). Two-thirds of
the advisory council shall be in-
dividuals who are not health care
providers.

(3) Health planning agencies
combine the functions of existing
areawide health planning agencies
and Regional Medical Programs.

P.L. 89-749—

(1) Assures comprehensive plan-
ning for health services, health
manpower, and health facilities.
Strengthens leadership and capa-
cities of state health agencies and
support of health services provided
to people in their communities "but
without interference with existing
patterns of private professional
practice of medicine, dentistry, and
related healing arts."

(2) Establishes a state health
planning council to include repre-
sentatives of state and local agen-
cies and non-governmental organi-
zations, health professionals and
consumers — a majority of such a
membership to bo representatives
of health services of consumers.

H.R. 13472 and S. 3166—

(1) Establishes a Statewide
Health Coordinating Council but
does not specifically call for a State
Health Council where regulatory
authority is housed.

(2) Secretary of HEW would au-
thorize a 25% increase in the
state's allocation if the state agrees
to regulate capital expenditures
and agrees to certain rate regula-
tory responsibilities.

(3) The Statewide Health Coor-
dinating Council would be estab-
lished by two or more HSA's and
be comprised of at least two mem-
bers of each HSA (one a consumer

al, the other a pro-



5A will assume a
hare of the costs
iealth Coordinating
t to be established
y). The state would



be permitted to contribute up to
25% of the amount required.

(5) Establishes the HSA's as
"public benefit corporations, a
unique and successful legal con-
cept in New York State which
provides greater authority and
flexibility in management and
operation." (Javits, Rep. N.Y.)

S. 3139—

(1) "In lieu of Federal interven-
tion into state public health police
powers where a state fails to com-
ply with the provisions of the bill,
the bill rather withdraws all fed-
eral funding programs support."
(Javits.)

(2) Establishes health planning
agencies as "public benefit corpora-
tions" as in S. 3166.

(3) Sets procedures and criteria
for reviews of proposed health
system changes.

(4) Establishes State Health
Commissions (designation of State
Health Commissions) determined
by the Secretary on a trial basis
(not to exceed 24 months). The
Secretary shall recognize the
agency designated by the Gover-
nor on a conditional basis. Condi-
tions of recognition are detailed
in the bill.

FUNDING

H.R. 12053 — Provides 100%
federal funding and guarantees a
minimum of $150,000 per agency.
Provides a federal match for local
funds but limits local match to no
more than 5% from any one pri-
vate contributor. Funding to June
30, 1976.

S. 2994 — Provides federal fund-
ing similar to H.R. 12053 and al-
lows non-federal funds for match
with the exception that no part
of the funds can be contributed
by private contributors. Funding to
end June 30, 1977.

P.L. 89-749 — Provides federal
support not to exceed 75% of
costs. Funding to June 30, 1973
with one year extension granted to
June 30, 1974.

H.R. 13472 and S. 3166 — Pro-
vides unconditional contributions
from any private source of up to
5% of assistance from the Secre-
tary and up to 25% of the amount
from any public sources. (Amounts
to be established by the Secretary.)

S. 3139 — Provides for funding
support similar to H.R. 12053.





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Online LibraryMontana. Division of Comprehensive Health PlanningMontana comprehensive health planning news (Volume 1974 VOL 5 NO 4) → online text (page 3 of 3)