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National Health Fund Urged as Aid to Uninsured

Times Medical Writer

Wilbur Cohen, the former federal official credited with conceiving the Medicare and Medicaid programs that pay for health services of 50 million Americans, today is worried about an additional 50 million citizens who have inadequate health insurance or lack coverage of any kind.

The solution, Cohen suggested, is to establish a health fund with contributions from employers and the federal, state and county governments. Failure to do this or to find some other way to provide care for the uninsured group--many of them working poor--will eventually add still greater cost to the Medicaid program, he said.

“But nobody on a national basis is doing anything to solve this problem,” he said. “They’re all wrapped up with Nicaragua and skyjackers.”

Successes Noted

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Medicare and Medicaid, launched 20 years ago after a stormy 15-year battle through Congress, have shown that massive health programs are not only administratively feasible but that they extend life expectancy and relieve the pain of illness for millions who previously often went without care, Cohen told a public hearing on the two programs Saturday.

Critics who attack them because of waste or fraud, he said, “are overlooking one of their biggest objectives--to provide a system that gives the right to medical care without having to bend a knee to anybody.”

Cohen, a professor at the Lyndon Baines Johnson School of Public Affairs at the University of Texas in Austin, spoke at a hearing in Patriotic Hall organized by the Medicare/Medicaid Defense Project. It was held to protest a conference last week sponsored by the federal government and the California Health and Welfare Agency to celebrate the 20th anniversary of the two programs. (Medicaid is Medi-Cal in California).

Conference Fee Criticized

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The organizers of the “counterconference"--38 public health, labor and consumer organizations--said the excessively high admission fee to the federal conference kept consumers and most people other than health care providers from attending the sessions, at which the future of Medicare and Medicaid were discussed.

Unlike the earlier conference, Saturday’s public hearing, chaired by Assemblyman Burt Margolin (D-Los Angeles), heard from some beneficiaries of Medicare and Medi-Cal. They talked about the value of the programs and the problems they have encountered in trying to obtain services--information they believed would be of value to agencies considering the programs’ futures.

The government-sponsored conference was concerned chiefly with methods being tried by the Reagan Administration to contain the rapidly growing cost of the two programs, which together this year will consume $112 billion in federal and state taxes.

Growth Called Inevitable

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In an interview, Cohen said the cost of Medicare, which is primarily for people over 65, inevitably will continue to grow because ever-expanding technology brings improved care and thus an ever-increasing number of aged people.

Every day of the year, 2,500 Americans reach the age of 65 and about 1,500 over 65 die, Cohen said, adding 1,000 people a day to the Medicare program. The medical costs of people over 65 are three times greater than for the general population, he said.


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