Bowen Left in Dark by Reagan Talk

Health and Human Services Secretary Otis R. Bowen said today he still does not know whether President Reagan’s legislative recommendation on catastrophic health care for the elderly will include his own proposal to tie such a plan to Medicare.

“I guess I would have to say that they are still studying it,” Bowen told the Senate Finance Committee. “I don’t know that it’s all been ruled out or that it’s all been ruled in.”

Bowen testified nearly 12 hours after Reagan promised in his State of the Union speech to submit legislation to help relieve the fear of elderly Americans that they will be financially devastated by serious illness.

Bowen acknowledged that there is concern among some in the Administration that his proposal to attach a self-financing catastrophic health provision to the existing Medicare program “would not remain a pay-as-you-go plan.”

Private Insurance Role

“There is fear also of removing something from the private (insurance) sector,” said Bowen.

But he said he did not believe his proposal would hurt private insurance companies because there would still be plenty of opportunity for them to sell policies covering the $2,000 a year that even a catastrophic plan would not pay for as well as such expenses as eye care, dental care and drugs that would remain outside Medicare.

Reagan stopped short of embracing the Bowen plan in his State of the Union speech. But neither did the President’s speech, nor a set of “guidelines” issued by the White House, rule out eventual acceptance of Bowen’s proposal.

The health secretary’s plan has drawn wide bipartisan support in Congress, at least as a starting point, and he has been roundly praised for pushing it despite opposition from others in the Administration who argue against any expansion of government health programs.

Bowen Plan Popular

The consensus of congressional and private health care activists in advance of Reagan’s speech was that he would not risk the political damage of using such a visible public forum to put the Administration on record against the popular Bowen plan even if the White House later tries to sidetrack it.

Under the Bowen plan, the Part B Medicare premium--which is voluntary and now generally covers doctor bills--would be increased $4.92 a month to insure Medicare beneficiaries against paying any more than $2,000 out-of-pocket expenses a year for hospital and doctor bills.

Under the current Medicare program, which is financed by Social Security tax deductions, only days 2 through 60 of a hospital stay are covered. The first day must be paid by the patient or private insurance, as well as anything over 60 days in a single year.