Health and Human Services Secretary Donna Shalala, responding to lawmakers' complaints that President Clinton's health care reform legislation has not yet been sent to Capitol Hill, said Tuesday that the White House is taking another look at the plan's widely challenged cost estimates.
Appearing before the House Energy and Commerce subcommittee on health and the environment, Shalala said that she could not confirm earlier estimates of the plan's costs, the subsidies that would be needed to help small businesses purchase employee health insurance or estimated spending reductions.
She said that work on the bill is expected to take another two weeks and that she could not discuss specifics until the review is completed.
Republicans on the subcommittee expressed frustration that they have not yet seen the Administration's legislation.
"We have to see the actual bill. Until we do, it's very difficult to ask Congress to get all of the hearings over before the end of this congressional session," said Rep. Carlos J. Moorhead (R-Glendale).
Rep. Thomas J. Bliley Jr. (R-Va.) said that Congress needs to focus on the actual plan, not a general outline, particularly since the financing has been questioned by many economists.
"Because we are working from a moving vehicle, both Congress and the public are told different and sometimes contradictory things about the plan on a daily basis," he said. "I am not aware of one independent health care expert or economist who has found your financing and cost containment proposals credible."
Shalala said that she wants to avoid using actual numbers "because the numbers which are currently being reviewed by my own department, by the Office of Management and Budget and by the Treasury will accompany the bill when it comes to (Capitol) Hill."
Meanwhile, health care providers--physicians, nurses and hospital officials--said in Senate testimony Tuesday that there is more "common ground" than "battleground" in President Clinton's proposal to reform the nation's health care system. Nevertheless, they quibbled with some details of the plan.
Officials from the major organizations representing health care providers, testifying before members of the Senate Labor and Human Resources Committee, said that they support many of the plan's overall principles--such as providing coverage and a guaranteed package of health benefits for all Americans and curbing health care costs.
But many of the groups said that they disagree with President Clinton on how best to reach those goals and on other elements of the plan.
Dick Davidson, president of the American Hospital Assn., which represents 5,000 hospitals and other health care providers in the United States, said that his organization would oppose federal efforts to generate billions of dollars to help pay for the plan by slowing the growth of Medicaid and Medicare payments to health care providers. Hospitals could be directly affected by these curbs since a majority of patients treated in hospitals are Medicaid patients.
"These changes are not intended to fix what's wrong with the Medicaid program (but to) fund prescription drug and long-term care benefits for the elderly," he said. "We are supportive of those benefits, but we can't support underpaying hospitals in order to finance them."
Dr. James Todd, executive vice president of the American Medical Assn., said that mechanisms in the proposal to save money could interfere with the doctor-patient relationship, "making it difficult to make the best possible decisions on behalf of patients."
Dr. Leonard Lawrence, president of the National Medical Assn., representing more than 17,000 of the nation's black physicians, urged Congress to focus on the special health needs of minorities, which he said have long been underserved, and to ensure minority participation in decision-making.