Powerful Allies Push Universal Coverage : Legislation: AFL-CIO, doctors and seniors’ lobby call for comprehensive health reform. They fear Clinton, Congress may settle for something less.


In a boost for President Clinton’s health reform initiative, leaders of three powerful groups forged an unusual alliance Wednesday and called on Congress to enact comprehensive reform that achieves universal coverage by requiring employers to provide insurance.

The demand was issued by the AFL-CIO, the American Medical Assn. and the American Assn. of Retired Persons amid growing signs that the White House and Congress may settle for something less than coverage for everyone and rely on financing mechanisms that will not deliver sufficient subsidies to the needy.

If those proposals are followed, new hardships will be inflicted on the three groups in the alliance. For instance, reimbursement rates for doctors will be lower, union members will have a smaller field of providers to chose from and the elderly will see deeper cuts in the Medicare program.


Reform measures that do not provide universal coverage are expected to raise the cost of insurance premiums and may actually increase the number of uninsured, now estimated at 38 million.

“Covering all Americans is essential to effective insurance reform, eliminating cost-shifting, and ensuring patient choice of physician and health plan,” the groups’ leaders said.

“Doing nothing is a prescription for disaster,” Horace Deets, AARP executive director, said at a press conference. “Doing too little, too late is a prescription for slow-motion disaster.” Deets was joined by James Todd, AMA executive vice president, and Lane Kirkland, AFL-CIO president.

“It’s late in the day for Congress,” Deets said. “We can’t let this opportunity slip by.”

In urging Congress to take bold action this year, the three groups put aside their differences over narrower issues, touching off speculation that other major interest groups may follow suit in these climactic weeks of congressional action. For instance, the American Hospital Assn., which has differences with the three groups on various issues, issued a letter hailing the alliance’s call to action.

But some analysts were dubious about a new outpouring of support and wondered whether Wednesday’s announcement will breathe new life into Clinton’s agenda or, in the words of Washington analyst Bruce Fried, merely “add to the cacophony.”

The three groups got together once before--when they called a little-noticed press conference two years ago to urge candidates in the 1992 presidential campaign to discuss health care reform thoroughly.


“Disappointingly, much of the ensuing public dialogue has been clouded by misinformation, scare tactics and negative messages,” the three leaders said in their statement Wednesday.

The need for reform now is “more urgent, more timely and more crucial,” Deets said. He also said that true reform must offer universal coverage “not as a vague promise but on a timetable specified in law.”

All three men said that their organizations would step up pressure on Congress to act. Kirkland said that he fears Congress will adopt “some kind of pseudo-reform that will exact an enormous price from working people.”

All three warned against enacting reforms only in the insurance market, such as barring insurers from jacking up premiums on those who develop costly illnesses or refusing to cover those with such conditions.

Prohibiting such discriminatory practices without also providing universal coverage could lead to higher rates for the insured and increase the ranks of uninsured, as the experience of New York state has demonstrated.

“Without universal coverage and an employer mandate, any health care reform bill will betray the hopes of America’s working families and the AFL-CIO would oppose such legislation,” Kirkland said.


Separately, First Lady Hillary Rodham Clinton made that same point, warning Senate supporters on Capitol Hill against “piecemeal reform.”

Todd’s 300,000-member AMA has come full circle on workplace-based coverage, from supporting to opposing to supporting it again. “We agree that universal coverage is important,” he said. “We agree that it should be a shared responsibility between employers and employees. It is a historic point that cannot be missed and health system reform of a meaningful nature must occur this year.”