Clintons Piecing Together Reforms in Health Care

Although the nation roundly rejected their ambitious bid to revamp America’s health care system five years ago, Bill and Hillary Rodham Clinton are back at it, churning out narrower health care proposals that, put together, are almost as sweeping.

From universal prescription drug coverage for the aged to their newest initiative--expanded mental health benefits--the president and the first lady seem to have a solution for every perceived health problem.

On Monday the Clintons convened the first-ever White House conference on mental health and both fervently urged insurers to offer coverage for disorders of the mind equal to coverage for the rest of the body--while rejecting the industry’s contention that “parity” would drive up premiums for all.

“We must do whatever it takes,” declared Mrs. Clinton.

“It is high time that our health plans treat all Americans equally,” the president added. “Government can and must lead the way to meet this challenge.”

Setting the standard, Clinton directed the Federal Employees Health Benefits Program, the nation’s largest private insurer, to provide full parity by 2001 to its 9 million beneficiaries.

Hailing the fact that mental illness no long carries the stigma it once did, the president added: “Attitudes are fine, but treatment matters most.”

Expanding mental health benefits is only one of an array of administration initiatives that would bring far-reaching changes to the nation’s health care system.

List Includes Patients’ Rights, Child Programs

The White House also wants to strengthen the rights of managed care patients, enroll early retirees in Medicare, expand coverage to children, protect privacy of health records, provide tax credits for long-term care and improve nursing home quality, to name a few of its initiatives.

“What was being done all at once is being addressed one at a time, in piecemeal and incremental fashion,” said Dr. Bernard S. Arons, a government physician who helped draft Clinton’s controversial 1,342-page “Health Security Act” in 1993-94.

“There’s a tremendous amount of activity,” added Rep. Rosa L. DeLauro (D-Conn.). “The problems didn’t go away just because Congress didn’t act.”

Although it was a Democratic-controlled Congress in 1994 that killed the massive health care reform plan produced by Mrs. Clinton’s task force, most Democrats today are more in sync with the Clintons on an array of health care issues.

Thus even though Congress is now under GOP control, some of the administration’s proposals could pass--especially with health care costs again on the rise, at an annual rate of 9% this year, along with the steady increase in the number of uninsured Americans, now estimated at 43.5 million people.

But other initiatives, such as Medicare reform, remain longshots at best.

The Clintons’ health care agenda says a lot not only about the domestic business that the president has in mind for his remaining 17 months--but also what his wife is considering in her likely Senate race in New York.

For the president, it is a matter of legacy. For the first lady, it is no less personal. By championing health issues, however, she will be reminding voters of her role in what was the president’s most spectacular failure.

In addition to calling for mental health parity, the president on Monday also announced an array of new initiatives to improve public awareness and care of mental illness, including $61 million to fund new National Institute of Mental Health clinical studies to find more effective treatments.

Tipper Gore Chairs Conference

The daylong mental health conference was chaired by Tipper Gore, wife of the vice president. She disclosed recently that she was treated for depression 10 years ago after the couple’s only son was struck by a car and nearly died.

That both Clintons spoke passionately about mental health was no surprise to activists like Ron Pollock, head of Families USA, an organization that promotes universal health insurance coverage.

“This is an area where the president has the deepest set of convictions,” Pollock said. “He knows that there’s a lot that remains to be done.”

In his remarks at the conference, Clinton conceded--but only in part--that medical insurers have a legitimate concern that providing parity for mental health will “send costs and premiums skyrocketing.”

But he added: “Now there may be arguments to be made at the margins on both sides of these issues. But I believe that providing parity is something we can do at reasonable cost, benefit millions of Americans and, over the long run, have a healthier country and lower health care costs.”

The president also urged Congress to conduct hearings on the issue of parity in coverage, saying that 24 states and numerous businesses “have begun” to provide such parity and that their overall costs are “not notably increasing.”

One of the administration’s biggest fights may come over revamping Medicare, the health insurance program for the elderly and the disabled.

John Podesta, the White House chief of staff, said on Sunday that the president intends to propose that all 39 million Medicare recipients be made eligible for coverage for outpatient prescription drugs--a costly tab that seniors now must pay themselves.

To be eligible, however, beneficiaries would have to pay an as-yet unspecified monthly premium, Podesta said.