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Social Welfare Policy: Catastrophic Helthcare Insurance

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Samuel Paredes

on 3 May 2011

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Transcript of Social Welfare Policy: Catastrophic Helthcare Insurance

H E A L T H C A R E -"Older Americans worry about two things-their finances and their health," said HHS Secretary Otis Bowen in 1987. "and wonder which will run out first." -Healthcare costs spiraled in the 1980's many American families faced financial ruin in the case of a catastrophic illness. -In the 80's senior citizens accounted for 50% of all public and private healthcare costs in America. -In 1987 the rules for co-payments were; after 60 days you pay $130 dollars a day, after 90 days the co-payment rose to $260 dollars a day. Medicare ceased altogether after 150 days.

-Affluent senior citizens were able to supplement their healthcare coverage. But, the majority was left vulnerable to a catastrophic illness.

-Congress had long wanted to fix this problem. But, they were afraid President Reagan would not want to expand any social services. -President Reagan’s 1986 State of the Union address confronted the current issue of catastrophic healthcare. He asked the Director of Health and Human Services to help him come up with a way the public and private sector as well as both parties could meet eye to eye on this issue.

-Because of the significant Republican and Democratic support for the concept, Congress took the lead on catastrophic healthcare. In 1987 Medicare was utilized by 28 million elderly citizens and 3 million disabled persons in America. There are two parts to Medicare:

Part A is the hospital insurance program that helps pay for impatient hospital care or at home nursing care.
Anyone over 65 is automatically eligible for part A if they qualify for social security benefits, and it can be purchased by those over 65 who are not eligible for coverage already.
Program financed by Social Security payroll tax. Part B is the Supplemental Medical Insurance program. This portion is elective and allows for 80 percent of the doctor bills after the annual deductable is paid. In house markup hearings in late 1987, the legislature expanded existing coverage and benefits to provide acute-care coverage, extended coverage for out patient mental health, nursing home, and hospice care.

House approved the bill on July 22, 1987.

In the Senate all catastrophic healthcare became optional and by dropping Part B coverage enrollees could avoid the new premiums. Under the house bill those in higher tax brackets would pay more for Part A, even if they dropped part B. Senate passed their version of the Bill oh October 27, 1987. Throughout 1987 the Catastrophic Healthcare bill was very popular
It was called a “motherhood” bill
It attracted strong bi-partisanship/ Little Whitehouse opposition The AARP supported the bill
Opposition came from the National Committee to Preserve Social Security who urged its members to oppose the bill
This interest group had a nasty reputation on Capitol Hill for its use of inflammatory tactics to frighten the elderly in order to fill its own coffers. •The bill would finance itself by increasing the Medicare part B premiums over a five-year period and assessing the highest charges on those most able to afford it. On June 2 the House approved the catastrophic insurance bill by a vote of 328 to 72.
A week later the Senate also ratified the conference report in a bipartisan vote of 86 to 11.
On July 2, President Reagan signed the bill. Catastrophic healthcare did not end with the signing ceremony.
House democratic sponsor “I think most of the complaints are from those who don’t understand”
Vocal uproar grew from 1988 to 1989 and senior citizens began to protest.
Several bills introduced in the 101st congress to change the financing of healthcare benefits.
The elderly took a strong stance against the “catastrophic care” in the form of protests.
Elderly protested against Dan Rostenkowski- by blocking in his car
Coverage from the New York Times and Newsweek Roosevelt’s National Committee was influencing its 5 million members to pressure congress to repeal the “seniors-only surtax” and began to truly infuriate Congress
There was a progression of the bill in the House and the Senate, but began to cause controversy with Henry Waxman (D-Calif) claiming that House members finally voted because they felt the elderly were ungrateful and needed to sit in their own situation. October 4, 1989: House voted to repeal the surtax and eliminate the expanded medicare benefits.
6 weeks later the Senate gave up the idea of fighting and passed the House version.
1:52am on November 22, 1989 the senate and the House joined together and voted to repeal public law 100-360
The Medicare Catastrophic coverage Act, passed with such fanfare only 16 month earlier, was wiped off the books The Regan administration was internally divided and left the decision up to Congress.
This stance continued to be true even through the Bush administration, as he took office 6 months after the bill passed.
The White House refused to take a stand on the situation, infuriating Capitol Hill
Members quoted saying “I guess they don’t have a dog in this fight” “The case shows that congress as a representative institution can lead policymaking but remains vulnerable to powerful, vocal interests.”
Congress believed that this was a pressing issue but they do not have the “bully pulpit” that the president has and lacks the stance they needed.
As of 2002 there was little progress made with the bill. This has been a pesentation by:

Melissa Halloway
Desiree Kerfoot
Sam Paredes
Kathryn Tallo &
Mabel Vega THANK YOU!
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