*MORE* MICASA.  Politics as usual.

;-) ISM


-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]On Behalf Of Stephanie
Sent: Sunday, January 30, 2000 7:03 PM
To: [log in to unmask]
Subject: FW: Republicans on Long Term Care


----------
From:   Bob A Kafka[SMTP:[log in to unmask]]
Sent:   Tuesday, January 18, 2000 1:32 PM

Hi:

Read and weep!!  It appears we need to send the candidates to LTC
reorientation camp.  Depressing how little they get it.

bob k............

(from the long term care campaign)

DATE:     1/18/00

SUBJECT:  Republicans on Long Term Care

On Saturday, the Des Moines Register hosted a candidate debate among
those vying for the Republican nomination.  We had urged all of our
Iowa advocates to contact the Des Moines Register in the weeks leading
up to this debate to ask that a question on long term care be included.
Below, please find a transcript of the LTC-related question that was
asked and the candidates' responses.

FROM the DES MOINES REGISTER/GOP debate held 1/15/2000:

RYERSON. I have an 87-year-old father who has Parkinson's Disease and a
47-year-old brother with Down's Syndrome who has lost his Medicaid
coverage. The cost of long-term residential care simply can't be managed
by families such as mine. As president, what steps would you take to
insure that affordable, long-term care is available to anybody who needs
it regardless of age or income. Mr. Bauer, you're first with one minute.

BAUER. Well, Richard, first of all, let me say something about veterans
long-term care. We've been closing veterans hospitals around the country
and that's outrageous. My father spent the last two years of his life in
a
veterans hospital. We made a bargain with those men, they answered the
call for the country. And I'll make sure that we do have long-term care
for our veterans.

For older Americans and other ones let me tell you something, Richard,
that you may not know. The politicians in Washington have taken care of
themselves and federal employees with a great federal health care plan.
Every year you get to choose from 200 health insurance policies. Many of
them do cover long-term care.

We've looked at this, a bipartisan commission determined that we could
let older Americans opt out of Medicare into that federal plan. We could
save money and provide the long-term care that your family needs and the
prescription drug coverage and save money in the process. This is the
kind
of reform I'll do as president. It's important and I'm committed to it.

RYERSON. O.K., Senator Hatch.

HATCH. Well, I'm not just talking about it, I'm not just making
promises.
I've actually worked on long-term care issues from the time I was in the
Senate. I'm one of the prime authors of the Home Health Care Bill that
brings home health care right into the home where the senior citizen or
the
person who's sick actually feels more acclimated, more psychologically
and psychiatrically secure. I've worked very hard on nursing home
issues.
For instance, I came to Iowa, I visited a number of the nursing homes,
especially the skilled nursing facilities where complex medical
patients,
like people with Alzheimer's, like people with difficulties described
here
today, are taken care of. They were not making it. There were 900 of
them
going into Chapter 11 bankruptcy or in Chapter 11.

I said I'd go back and do something about it. I went back and worked
right up to the end of this session. And literally in the last few days
of the
session, got the reimbursement levels up where these people were taken
care of. I'm not just talking about it. I've actually done it. And
that's
what I offer to the people here in Iowa and the people throughout this
country: experience.

RYERSON. Thanks, Senator. Ambassador Keyes.

KEYES. I think it's critically important that we understand that if we
want
to be able to allocate our medical dollars to reflect the right kind of
priorities, then we've got to take an approach that helps people to
maximize the cost-effectiveness of the medical care they receive. We
shouldn't have government and other bureaucracies dictating to people
who
are trying to act responsibly but instead we need to empower them
through
programs that voucherize the government system, that give people medical
savings accounts, that allow greater choice on the part of individuals
and families, allow them to make the decisions that can help us to keep
the costs down. And by making better use of our medical dollars, we will
then be able to allocate those dollars with priority to the things that
families really can't handle for themselves and that means giving top
priority to the kind of long-term care that can have a catastrophic
effect on the family budget. If we take the right approach, people will
be armed to keep the costs down and our medical dollars can be used more
effectively to help people meet those needs that they can't meet for
themselves.

RYERSON. Thank you. Senator McCain?

McCAIN. All of the proposals that my colleagues have mentioned are all
good, including tax deductions for those who itemize as well as those
who
don't. Medical savings accounts, etc. But I want to talk about a special
group of Americans that may not be able to do all these things and
that's
our World War II veterans, our greatest generation. Thanks to Tom
Brokaw's book, "The Greatest Generation," thanks to the movie "Saving
Private Ryan," Americans are beginning to appreciate the service and
sacrifice of these brave Americans who did make the world safe for
democracy. They're leaving us at 30,000 a month. We promised them, we
promised them health care benefits when we asked them to go out and
serve
and sacrifice. We're not doing that, my friends. They deserve the health
care benefits that we promised them. And I, as I'm on this book, for the
book I wrote then I see these World War II veterans they deserve far
better from what they're getting. And this administration is AWOL !
on this issu
   e.

RYERSON. Thank you Senator. Mr. Forbes.

FORBES. I think the key is putting patients in charge of health care
resources again. There's no need for all of these third parties,
H.M.O.'s, insurers, employers, gate keepers, government bureaucracies
that stand in the way. It's true, if you work for the federal government
as a civilian, if you're a member of Congress, you have your choice of
several hundred
different health care plans. If it's good enough for Congress, it should
be
good enough for the elderly in America. So that way, if you need
long-term care, you can choose a plan that does it. If you need
prescriptive medicines you can choose a plan that does it. And for those
on Medicaid, you should be able to have vouchers and coupons and the
like
so you make the choice, not where the government tells you to go.

This issue also, though, brings up the life issue. We've talked about
and
I hope we'll talk about the need for, keep the pro-life plank in the
platform, pro-life judges and pro-life running mates. But it also brings
up the issue of euthanasia and assisted suicide. We must fight both.
They
go hand in hand.

RYERSON. Thank you sir. Governor Bush.

BUSH. The danger in the health care debate is that America falls prey to
the idea that the federal government should make all decisions for
consumers and the federal government should make all decisions for the
  providers, that the federal government should ration care. The good
news
is none of us on this stage support that. The other two candidates,
running for Democrat Party, sound like they support that.

The current issue as far as the elderly is this, there's an agency
called
Hicfa that's controlled by a 132,000-page document to determine how to
allocate and ration Medicare dollars to the seniors. It is a plan that
is
inefficient, it is a plan that's antiquated. And what our government
must
do is empower our seniors to be able to make choices for themselves and
support premiums for the poorest of seniors.

In terms of long-term care for the baby boomers, I think we ought to
encourage the purchase of long-term care insurance and allow
deductibility of that insurance so that the new younger generations are
able to plan more aptly for when they retire and when they become more
elderly.

RYERSON. O.K., thank you, Governor. You each have 30 seconds for a
follow-up answer. Mr. Bauer.

BAUER. Well, let me just say on a related matter that I don't think any
of
us want Bill and Hillary Clinton or government bureaucrats running
health
care, but I have to tell you, I don't want H.M.O. bureaucrats running it
either. And I think our party got off on the wrong foot some months ago
when we stood against a patient bill of rights. I think if my mother is
mistreated at her H.M.O. and she's experienced medical malpractice, she
should have a right to sue. There's nothing Republican or nothing
conservative about standing with the big H.M.O.'s against the average
Americans. I'll support a patient bill of rights.

RYERSON. O.K. Senator Hatch.

HATCH. Well, personally, we did not go against patient bill
of rights. We have a Senate bill, a House bill. The Senate isn't as
good as the House bill. We're going to get together and resolve it. I'd
say home health care is pretty darn important for these people. So is
effective nursing home care. So are community health centers. So is the
Hatch-Waxman Bill that provided -- that seniors don't have to give up
food in order to get pharmaceuticals and cut pharmaceutical costs $8 to
$10
billion for each of the years since 1984. These are things that I've
done. These are things that I know how to do. I know more about health
care
and I can tell you I can solve these problems and I will.

RYERSON. Ambassador Keyes.

KEYES. I'm sort of sorry to hear Gary going down the road
that suggests we ought to turn all of this business over to the
judges. They don't do a very good job anywhere else, I doubt they'll do
it here. It just becomes an excuse for government domination. What we
really need to do is empower people, patients, to be in a position where
they will be able to enforce their judgment if they're not getting what
they need, not turn it over to trial lawyers so that they can go down
the
same wasteful road we have seen, raising the cost for all Americans and
burdening our health care system with an unneeded weight of litigation.
I
think it's a big mistake to go down that road.

RYERSON. Thank you Ambassador. And we'll go now to Senator McCain.

McCAIN. All of us in this room in the next 15 minutes, including with
Congressman Gansky here could sit down and work out a patient's bill of
rights. We all know it's simple. Allow a woman to see a
gynecologist, a second opinion, emergency room care, the right to sue
under
certain circumstances. Why don't we? Why is it hung up in Congress?
Because the Democrats are gridlocked by the trial lawyers who want
everybody to sue everybody for everything and the Republicans are
gridlocked by the big money from the H.M.O.'s and the insurance
companies.
The American people deserve better and until we get this soft money,
these
uncontrolled contributions out of Washington --

RYERSON. Thank you Senator.

McCAIN. -- we won't reach agreements.

RYERSON. All right. Mr. Forbes.

FORBES. I've put forth the strongest and boldest proposals to put
patients in charge of health care again, whether it's removing
restrictions on H.M.O.'s, giving you true choice and the like. It is
absolutely ridiculous in America today that you have to go through an
appeals process if you're not satisfied with the care you get. You know,
if you want to go from Wendy's to McDonald's you don't need an Act of
Congress. So remove those restrictions. They're undemocratic, they're
against freedom and they should be removed. You should be able to choose
your own doctor, choose your own specialist, choose your own health care
plan.

RYERSON. Thank you. Governor Bush.

BUSH. One of the things I've learned as the governor of Texas is that if
you set a clear enough agenda during the course of a campaign, and you
know how to bring people together to achieve an agenda, things can get
done. Unfortunately, this administration has used Medicare and the issue
of Social Security as a political football. Should I become the
president, reforming Medicare and Social Security are going to be a
primary objective of mine. And I intend to work with Republicans and
Democrats to do what's right for America.





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