Congressional prescriptives.

• Author: Tubbesing, Carl
• Position: Includes related article

While the public was waiting for the White House to unveil its health plan, several congressional members were hard at work on their own.

President Clinton isn't the only one with a health-care plan. There are four major congressional proposals that may be part of the prescription for curing our health system. Sponsored by both Democrats and Republicans, these plans are serious contributions to the health-reform debate. They are likely to define in some way the very focus of that debate. Here are sketches of the four major congressional alternatives to the Clinton plan:

The Cooper Plan

Tennessee Congressman James Cooper has offered one of two major Democratic alternatives to the president's plan. Cooper claims his approach would achieve universal coverage through purchasing cooperatives for small employers, requiring large employers to offer coverage and subsidizing coverage for families below 200 percent of poverty. This managed care approach features a National Health Board that would recommend a standard benefits package, set quality standards for "accountable health plans," set reporting standards and monitor the reinsurance market. Its purchasing cooperatives would contract with health plans, enroll individuals in them and monitor client satisfaction. States would designate areas for the purchasing cooperatives, arrange with other states for multi-state cooperatives, develop plans for underserved areas and assume responsibility for financing long-term care. This legislation would pre-empt state mandated benefits laws and laws that regulate managed care, like those found in as many as 24 states. The Cooper approach would eliminate Medicaid, but continue Medicare. The congressman has not yet specified a financing mechanism. Cooper's plan would bar states from testing a single-payer system. He claims that state experiments would be "disruptive to the free market."

The plan has been endorsed by the Business Roundtable, a group of CEOs representing the nation's 200 largest corporations.

Senate Republican Plan

A task force chaired by Rhode Island Senator John Chafee formulated a plan that shares some features of the Clinton program. Focusing on universal access and administrative reforms, the Chafee proposal includes purchasing cooperatives for small businesses and individuals and emphasizes preventive care. It would achieve savings by capping Medicaid spending, requiring managed care for Medicaid recipients, instituting electronic data...