A President explaining his health plan to Congress:
First, it offers every American an opportunity to obtain a balanced, comprehensive range of health insurance benefits;
Second, it will cost no American more than he can afford to pay;
Third, it builds on the strength and diversity of our existing public and private systems of health financing and harmonizes them into an overall system;
Fourth, it uses public funds only where needed and requires no new Federal taxes;
Fifth, it would maintain freedom of choice by patients and ensure that doctors work for their patient, not for the Federal Government.
Sixth, it encourages more effective use of our health care resources;
And finally, it is organized so that all parties would have a direct stake in making the system work–consumer, provider, insurer, State governments and the Federal Government.
BROAD AND BALANCED PROTECTION FOR ALL AMERICANS
Upon adoption of appropriate Federal and State legislation, the Comprehensive Health Insurance Plan would offer to every American the same broad and balanced health protection through one of three major programs:
–Employee Health Insurance, covering most Americans and offered at their place of employment, with the cost to be shared by the employer and employee on a basis which would prevent excessive burdens on either;
–Assisted Health Insurance, covering low-income persons, and persons who would be ineligible for the other two programs, with Federal and State government paying those costs beyond the means of the individual who is insured; and,
–An improved Medicare Plan, covering those 65 and over and offered through a Medicare system that is modified to include additional, needed benefits.
One of these three plans would be available to every American, but for everyone, participation in the program would be voluntary.
The benefits offered by the three plans would be identical for all Americans, regardless of age or income. Benefits would be provided for:
–hospital care;
–physicians’ care in and out of the hospital;
–prescription and life-saving drugs;
–laboratory tests and X-rays;
–medical devices;
–ambulance services; and,
–other ancillary health care.
There would be no exclusions of coverage based on the nature of the illness. For example, a person with heart disease would qualify for benefits as would a person with kidney disease.
In addition, CHIP would cover treatment for mental illness, alcoholism and drug addiction, whether that treatment were provided in hospitals and physicians’ offices or in community based settings.
Certain nursing home services and other convalescent services would also be covered. For example, home health services would be covered so that long and costly stays in nursing homes could be averted where possible.
The health needs of children would come in for special attention, since many conditions, if detected in childhood, can be prevented from causing lifelong disability and learning handicaps. Included in these services for children would be:
–preventive care up to age six;
–eye examinations;
–hearing examinations; and,
–regular dental care up to age 13.
Under the Comprehensive Health Insurance Plan, a doctor’s decisions could be based on the health care needs of his patients, not on health insurance coverage. This difference is essential for quality care.
Every American participating in the program would be insured for catastrophic illnesses that can eat away savings and plunge individuals and families into hopeless debt for years. No family would ever have annual out-of-pocket expenses for covered health services in excess of $1,500, and low-income families would face substantially smaller expenses.
As part of this program, every American who participates in the program would receive a Health-card when the plan goes into effect in his State. This card, similar to a credit card, would be honored by hospitals, nursing homes, emergency rooms, doctors, and clinics across the country. This card could also be used to identify information on blood type and .sensitivity to particular drugs-information which might be important in an emergency.
Bills for the services paid for with the Health-card would be sent to the insurance carrier who would reimburse the provider of the care for covered services, then bill the patient for his share, if any.
The entire program would become effective in 1976, assuming that the plan is promptly enacted by the Congress.
Richard M Nixon, 1974