
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, May 19, 1993                   TAG: 9305190075
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-1   EDITION: METRO  
SOURCE: Los Angeles Times
DATELINE: WASHINGTON                                LENGTH: Medium

CARE OF DISABLED PUT IN HEALTH PLAN

In a major new health-care initiative, President Clinton has tentatively decided that every severely disabled American, regardless of age or financial means, should have insurance coverage for long-term care at home, sources said Tuesday.

The new $15.4 billion-a-year benefit is to be included in the core package of medical insurance benefits being designed by the administration as a nationwide standard for all Americans, especially the estimated 37 million without insurance, sources said.

The long-term care coverage would provide assistance with such daily at-home necessities as meal preparation, cleaning and dressing.

Many details of the program remain unclear, such as how the White House Task Force on National Health Care Reform, chaired by Hillary Rodham Clinton, arrived at the cost figure and how the program is to be paid for.

Health-care analysts say that as much as 80 percent of long-term home care is now provided for free by relatives and friends.

"It's very easy to spend $30,000 to $40,000 a year on intensive home care, but the average figures are a lot lower than that - in part because people don't get enough. That's why all the numbers are so soft," said Edward F. Howard, executive vice president of the Alliance for Health Reform, a nonpartisan, not-for-profit Washington organization.

The emerging basic-benefits package, which also is expected to cover mental health services and abortions, is at the core of the overall health-care reform agenda that the president is expected to unveil in mid-June.

That Clinton has tentatively decided to include long-term care in the basic benefits package is not a surprise, although it would be a dramatic turn in federal policy.

Administration officials, most notably Hillary Clinton, have strongly argued that long-term custodial care at home is much cheaper than that provided in a health-care institution or a nursing home.

Monday, she declared in a commencement address at the University of Pennsylvania: "If you are an older American and need help with prescription drugs and a start on long-term care, particularly in your home, you will be insured."

Last week, senior White House aide Ira Magaziner, the manager of the task force, said that a separate fund would be used to pay for long-term care.

The long-term care program is expected to be vigorously supported by powerful groups like the American Association of Retired Persons - but just as strongly opposed by the insurance industry, which wants private insurers to continue selling policies for profit.

The administration's long-term goal is to provide coverage for institutional care as well.

"We've always said we'd made a start [toward long-term care coverage] but that it's impossible to do full-scale long-term care on day one," a White House official said Tuesday.

One top insurance industry official called it "a fundamental mistake" to include long-term care for all disabled Americans.

by CNB