- Administration Health Care Goals Addressed Rural Needs
- Rural Proposals No Longer Being Considered in Congress
- Watered-Down Health Care Bill -- Not What the Doctor Ordered
- Farm Organizations Push for Real Health Care Reform
- RESOURCES/ACTION ALERT
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ADMINISTRATION HEALTH CARE GOALS ADDRESSED RURAL NEEDS
Most farm families were encouraged last June when First Lady
Hillary Rodham Clinton indicated that health care reform would
include special provisions for all rural residents and self employed
family farmers.
During a nation-wide conference call the First Lady described a plan
where "insurance reform will make it illegal to charge farmers higher
premiums or to drop their health insurance when someone becomes
ill or has an accident. Rural areas will get help attracting doctors and
nurses so health care is not just affordable, it is actually available.
And for the first time family farmers will get the same 100 percent
deduction that only big employers and government get today."
Unfortunately, the health care proposals currently circulating in
Congress do not include provisions similar to those outlined by the
First Lady.
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RURAL PROPOSALS NO LONGER BEING
CONSIDERED IN CONGRESS
Political battles in Congress have prevented most rural initiatives
from making their way into supported national legislation.
The Rural Health Delivery System bill (H.R. 4555), for example, which
was endorsed by the House Rural Health Care Coalition to ensure
adequate care for rural Americans, has not made it past initial
subcommittee consideration. The national single-payer bill (H.R.
3960) made it past some committees, but has not been scheduled on
the Congressional calendar for floor consideration. The Mitchell and
Gephardt bills (amendments to President Clinton's Health Security
Act), while not perfect, but which still offered some improvement
over the current health care system for rural Americans, are said to
be politically "dead."
The only health care proposal currently circulating in Congress with a
chance for approval this fall -- the Senate Mainstream Coalition Plan
-- offers little hope for real health care reform in rural communities.
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WATERED-DOWN HEALTH CARE BILL -- NOT WHAT THE DOCTOR
ORDERED
The Mainstream Coalition Plan proposes coverage for 92 percent of
all Americans by the year 2004, phases in tax deductions for health
insurance costs beginning in 1996 at 25 percent, cuts Medicare and
Medicaid by $80 billion, and mandates relatively unsubstantial
insurance reform -- no caps on premiums, no cost containment and
no single-payer option for individual states.
Rural health care advocates say universal coverage is a must, and
reaching 92 percent coverage by the year 2004 is just not good
enough. The National Farmers Union notes that many of those
Americans left uninsured will be family farmers and rural residents.
Family farmers and other self-employed workers are currently
unable to deduct any of their health care costs from their taxes.
Until earlier this year, they were able to take a 25 percent deduction,
but lawmakers let the provision expire in anticipation of improved
health care reform. The Mainstream plan restores this 25 percent
deduction in 1996 , but doesn't accomplish full tax deduction until
the year 2000.
Cuts to Medicare and Medicaid will further exacerbate the
deterioration of rural medical services for the aging rural population
and all rural residents because more rural hospitals and clinics will
continue to close as these benefits are cut.
Failure to significantly reform the insurance industry or to cap
insurance premium prices will force many farm families to forego
health insurance because premium costs will be allowed to continue
rising above affordable prices.
In addition, states will not have the option to introduce a single-
payer plan under the Mainstream bill. This essentially limits states'
ability to make decisions on how to administer health care to
residents.
A number of Washington observers warn that failure to pass any
type of health care reform this year will erode the opportunity for a
better plan in the future. Lawmakers and range of organizations,
therefore, are considering whether or not to accept the Mainstream
plan.
However, most farmers and farm organizations, including FARM AID,
don't agree that "something is better than nothing." Watered-down
deals like the Mainstream Coalition Plan do nothing to achieve real
health care reform for family farmers.
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FARM ORGANIZATIONS PUSH FOR REAL HEALTH CARE REFORM
FARM AID, along with other groups like the National Farmers Union,
have long been advocates of fundamental health care reform that
provides expanded coverage and improved access for all rural
Americans.
Expanded Coverage.
Everyone must be covered equally. Because rural areas have a high
percentage of uninsured people who can't afford to pay for rising
insurance premiums, health care reform must ensure that people in
rural areas have the same access to quality, affordable health care as
those living in urban areas or cities.
Improved Access.
People living in rural areas, which are considered "care shortage
areas," need health care provisions that provide more access to
medical services. Innovative approaches should be used, such as
incentive pay, rotation, and continuing education programs to attract
physicians and other health care practitioners to rural communities,
and to support existing rural hospitals and clinics.
Many farm groups ultimately support a national single-payer plan
to accomplish these goals. Under the House single-payer plan,
roughly modeled after Canada's health care system, everyone would
be covered by health insurance administered through the
government or another agency and financed through a 7.9 percent
payroll tax on all employers, increases in corporate and personal
income taxes and tax reform. This plan offers the most
comprehensive approach to real rural health care reform, but is
unlikely to generate enough immediate support in the Senate to
become a reality.
Family farm organizations, therefore, press that the following
minimum provisions be included in any federal health care reform
package:
- Universal coverage;
- Immediate 100 percent tax deduction of health care costs;
- Employer mandates;
- Subsidies to attract and support rural hospitals, clinics and doctors;
and
- The ability of individual states to enact a single-payer plan.
FARM AID urges everyone to contact their Senators and
Representatives to ask them to support a health care plan that
includes the above provisions, and to work toward a national single-
payer plan over the long-run.
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Sources: Philip Brasher, "Farmers Fight for Equal Deductions: Tax
Break Is Top Issue for Farmers in Health Debate," AG WEEK, August
29, 1994; " How People in Rural Areas Benefit Under the Single-
Payer System," CAMPAIGN FOR BETTER HEALTH CARE; Gene Lucht,
"Health Care Diagnosed as Year's Biggest Issue," IOWA FARMER
TODAY, March 26, 1994; "Rural Health Care Concerns Addressed by
Legislation," THUMB FARM NEWS, June 22, 1994; Mark Haugen, "First
Lady: Health Care Plan Helps Farmers," THE NEIGHBOR, February 25,
1994; Jeffrey Smedsrud, "Just Say 'Whoa' to Health Care Reform,"
FARM & RANCH GUIDE, August 12, 1994; "Rural Areas Are Latest
Health Care Battleground," AGRI NEWS, July 28, 1994; Telephone
interview with Jeff Smedsrud, Communicating for Agriculture,
September 12, 1994; Clay Pederson, NFU, September 12, 1994.
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RESOURCES
1. "Winning the Battle: Putting Rural Health Needs First in Health
Care Reform." Contact: Communicating for Agriculture, P.O. Box 677,
Fergus Falls, MN 56538. 1-800-844-6273 or (612) 854-9005. First
copy free. Additional copies $9.95. A 56-page book that documents
numerous studies and outlines the unique health care problems
faced by rural residents.
2. The National Farmers Union is offering educational resources,
speakers, videos and summary materials to promote a dialogue on
health care reform plans being put forth in Washington. Any
interested groups should contact Judith Ahlberg, Wisconsin Farmers
Union, 1-800-272-5531 or (715) 986-2383.
3. For more information about the single-payer system, contact Jon
Youngdahl or Kip Sullivan of Minnesota COACT, (612) 645-3733. Fax:
(612) 645-4339.
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ACTION ALERT
The National Farmers Union will conduct a fly-in of more than 200
farmers and ranchers to Washington D.C. September 18-21 to
demand real health care reform, outline objectives for the 1995 farm
bill and to discuss provisions of the Uruguay Round GATT accord.
Contact Emil T. Mushrush for more details: (310) 241-6630.
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We welcome comments and suggestions: contact Harry Smith at
FARM AID, (617) 354-2922. We encourage the reproduction of
FARM AID NEWS. Produced by The Institute for Agriculture and
Trade Policy (IATP) for FARM AID. Editors: Gigi DiGiacomo and
Harry Smith. For information on other agriculture bulletins, contact
IATP: (612) 379-5980.
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