WHEREAS:

Since 1981 the Federal government has cut its Medicaid spending by 8%, and through eligibility cutbacks in Aid to Families with Dependent Children 700,000 children have lost their Medicaid coverage; and

WHEREAS:

Federal Medicaid cutbacks have led to similar state cutbacks with virtually all states reducing services, staffing, and eligibility for the program; and

WHEREAS:

Over 40% of Medicaid expenditures are for care for the elderly; and

WHEREAS:

Since 1981 the Federal government has cut the Medicare program by 5% while increasing out of pocket costs to the elderly for premiums, copayments and deductibles. The aged spent an average $1154 per person privately on health care in 1981; and

WHEREAS:

The Medicare Trust Fund is expected to be bankrupt by the end of the century; and

WHEREAS:

The Reagan Administration's Advisory Council on Social Security, overwhelmingly composed of providers, insurers and business representatives, recommends solving the Medicare funding crisis by taxing workers' health insurance; raising the eligibility age from 65 to 67 beginning in 1985; requiring beneficiaries to pay more out-of-pocket for care and to pay an annual surcharge of $41; and increasing the deductible for part B medical services; and

WHEREAS:

The Reagan administration's major cost-saving initiative — flat-rate payment for inpatient hospital care on the basis of diagnosis (diagnostic related groups or DRGs) controls only inpatient operating costs reimbursed by Medicare, not what can be billed to the patient, not capital expenditures, not doctors charges and not what is shifted to private payors.

THEREFORE BE IT RESOLVED:

That AFSCME supports the following four-point alternative program for reducing Medicare and Medicaid costs without reducing benefits. We call on Congress to:

1. Enact immediately a comprehensive, across-the-board cost containment system for all payors, public and private, such as provided by Kennedy-Gephardt proposal.
2. Include in the cost containment program a mechanism for limiting physicians' fees, while protecting the rights and interests of non-supervisory health care employees.
3. Include in the cost containment program mechanisms to prevent providers from increasing hospital admissions and to limit the rate of growth in hospital capital expenditures.
4. Add to the Medicare program a number of initiatives that have been developed by labor and management to control the rate of increase in costs without reducing benefits. A few such examples are pre-admission, second opinion, and other options; and

BE IT FURTHER RESOLVED:

That AFSCME shall support constructive proposals for restructuring the Medicare program to provide greater flexibility to adapt to changes in the health care system and in the Federal budget; to expand the financing base and to raise additional revenue; and to avoid reducing the scope of services covered or increasing the cost sharing requirements for the elderly and disabled Medicare beneficiaries who use the services. AFSCME shall support only those proposals which do not place an unfair financial burden on middle and low income households and which do not betray the original goal of the Medicare program — to ensure that decent health care is universally accessible to all elderly and disabled citizens; and

BE IT FURTHER RESOLVED:

That AFSCME shall continue to press the federal and state governments to disclose Medicare, Medicaid and other insurance-related data describing access, cost and quality information on physicians, hospitals and other providers to better inform consumers and protect their rights and interests to decent health care; and

BE IT FURTHER RESOLVED:

That wherever the Medicare and Medicaid programs are used to promote new health or related services delivery systems, AFSCME shall work aggressively to protect the rights and interests of health care employees and consumers affected by these changes.

SUBMITTED BY:

International Executive Board