Table of Contents

Health Security, The President's Report to the American People


     Letter from President William Jefferson Clinton

     Foreword by First Lady Hillary Rodham Clinton

1    Why Change     1    
          Rising Insecurity   2
          Growing Complexity  6
          Rising Costs   7
          Decreasing Quality  12
          Declining Choices   14
          Growing Irresponsibility 14
          An American Challenge    16

2    Principles of Reform     17   
          Security  17
          Simplicity     18
          Savings   18
          Quality   19
          Choice    20
          Responsibility 20


3    How the New System Works 21
          How Reform Will Affect You    21
          Small Business in the New System   24
          Discounts for the Smallest Companies    26
          An Overview of the New System 26
          Flexibility    27

4    Security  33
          Comprehensive Benefits   34
          Insurance Reform    39
          Limits on What Consumers and Businesses Pay  40
          Protecting Older Americans    41
          Access to Care in Rural and Urban Areas 43

5    Simplicity     47   
          Reducing Paperwork  47
          Cutting Red Tape    51

6    Savings   53   
          Increasing Competition   54
          Strengthening Buying Clout    56
          Lowering Administrative Costs 58
          Limiting Premium Increases    58
          Reducing Health Care Fraud    59

7    Quality   61   
          Better Information for Judging Quality  62
          Investing in Research    64
          Emphasizing Preventive Care   65
          
     
8    Choice    71
          Choosing a Doctor   71
          Choosing a Health Plan   73
          Increasing Options for Long-Term Care   74

9    Responsibility 77

          Medical Malpractice 78
          Paying for Health Security                            
     80                                                           
                

Conclusion     85

Speech to Joint Session of Congress     89
          President William Jefferson Clinton     
          September 22, 1993



Appendix  107

I.   Existing Government Programs  107
     
          Medicare  107
          Medicaid  108
          Department of Defense    108
          Veterans Health Care     109
          Federal Employees Health Benefits Program    110
          Indian Health Service    110

II.  Scenarios Under Reform   111
Today          111
The Health Security Act  111
     Employer Share 113
     Two parent family   114
     Couple         115
     Individual     116
     Self employed consultant 117
     Small Business 118
     Union worker   119
     Teacher   120
     Professional couple 121
     Low-income family   122
     Low-income couple   123
     Part-time worker with no non-wage income     124
     Part-time worker with non-wage income   125  
     Self-employed farmers    126  
     Medicare beneficiary     127  
     Working medicare beneficiary  129
     Medicaid Beneficiaries (AFDC and SSI)   130  
     Medicaid Beneficiaries who do not receive AFDC or SSI  131
     Child with disabilities  132
     Undergraduate student    133
     Unemployed Individual    134
     Federal employee    135
     Veteran   136