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MEDICREDIT. Devised by the A.M.A. in the hope of heading off any more liberal system and introduced in Congress by Tennessee's Democratic Representative Richard Fulton and Arizona's Republican Senator Paul Fannin, would permit a tax credit on a sliding scale based on income. Families earning less than $5,000 a year could deduct the full cost of their health-insurance premiums from their computed tax. Families with incomes over $10,000 could deduct only 25% of their premiums. For all income groups the top limit would be $150 for a single taxpayer and $400 for those with dependents. For those so poor as to have little or no tax liability, the Federal Government would issue a "medical-care insurance-premium certificate" at the same $150 and $400 rates, which could be used to buy insurance from any approved carrier. Medicare beneficiaries would get income-tax credit for their Part B, supplementary coverage now being raised from $4 to $5.30 a month. Estimated cost: $9 billion to $11 billion.
JAVITS BILL. Introduced last month by Senator Javits, to establish a national health-insurance program by gradually extending Medicare coverage to the whole population. For two years after 1971, it would do little more than give full Medicare benefits to all over 65, saving them the Part B premiums. Then the Medicare program would be gradually extended to all Americans. Dental care for children up to age six would be added. Another year later, diagnostic benefits such as physical checkups and eye and ear examinations would be added. Most costs for drugs, dental care, eyeglasses, hearing aids and nursing-home care would not be covered. Javits would finance this with a payroll tax on employers and employees, its proceeds to be matched by an equal sum from the federal treasury. Estimated annual cost when in full swing: $22.7 billion. Other features of the bill would give financial incentive to the establishment of group practices and community health centers. To provide medical services, HEW could contract with both nonprofit and commercial carriers and with state agencies. The Javits plan would rely on the commercial companies to undertake most of the coverage, despite their traditionally unimaginative countinghouse mentality. Says Javits: "We simply have to hit the insurance carriers over the head and make them take the role we give them."
ROCKEFELLER PLAN. First proposed to the New York legislature in 1967 but pigeonholed in committee ever since. Recently resubmitted in modified form, with a companion bill to encourage formation of group practices. Would establish a set of minimum benefits to be bought from insurers: 1) 90 days of in-hospital (including psychiatric) care in semiprivate room; 2) outpatient Xray, diagnostic and other laboratory services, emergency care and minor surgery, physical therapy and psychiatric evaluation; 3) hospital or physician maternity benefits up to $150; 4) hospital-managed or other sponsored home care up to 100 visits a year. Patients would pay $2 in coinsurance for virtually all doctors', clinic and lab services. The state would pay premiums for all with incomes under $5,000 a year, split premiums in the $5,000-6,000 range, while those earning more than $6,000 would pay their own.