Dear Mrs. Clinton...

Forward Face

May 10,1993
Dear Mrs. Clinton,
I am writing you on behalfof Forward Face, a charity for children and families with craniofacial
disorders. We applaud your efforts to create a more equitable and accessible health care system for our
children. We ask you to consider their special needs as you fonn policies that will affect their future:
1. Pre-existing conditions - This category is currently used by insurance providers to exclude
applicants that may not be profitable to them. It does accomplish this purpose at great cost to families
seeking to move or better their employment, and to small insurance pools seeking to reduce costs. The
future ramifications of these policies are truly frightening. They serve as a precursor to genetic
discrimination.
2. Orthodontic, speech therapy and hearing aid treatment for craniofacial conditions - In many
cases plastic surgery for craniofacial conditions cannot be performed without orthodontic intervention.
Reconstructive surgery ofthe face often involves wiring the jaws, the use oforthodontic plates and the
realignment of teeth. It follows that children born with jaw and mouth disfigurement will need help
in developing nonnal speech. Speech therapy is an integral part of their treatment. Many affected
children experience hearing loss. Yet, most insurance companies deny benefits for these necessary
services.
3. HMOs and specialty doctors - Our children have been born with rare conditions. Often they
go undiagnosed for months. Most of us can tell you that our son or daughter is the only one with this
condition in their pediatrician's practice. We must be able to select the specialists who treat our child.
Health Maintenance Organizations deny this to their members when the plastic surgeon they have on
roster is often more adept at nose bobs than reconstructing the orbit ofan eye or remodelling a cranial
vault. Craniofacial conditions are highly specific in their need for surgical correction. Tragically, we
have manydocumented cases ofsurgeons, claiming to have the ability to help children with craniofacial
conditions, perfonning these specialized techniques and making the condition worse due to their lack
of experience.
4. Inequity ofcoverage - Insurance companies often distinguish between plastic surgeries for birth
defects and for reconstruction of a disfigurement caused by an accident. This is nothing more than
blatant prejudice. To deny reconstructive surgery to a child born with an underdeveloped ear, and yet
turn around and provide full services to a child who suffered damage to his ear through an accident is
unacceptable.
We ask that you consider these matters carefully as you develop a national health policy.
Sincerely,

Trudy S. Attenberg
Editor, Forward Face Newsletter

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Summer 1993 Illue

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Dear Mrs. Clinton...

Continued from page nineteen

A Reply
THE WHITE HOUSE
WASHINGTON

July 15, 1993

Trudy S. Attenberg
1611 Stratifield Road
Fairfield, CT 06432
Dear Ms. Attenberg :
On behalf of the President and Mrs. Clinton, I would like to
thank you for your interest in health care reform.
As you may know, on January 25, 1993, the President announced the
creation of a Task Force on National Health Care Reform.
The
President asked the Task Force to provide him with proposals for
comprehensive health care reform. The President also announced
on January 25 the creation of an interdepartmental working group
which would gather and analyze information and options for the
Task Force.
In over twenty meetings held during April and May, the Task Force
reviewed materials it received from the interdepartmental working
group and policy suggestions such as yours, formulated proposals
and options for health care reform, and presented those proposals
and options to the President. Each of those Task Force meetings
was announced in the Federal Register.
Having completed its mission, the Task Force was terminated on
May 30, as provided in its charter. The President is now in the
process of reviewing the proposals received from the Task Force
and choosing from among the policy options that were presented to
him.
I appreciate your participation in this vital endeavor.
Your
ideas have been very helpful during the deliberations on health
care reform. Again, on behalf of the President and Mrs. Clinton,
I thank you for your interest, time and support.

Sincerely,

Carol H. Rasco

Assistant to the President for

Domestic Policy

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The Forward Face Newsletter