Melcher's top priority: catastrophic-illness aid for the elderly

A trail of pennies leads to the inner office of Sen. John Melcher, the new chairman of the Senate Aging Committee. They're the toys of Fast Eddie. Eddie is a unique Washingtonian. He's a cat who has a special trick: He catches pennies between his forepaws. ``He won't catch silver,'' chuckles Senator Melcher, ``only pennies.''

Unlike his cat, who is initially skeptical of a visitor, Melcher, a Democrat from Montana, is at once open and friendly. He also has a serious side. When he talks about his plans for the committee, he turns serious indeed.

His top priority, he says, is to provide federal insurance to the elderly - and to all Americans - to cover the costs of very expensive illnesses.

He says this insurance should cover the expenses not only of people whose hospital stays are very expensive, but also of those who spend a protracted time in nursing homes, an expense (often more than $20,000 a year) not usually covered by medicare.

Melcher also wants to expand medicare to cover the expense of prescription drugs for older Americans, frequently $50 to $100 a month.

In addition, he also plans to advocate that many more federally aided centers be established to provide nutritious meals to the elderly. That way, he says, more older Americans could enjoy both a good meal and companionship, while paying what they could afford. The centers would obtain much of their food through government subsidy, as some existing centers do now.

Both ideas are strongly supported by organizations of older Americans, which can be expected to help him publicize his ideas. The Senate Aging Committee, of which he becomes chairman when Congress reconvenes next month, does not have the power to consider legislative proposals. But under exiting chairman Sen. John Heinz it has been a powerful voice for the needs of America's elderly.

The issue Melcher considers most important is catastrophic-illness insurance. ``You talk to the elderly,'' he says earnestly, ``and the first thing that always comes up is: `How do you meet the health costs?' ... We just ought to totally remove the fear [that many older Americans have] of the catastrophic problem.''

Older Americans worry, Melcher says, ``that the only way to pay the bills is to be on the dole, on medicaid'' - by spending all their assets, and only then being eligible for government assistance. For many elderly Americans that situation exists now for some expensive medical costs, such as long-term nursing-home care, which medicare does not cover.

Melcher says he is encouraged by the proposals of Secretary of Health and Human Services Otis Bowen to provide catastrophic-illness assistance. He would employ a combination of federal funds. He seeks tax incentives to encourage Americans to save money for medical care. He would also encourage private insurance companies to develop and sell their own plans.

Sen. Edward M. Kennedy (D) of Massachusetts says he intends to introduce the Bowen plan into the Senate ``and do all I can as chairman of the Senate Labor Committee to see that it receives the early consideration and action it deserves.''

Melcher would go well beyond the Bowen proposal. Health insurance for the most expensive medical costs, the senator says, is ``a federal responsibility ... you have to have a federal program.'' He would make every American, of every age, eligible for such federally provided assistance, after a deductible of not more than $4,000.

He would finance the program through general revenue, rather than through medicare, because the problem is ``a family affair. It isn't just an elderly problem.''

``I want to look to the elderly first'' to provide them with catastrophic insurance, the Montanan says, ``but then look at all age groups, because I don't think we can separate them.'' He says younger people can also incur staggering health costs.

And, he says, when an older person's care results in extraordinarily high costs, the entire family is affected, in trying to provide the financing or, alternatively, the care. By some estimates, 80 percent of the care provided older Americans comes from family or friends, often in courageous and difficult circumstances.

To do all this would be expensive, but Melcher does not yet have a price tag. One thing is for certain: It would take far more than Fast Eddie's pennies that decorate Melcher's office rug.