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Sen. Orrin Hatch, R-Utah, called Tuesday for vast, sweeping changes in the nation's health-care system to make health insurance and care more affordable for the poor.

In a speech at the National Press Club, he proposed a $6 billion to $10.5 billion a year plan to help the 37 million uninsured Americans gain better access to health care by:-Reducing overall health-care costs - thereby making insurance more affordable - by reducing malpractice suits, expanding sickness prevention efforts and eliminating some expensive and perhaps unnecessary insurance options mandated by several states for all health policies.

-Providing direct governmental assistance by allowing all employers to deduct costs of providing health insurance; expanding Medicaid to cover all people below poverty level; setting up state insurance pools for "uninsurable" people; and allowing employers of the "working poor" to buy into some Medicaid coverage at low cost.

Hatch admits the plan is complicated and sweeping, but he says it is much cheaper and more effective than a "quick fix" proposed by Sen. Edward Kennedy, D-Mass.

Kennedy wants to require all employers to furnish health insurance for any employee working more than 17.5 hours a week. Hatch contends that would cost the nation's employers $100 billion a year and eliminate vast numbers of jobs.

"It would make the working poor the unemployed poor," he said. "It would be easier to spend $100 billion to solve the problem, but we can't afford that; my program will accomplish the same thing for much less money."

Some of the most interesting details of Hatch's plan, which he hopes to formally introduce by July 4, would affect medical malpractice suits.

Hatch proposes that the Public Health Service establish guidelines for health care that, if met, would be a defense against malpractice. That would eliminate the need for what Hatch says now is extreme overuse of expensive tests and surgery to prove a doctor took no chances.

For example, he said obstetricians now perform twice as many Caesarian sections as experts say are necessary because of the fear of malpractice suits. And routine complaints of headaches often result in $60,000 CAT-scan tests to ensure the remote possibility a brain tumor does not exist, he said.

"We could save billions and billions of dollars by eliminating the fear of malpractice suits and unnecessary tests," he said.