Monday, April 28, 2008

Hillary and universal Mandate

After a bit of reading over the Health Care press coverage from 1993 and 1994, here is the brief history of it as I got to see it:

  • Hillary was feared as a co-president even when Bill Clinton was running for the presidency. The amount of control and power Hillary had without the accountability of an elected office was a major concern.
  • Bill Clinton handed over the mantle of Health Care reform to Hillary Clinton. Hillary brought together a task force of more than 300 "experts" and consumer and industry groups behind closed doors to come up with a "blue print" for the Health care reform. The secrecy of the process became the headlines for much controversy.
  • The plan was broadly called managed care, because of its focus on how health care costs and health care was managed in the country, and less regulations on how it was delivered.

  • The secrecy of the group and behind the door approach was questioned in a court of law. Health Care reform affects about 7% of the economy. The Judge ruled in favor of Bill Clinton requiring the confidentiality of the advice he seeks.
  • Ads began to run that took advantage of the secretive nature of the plan to demonize from the start as a socialist idea that provides the same health care to all people by inefficient means leading to rising costs and premiums.

The Death blow:
  • The proposal enjoyed support from a group of both democrat and republican senators, who were not comfortable with the idea of mandates on individuals to buy insurance policy. These included liberal Democrats like Paul Wellstone and moderate Republicans like John Chaffee, Senator John Breaux who had alternate versions of health care models. Hillary rejected these and publicly derided them from the outset as not passing the test of universal coverage.
This ensured that the health care proposal pretty much died before it was brought to the floor of the congress.

Its fair to say Universal Coverage remains an undying commitment of Hillary Clinton from the start. If anything, the lesson from the 90s should be that it will not pass without bringing in moderate democrats and republicans to support the ultimate plan, whatever that may be. But not Hillary. she would rather die for the ideal academic policy solution than compromise to have the dream realized.

No comments: