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February 24, 2008 at 06:13:21
by R. Queisser Page 1 of 2 page(s) |
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Hillary’s Past Leadership Failure in Health Care Repeated In Plan for Universal Insurance Company Prosperity. Hillary Clinton frequently portrays herself as “ready on day one.” In fact, her “Health Care” platform proves she has no better skills today about how to lead health care change than she had in 1993, when her ineptness destroyed the chance to reform U.S. health care. On January 25, 1993, President Clinton announced the formation of The President's Task Force on National Health Reform. The job of the Task Force, he said, was to "prepare health care reform legislation to be submitted to Congress within one hundred days of our taking office." He also announced that Hillary would head the task force and that Ira Magaziner would be its day-to-day operating head.
Recall those heady days of 1992-93, when Bill Clinton took office on the wave of national disgust over George H.W. Bush’s ballooning deficit and shallow world view. As a health care executive, I was thrilled to think that U.S. health care might soon become more comprehensive in scope and funded far more rationally.
Well, that was how it started. Never mind that Hillary’s only related job experiences were as congressional staff attorney and partner in a private law firm. Forget that Ira Magaziner was a “business” consultant, not a health policy expert, not even a provider. Ah, we had such naïve hopes!
Hillary and Magaziner Were Blind-Sided by Predictable Reaction of Vested Interests
Any leader, executive or manager understands that planning and implementing organizational change are among the primary challenges of leadership. Innovation, anticipating issues, co-opting parties with differing perspectives, finding winnable compromises, shaping coalitions for change—these are all bread-and-butter skills that differentiate real leaders from “bosses”.
But in 1993 Hillary Clinton and Ira Magaziner chose to exclude any physician, hospital, insurance and pharmaceutical industry players from their preliminary discussions. Guess what? Faced with exclusion from the discussions, these powerful industries marshaled massive advertising and lobbying campaigns to protect their vested interests.
The resulting debacle was both predictable and avoidable. Experienced leaders would have anticipated and planned for the inevitable reaction, but not Hillary and Ira. Instead, they were flattened by the “Harry & Louise” ads and the ridiculous phrase, “They choose, we lose.”
Hillary and Magaziner Were Blind-Sided AGAIN by Predictable Resistance from Congressional Interests
Inside Washington, Hillary & Ira Magaziner similarly failed to implement a plan for reform. For example, they were blind-sided by Sen. Robert Byrd, whom they should have prepared for the omnibus reconciliation budget approach they chose to use, and they were again blind-sided by Rep. Pete Stark’s (Ways & Means) temper tantrum when he was briefed on their fait accompli financing plan. Rather than consulting Congressional power brokers, Hillary and Ira naively tried the amateur’s end-run, and predictably failed in their implementation.
By the way, Hillary had three consultants helping [sic] her with this debacle in 1993: Mandy Grunwald, James Carville, and Paul Begala. Sound familiar, right?
Today’s Plan Institutionalizes Insurance Industry Costs, Avoids Funding Reforms, And Leaves Vested Interests in Complete Control
Hillary’s plan for health care includes very few health-related elements. Instead, its basic focus is on keeping your insurance plan, if you like it. Her only “big idea” is to offer the Federal Employee Health Benefits Plan (FEHBP) to all Americans—through commercial insurance brokers, of course. (But that was really John Edwards’ big idea.)
The few medically relevant points in the plan are quoted in these sample phrases from Hillary’s health care platform (HillaryForPresident.com) below:
(1) “Providers: will work collaboratively with patients and businesses to deliver high-quality, affordable care;”
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Is there any way insurance companies can be controlled?
Nothing is more interstate than insurance, where ownership & management are nowhere near the location of the insured. Why must we have regulation only at the state level, allowing pockets of "looseness" of good business practices? Considering that Connecticut gets the fame of housing many insurance companies, what is the likelihood that Congress will ever get around to introducing national regulation of medical insurance? Medical insurance is different from other forms of insurance. Could any inroad be made in requiring insurers to adopt uniform standards of coverage and regulation? Then perhaps we could have a national system of some sort. I certainly agree that Clinton's past and present activity is good for all insurance companies and fantastic for the flybynighters. by Margaret Bassett (45 articles, 2909 quicklinks, 42 diaries, 1851 comments [99 recommended, 0 rejected]) on Sunday, Feb 24, 2008 at 9:52:39 AM  (0+)
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Reply: Yes, We Can Control Insurance Companies
Thanks for commenting, Margaret. Yes, we can control the pernicious influence of insurance companies by eliminating them from the mix. 30 years ago there were almost no health insurance companies. Not-for-profit physician-run "service bureaus" processed payments. Then places like Texas and California developed not-for-profit "Blue Shield" plans to reimburse physicians and "Blue Cross" plans to pay hospitals. Now, Medicare contracts with insurance companies (fiscal intermediaries) to process claims, and dozens of life insurance companies jumped in to make an easy profit. But insurance is not necessary. A series of standard regional Federal agencies could easily process claims. After all, if the goal is to pay doctors fairly, not to deny them legitimate payments, claims processing is really pretty simple. If everyone is eligible (as in "universal" health care) then there is no need for screening--just pay the claim and move on to the next! by R. Queisser (15 articles, 0 quicklinks, 1 diaries, 81 comments) on Sunday, Feb 24, 2008 at 2:32:03 PM (0+)
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Wheres the beef?
Every First Lady adopts a cause, and Mrs. Clinton chose health care, a worthy goal indeed. That she went about it all wrong, that the administration itself would never have supported the radical changes necesary to reformation of our abysmal health care industry then and now is moot. That no candidate , of the three principle ones, gets it right is factual. That the elimination of, or the creation of an option to, for profit health care is the true solution is a fact as well. That none of them dare endanger the campaign largesse that falls from the insurers, the HMO's, the industry itself is the reason. Speaking of reasons this is a great one to reconsider ones support for any of them. I am awaiting the health care strategies of our newest candidate, Ralph Nader. by ardee D. (6 articles, 4 quicklinks, 1 diaries, 2377 comments) on Sunday, Feb 24, 2008 at 10:24:33 AM (0+)
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Hillary, Obama & Health Care
Obama's plan is similar, minus the individual mandate, right? There is really only one reason why insurance companies are highlighted in both plans; they dominate health care now, and they are powerful enough to stop any reform unless they are in on the plan. Nader will accomplish nothing positive, regardless of how attractive his statements or platform might be. He might accomplish the defeat of the more progressive candidate if the race gets close. Then, instead of Obama's or Clinton's faulty plan, we'll get no plan at all from McCain, even if he proposed one just to fill that hole in the campaign. It's not something he's concerned about. Nader votes, unless the election aint even close, could have the same contradictory effect they had in 2000: voting against war and the military overspending and the sorry environmental record of the Clintons, Nader voters helped usher in Bush's war in Iraq, the huge increases in the defense budget, and the trashing of our environment. Really. If Nader runs, it's only about his inflated ego, but the effect could be just as contradictory as it was in 2000. by Douglas Smyth (27 articles, 5 quicklinks, 1 diaries, 90 comments [7 recommended, 0 rejected]) on Sunday, Feb 24, 2008 at 2:30:02 PM (0+)
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