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Learning From Clinton’s Mistakes

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Posted on Jan 12, 2009

By E.J. Dionne

    When Bill Clinton’s health care proposal was foundering in the summer of 1994, a group of senators suggested that the administration put off trying to get universal coverage and insist instead on insuring all children. The idea was to make, at least, a down payment on reform.

    The White House said no and pressed on with its doomed effort to get a bigger bill. The Republicans won control of Congress in the fall. It wasn’t until 1997, thanks to the unlikely duo of Sens. Ted Kennedy and Orrin Hatch, that a children’s health care program was finally passed.

    One of the clearest signals President-elect Barack Obama has sent is his determination to learn from the Clinton years, and particularly from the former president’s failures on health care.

    When Tom Daschle, Obama’s pick to be secretary of health and human services, returned to the Senate last week for his first round of confirmation hearings, he offered a long list of criticisms that others had directed at the original health care reform effort. This time, he said, would be different.

    And this week, the House of Representatives is determined to prove Daschle right. It is scheduled to take up an extension of the State Children’s Health Insurance Program (SCHIP), as the Kennedy-Hatch initiative is called, so that 10 million kids can get health insurance. Getting more children covered before Congress starts wrangling over the larger health care bill is good politics, and the right thing to do. Congress needs to act anyway, since the program expires March 31. It might as well act fast, and act generously.

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    The SCHIP bill is unfinished business from the Bush years, and Democrats have no better way to show, and quickly, how different their approach to government will be from the style and priorities that prevailed during the outgoing president’s term.

    President Bush twice vetoed an extension of SCHIP. He opposed the additional $35 billion the Democrats wanted to spend to cover more children and also disliked the tobacco tax they proposed using to pay for it. There are many big things people hold against Bush, but this one has always stuck in my craw. If “compassionate conservatism”—remember that phrase?—means anything, surely it should mean helping more kids go to the doctor when they need to.

    Some advocates of universal coverage have argued that an expansion of SCHIP should be delayed so that the issue of covering kids can be taken up as part of a larger health proposal. The worry is that passing the most popular part of reform now (is there a more sympathetic group to cover than children?) would make it easier to delay the broader effort. 

    These are good faith concerns, but Congress would be right to ignore them. The economic downturn has made the expansion of SCHIP all the more urgent.

    It’s not just that sharp increases in unemployment add to the ranks of the uninsured. State governments are hurting, too, and they are responding to revenue shortfalls by shrinking health care programs.

    According to Families USA, a group that pushes for fundamental health care reform, states have enacted budget cuts that will leave some 275,000 people without health coverage, including 260,000 children in California. By the end of this year, if further proposed cuts go through, the number losing health coverage nationwide could rise to more than 1 million, almost half of them children. Other states have reduced benefits to those they still insure.

    All this makes the case for fiscal relief to the states in a stimulus bill more compelling. It also makes clear that universal health insurance coverage should be an urgent priority. But getting the children’s program done in the meantime could create momentum for the larger program and reduce the size of the problem that needs to be solved in a comprehensive bill—10 million kids now, the rest later.

    Senate Majority Leader Harry Reid has not made any commitments as to when he would take up children’s health care, though he has listed it as a priority. It would do the new president and members of the Democrats’ expanded congressional majority no harm to move expeditiously on a proposal that is simultaneously bipartisan—SCHIP has always enjoyed significant Republican support—and embodies Obama’s oft-stated commitment to “programs that work.” This one surely does.

    How often did Obama promise to “turn the page,” implying that his presidency would be very different from George W. Bush’s while also taking lessons from Bill Clinton’s shortcomings? Winning a quick health care victory for children would prove he’s determined to do both.
   
    E.J. Dionne’s e-mail address is postchat(at)aol.com.
   
    © 2009, Washington Post Writers Group


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By KDelphi, January 14, 2009 at 6:25 pm #

As MLK, Jr., proclaimed more than 40 years ago: “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”
     
In honor of the birthday of the Rev. Martin Luther King, Jr. (January 15, 1929 – April 4, 1968), we are gearing up for the second national call-in day to Congress on Thursday, January 15, 2009.

http://www.calnurses.org/

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By KDelphi, January 14, 2009 at 6:19 pm #

Here, from the Californnia Nurses:

http://www.calnurses.org/media-center/press-releases/2009/january/first-of-its-kind-study-medicare-for-all-single-payer-reform-would-be-major-stimulus-for-economy-with-2-6-million-new-jobs-317-billion-in-business-revenue-100-billion-in-wages.html

That link looks wierd! Let me check it!

They ask you to , also, call you rep and senator tomorrow , for MLKJr. Day to ask for single payer! (quote in next post)

Universal Medicare:

Create 2,613,495 million new permanent good-paying jobs (slightly exceeding the number of jobs lost in 2008)
Boost the economy with $317 billion in increased business and public revenues  
Add $100 billion in employee compensation
Infuse public budgets with $44 billion in new tax revenues


Print Text Only Tell-a-Friend  
Single-Payer Health Care Would Stimulate Economy
By John Nichols
The Nation
January 14, 2009

“There is an unhealthy tendency on the part of politicians and journalists to see discussions about economic recovery and health care reform as separate debates. In fact, one of the most important steps on the road to economic recovery – or, more precisely, toward a new, responsible and sustainable prosperity – involves the fundamental reform this country’s broken health care system. But it must be the right reform: the establishment of a national single-payer style healthcare reform system by expanding the existing Medicare system to cover all Americans. According to a new “Single Payer/Medicare for All: An Economic Stimulus Plan for the Nation” study releases toady by the National Nurses Organizing Committee/California Nurses Association, such a reform would provide a major stimulus for the U.S. economy by creating 2.6 million new jobs and infusing $317 billion in new business and public revenues into the economy. This reform would, according to the study released today, add $100 billion in wages to the currently sputtering U.S. economy…”
The link above is correct (it is a study of Medicare for all’s effect on the economy. Here is the origianl link:

http://www.calnurses.org/about-us/

Thanks! (for the 20,000 that might not die this year!)

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By KDelphi, January 14, 2009 at 5:33 pm #

screamingpalm—Thanks…your situation gives MONEY life and death over people…think about it, those who support private plans…is this the country you want??

As I have sadi, this is NOT “just about health care”—it is about, whether , the US wants to continue with an attitude of “profits before people”. I do not…

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By screamingpalm, January 14, 2009 at 5:15 pm #

G. Anderson:

Clinton is the epitome… the embodiment of the Democratic Party.

KDelphi:

Great posts as usual. The costs and need for services can be managed if we focus on preventative care, and get rid of the insurance companies. I believe a focus on preventative care will also give more incentive to professionals to choose primary care instead of specializing.

In my situation I am stuck between my doctor saying I need a particular treatment and the insurance company saying they won’t cover it because it doesn’t fit their guidelines. Insurance companies should not have this power.

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By KDelphi, January 14, 2009 at 3:35 pm #

I was on COBRA for about 2 yrs, but, my family had a litle money then, before a couple family members got sick..it was very expensive.But, it wouldnt happen in Canada or EU.

“Universal health care is not going to solve America’s health problems, because America is facing a severe shortage of health care providers, and millions of people who get virtually nothing from the health care insurance the pay for now.”

It will no “solve” “health problems”—who thinks it will do that?? If the system was reformed, people would “get something for it”. Just take a little of the insurance industries’ ,masasive $86 billion dollar annual profits!

We could cancel peoples’ debts for medical school, if they will go into family practice etc. Also, nurses…

“This country will go bankrupt, providing unlimitted treatment for people whose medical problems have no solution”

Who watns to provide “unlimited care”, or, any care that has “no solution”? Lets get the care back in the hands of doctors decisons—not the insurance industry! Take away the incentive, by stopping doctors from promoting private hospitals and paying off their CT Scan machines. Give them a salary—like the EU. More doctors will go into medicine for he right reasons.

There are lots of limits on universal care. There has to be. Let a doctor who has no financial stake in the decisions decide when just paliative care is needed. But, some people , who have incurable illnesses , cannot even be made comfortable, as it is.

I agree with you , on fixing our filthy environment. I also think that there should probably (maybe not older people , who started to smoke in the military because they were free)be limits on how well you are covered is you keep up unhealthy habits.

It is not as hard to quit smoking as some people think…it is not easy—but it is far from the “hardest thing I’ve ever done”, as i hear some say.Universal coverage would be more concerned with long term costs,hence, more likely to provide patches, groups, pills, etc. to stop smoking, and, to prescribe diet and exercise, when it woudl be helpful. Also, promote vegetarianism,etc. As far as teh food supply and environemtn, we need to fund them. None of this should be optional, because it is good for people, and, it wastes money.

I agree with you ie: Clinton. But Obama is hiring on all the same people. If it is going to be different…I dont see it. Maybe if Obama would throw the poor a bone—-he could get their support.

If Obama does Daschle’s plan, it wil be drastically expensive, because they will still be paying 1/3 of the medical cost to insuracne companies. $2500 off on your taxes wont do it when a regular plan is , for an individual , $12,500.

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By G.Anderson, January 14, 2009 at 1:37 am #

Recently I read an article somewhere, you may have seen it, about a study of Cobra. The conclusion of the study was that Cobra was basically useless because it was too expensive.

Anyone who has been in a position to have to use Cobra, could have said the same thing almost a decade ago.

This is one of the supposed health care reforms that Clinton gave us.

Although I am a Democrat, I have never considered Bill Clinton to be a Democrat, but instead a man that helped Repblicans get through an agenda that allowed corporate America to send millions of working people into poverty.

Most of those people kept wondering where the boom was during his adminstration, because they didn’t even come close to sharing in it.

Bill Clinton, got NAFTA through congress and he also put through welfare reform that provided an influx of cheap workers into the market and into a life of worsening poverty, and debt that could never be paid back, because that was the plan.

So I hope Obama does learn from Mr. Clinton. Because the future of this country depends on how well he does, as does the future of the Democratic party.

Universal health care is not going to solve America’s health problems, because America is facing a severe shortage of health care providers, and millions of people who get virtually nothing from the health care insurance the pay for now.

This country will go bankrupt, providing unlimitted treatment for people whose medical problems have no solution.

Just the expense of one persons hosital treatment, can run into the millions of dollars. Who will decide whether their treatment should be paid for? We simply can’t afford to pay for everthing, for everyone. Nor should we.

My hope is that now that the people will be paying the bills, that something can be done about the root cause of our illness, the toxic food, air, water, the smoking, chemicals, pesticides, and poisons that we all ingest everyday, that are no longer someone elses problem to solve.

If the Democratic party doesn’t support Obama, but instead disintegrates into a bickering bunch of hyena’s, bent on feeding their own ego’s at the countries expense, then it will be the end for them, and the end of the Democratic party.

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By Folktruther, January 13, 2009 at 3:09 pm #

Right on, KDelphi. 

Anarcissie, your Faith in the evolution of Obama ignores the reason that the neoliberal imperialists help put him in office.  The time for an administration to do something novel domestically is in the beginning of its rule.  This political credit is going to be spent,apparently, by continuing Bush’s efforts to gut social security and medicare.

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By KDelphi, January 13, 2009 at 12:06 am #

From PNHP site, Dr. Don McCanne, as to why it is past time for “incremental plans”.

“.....The leadership of Families USA understands this. Thus for the past decade they have supported “strange bedfellow” coalitions, bringing together organizations that traditionally have been at odds on the reform issues. Each of these efforts has been introduced with considerable fanfare, with the obligatory statements from each participating organization to the effect that finally we are coming together to fix our health care system.

What happens? Behind the scene the opponents of reform continue to sabotage the efforts. The opponents are using the reputation of Families USA to burnish their own tarnished images, while gaining additional years before they must face the inevitability of a bona fide national health program…

“...The debate over an incremental versus comprehensive strategy for reform has been an unfortunate digression that has splintered one side - the supporters of health care justice. PNHP, Families USA, UHCAN, Healthcare-NOW!, Health Care for All, the HCAN coalition, and all of the other individuals and organizations that share the common goal of health care for everyone must unify in support of truly comprehensive reform that does not compromise on the policies that will get us there. This goal must have precedence above all others and must represent the primary thrust of our efforts.

That does not mean that there is no place for incremental measures. The Children’s Health Insurance Program (SCHIP) is an incremental measure that must be renewed and expanded immediately, but only as an urgent, temporary measure until we can enact a comprehensive program for everyone, including children…..”

“...It is absolutely crucial that we all pull together now, pulling out all the stops, especially while we are in this political window. Once we have a comprehensive system, the incrementalists can have a field day tweaking the inevitable glitches in the system…......”

http://www.pnhp.org/news/2009/january/families_usa_report_.php

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By KDelphi, January 12, 2009 at 11:55 pm #

This is nonsense! The Congress is of a completely different makeup…and Obama’s team is SO much different from Clinton’s——how??

All of it is just an excuse to not upset the big moneyed insterests in the health insurance scheme.

“According to Families USA, a group that pushes for fundamental health care reform, states have enacted budget cuts that will leave some 275,000 people without health coverage, including 260,000 children in California…(Families USA is an advocate of REFORM, not universal care—-like the NEW Harry and Louise) (qare thest stats from California—275,00 not covered in California?? or US??)

Exactly more reason to save the economy , and many businesses with universal coverage…

I agree to go ahead and do SCHIP—it may “slow down” universal, but, we just cannot “cut off kids”. It may make the GOP (and Blue Dogs) come back with the “kids only, because adults should get a job” argument, but, so be it…there are alrady going to be so many people whose COBRA runs out, that Medicaid rolls will swell..

Single payer, like HR 676, would eliminate the need for SCHIP, Medicare , Medicaid,(and, people could work and stil retain coverage—as well as lose work and retain coverage) VA coverage, Medicare Advanatage , Medicare Part D, etc.

I would list here all the countries that have universal coverage, if anyone is interested…it is absurd to assume that “it cant be done” when Dems have control of all three branches.

Physicians for a Natl Health Plan, Progressive Dems of America, move on .org, and many other groups, support single payer, as well as 67% of citizens in Ohio, even if it means a tax increase…not exactly a “liberal” bastion..try going to change.gov, specifically on the heatlh care issue. Most of the people there that are opposing single payer are GOP neo-cons. Alot of the support comes from countries that already have universal, many who have moved back to the uS and cannot believe that the same arguments abound…

Everyone in the “free” world has a similar plan. Daschle’s plan would cover 85%—15% uncovered. I doubt that we will get even that.

Purple Girl—“But to continue to allow them to call the shots on costs and services of necessary medical services is morally depraved.” True!

All of your proposals sound good, until you stop to think why insurance exists—to make money. We cannot get them out of the system by planning a system around them. (hillary care was basically that—although, she says she planned to “cover everyone”)
Plus, 90% of medical malpractice suits , never even make it to court. I can see limiting the amounts,($250,000 is too low—what if someone dies or their child is daiabled for life) but, with medical care as it is (we are 34th in the world in terms of quality), civil suits are the only recrouse that patients have…you cannot sue anyone practicing within most govt programs, anyway.


“Insurance” uses up 1/3 of our health care costs now. That could go to doctors. Lets’ join the civilized world.

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By mark, January 12, 2009 at 3:58 pm #
(Unregistered commenter)

Per Purple Girl

insurance companies (HMO) = bad

trial lawyers = bad

I’m no fan of either of those. Or greedy or deluded patients out to make a buck, for that matter.

MDs? Well they’re only human and bound to make a few mistakes.

If you’re gonna reform health care, seems to me that your analysis must also include the providers.

Due to political concerns, State licensing boards do a mediocre job, at best, of culling mistake-prone doctors from the ranks of licensed MDs.

BTW, med malpractice insurance policies routinely provide that carrier CAN’T settle a lawsuit without the MD’s approval. Litigation becomes protracted because MD’s ego (and concerns over future earning power) won’t let him admit he’s done anything wrong.

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By grumpynykr, January 12, 2009 at 2:43 pm #
(Unregistered commenter)

The Senate shouldn’t confirm any Clintonistas from Eric Holder to Hillary.  Some of this financial mess started under Clinton with crooks like Robert Rubin, Larry Summers, Eric Holder, etc.  Obama should get real economists like Joseph Stiglitz to help him bail the us out of this mess.

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Anarcissie's avatar

By Anarcissie, January 12, 2009 at 12:32 pm #

One can learn too much from the Clinton years.

Inevitably, though, it seems that Obama must start out by trying to rerun the Clinton administration.  I give this prelude six months to a year; eventually it will occur even to our great leaders that they are living in different times.

As for holding the Bush administration accountable for anything, I think that is going to be played out slowly, for maximum political effect, and the initiatives will seem to be coming from the margins.

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Purple Girl's avatar

By Purple Girl, January 12, 2009 at 12:01 pm #

Several things must happen to rein in our health care costs.
First and Foremost get Profiteers out of the middle of the exchange.The worst offenders are those HMO’s et al who get between Medicare and the Seniors- they are ripping off both!
Then end the Lawyers cut where Profits are made from Human error. Ameircans must come to the realization that those medical professionals are ONLY Human. something the AMA has tried to Deny for centuries- victims of their own Propagnda and God complexes. Mistakes WILL happen. What should be addressed in any lawsuit is whether the mistake was caused through malice or indiffernce. thus reducing the cost of Malpracitce on Medical professionals. Many graduating MD’s avoid practices which carry heavy insurance costs (OB) because the cost of their education alone taxes whatever income they may earn, so insurance costs only add to that economic burden.
Reimbursement should also be streamlined between those who are insured by Private insurance and those under Gov’t programs. Docs only make about $20.00 to visit a nuring home patient, and limited to only One visit a month..so they carry far more patients than can be properly served.There is a dire need for GP’s OB/GYN’s and Geriatric MD’s, yet most are graduating in specialities like Cosmetic surgery- Big Bucks.
Such elective should not be covered under a universal health care and could be a realm the insurance Corps provide. But to continue to allow them to call the shots on costs and services of necessary medical services is morally depraved.

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By troublesum, January 12, 2009 at 8:41 am #

As I said he would six months ago, Obama stated in an interview yesterday that he is against holding the Bush administration accountable for the lawlessness of the last eight years.  I knew what he would say, as he did say yesterday: “We must look forward, not backwark.”

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