Politics of health care have changed since the Clinton plan

 

Tuesday, Mar 10,2009, 5:15:39 PM   Click:

Copyright: The Philadelphia Inquirer
Source: Philadelphia Inquirer, The
Wordcount: 1119


PHILADELPHIA _ Sixteen years ago, the opposition that killed President Bill Clinton, the massive plan for universal health care coverage has been distilled in a 30-second show "Harry and Louise", a fictional middle class couple BAT documents and complain about "government bureaucrats", which limits their choices.

But last week, after the White House summit on health care reform, the head of the professional association of insurance companies _ the successor to the group that has spent millions of these advertisements is _ are committed to support President Obama push for an overhaul of the health care system to reduce costs and expand access.

"We understand we have to win a seat at the table," said Karen Ignagni, president of the America's Health Insurance Plans, face Obama in the East Room golden. "You have our commitment to play, to contribute and help move the health care reform this year."

The turnaround has been a striking illustration of what the policy of health care have changed, say analysts. Former adversaries are in agreement that something must be done: the costs are spinning control, harm to business and government, and 47 million Americans have no insurance. Economic highest in six decades has only intensified the discussion.

"Now is exactly the time for us to cope with this problem," said Obama. "This is one of the most serious threats not only for the well-being of our families and the prosperity of our businesses, but the very foundation of our economy. "

His approach shows that Obama has learned from the collapse of the Clinton plan, the last major attempt to systematically _ a universal health care coverage _ who escaped from Presidents Harry S. Truman.

Exhibit A is the summit Thursday, attended by 150 people of various issues in the system: the leaders of Congress, representatives of the insurance and pharmaceutical companies, doctors, nurses and hospital administrators, the union leaders and business leaders.

In 1993-94, a plan was drafted largely in secret meetings and the White House, by a working group led by First Lady Hillary Rodham Clinton. With little public spat group of a bill 1324-page interest groups taken outside for months. And because members of Congress were not consulted, or they opposed the bill or, at best, are not willing to defend something they had no part in creation.

The Clinton plan was complex _ relying on the government of the pastoral care of persons in care management through procurement plans _ and it was presented at the same time, face-numbing detail. By contrast, Obama has been vague, preferring to build consensus around principles. He said that Congress should draft legislation, congressional leaders say they want to pass a bill this summer.

Obama alleviated some fears by pointing out that he wanted to build on the current system rather than creating a nationalized single-payer system. That, say analysts, has eased the fears of the health industry and in the middle class, even if Obama has angered some Liberals.

In addition, Obama has taken a progressive approach and proposed a deposit. It included 634 billion dollars of health care in its reserve fund in 2010 budget proposal. This money would be raised, in part, by reductions in payments targeted program of health insurers, doctors, hospitals and DRUGMAKERS _ and a reduction in the Bush-era tax cuts for the rich .

Conduct of the medical lobby in the arms of the administration: the attraction of tens of millions of new customers. If Obama manages to cover many other Americans, they will take the insurance to go to the doctor, buying medicine, surgery and _ to increase revenue for suppliers.

Other relief activities are still rising costs of health care.

"Many companies have decided recently they have more to fear from the status quo rather than changing the opposite _ 16 years," said Robert I. Field, professor of health care policy at the University of the Sciences in Philadelphia. "Insurance companies see the escalation of costs out of control, and losing customers themselves as fewer companies are able to buy insurance."

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Rep. Allyson Y. Schwartz, D-Pa., Who attended the summit, said the change is a "fiscal imperative" for the private sector and government. "An increase in double-digit health care cost every year is unsustainable," Schwartz said in an interview.

Fear is at work, too. Tom Donahue, president of the American Chamber of Commerce, said that the momentum is clearly towards a major change and that stakeholders wanted to try to shape it. "If you do not get in this game, so ... you are on the menu," he said.

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However, difficult questions are hidden beneath the surface of the cherry consensus. If the government mandate that people buy insurance, or that employers provide it? How will it be paid? If a government health insurance plan in competition with private insurers? Such an approach could have the insurance to more people, but it would be unfair to private sector firms because the government could undermine the price?

Already, there is opposition, even among Democrats, Obama on a proposal to raise funds for the reform by removing the tax deduction for health care benefits. Some oppose the reductions in tax cuts Bush. And AARP is opposed to a proposal that the wealthiest seniors pay more for Medicare.

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"Everyone agrees that we must rid ourselves of the effectiveness, focus on primary and preventive care, and get everyone in the system with affordable," said Schwartz. "The difficulty is, of course, what does this mean? ... Now the work begins. "

Chairman of the Finance Committee of the Senate Max Baucus, D-Mont., Okay. "This will be very difficult," he said at the summit. "To not be naive about the costs."

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But the legislator told Obama they were ready to try. The leaders of both chambers have also said they would leave the Republicans to help write legislation, raising hopes that the process will be more than the recent bipartisan fight on the economic and stimulation.

"The bipartism is not only a good thing we say to each other before they touch gloves, go to our corner, and out swinging when the bell rings," Senator Robert F. Bennett, R-Utah, a veteran of the Battle of the Clinton plan, said at the summit.

Review of health care would be "wrenching change," said Bennett, and the only way, is that if the leaders of both parties are willing to "join hands and jump off the cliff together."


(c) 2009, The Philadelphia Inquirer.

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