Health care reform died in the 1990′s for many reasons. Yes, the scare campaign from right played a big part but miscalculations by the Clintons were also a major factor. Despite the attempts of the right to attack health care reform today as ObamaCare and claim it is essentially HillaryCare, there are major differences.
HillaryCare went far beyond current plans. While I don’t entirely agree with Ezra Klein’s analysis, it does provide some perspective as to the differences then as compared to today. Among the differences, while managed care was around to a greater degree than it would seem from Klein’s article by the early 1990′s, healh care has changed considerably since then.
I agree with Klein’s basic premise that the emergence of managed care necessitated greater degree of government regulation to protect beneficiaries from the trend by insurance companies to deny coverage to increase profits, I disagreed with the idea of HillaryCare to cope with the situation with an overly bureaucratized and complicated plan.
The problem with Hillary Clinton was not only that her mind set was to deal with everything with overly complex government control, but that it had to be done her way. Her government philosophy is basically that of George Bush with more liberal tendencies is some areas. The health care plan was written by the Clintonistas in secrecy. Hillary convinced Bill to even threaten to veto anything which might be passed by Congress which differed, giving us essentially a choice between HillaryCare or nothing.
The situation is quite different now. The insurance crisis has become far worse with doing nothing no longer being a viable option. Obama is handling the crisis far different from Hillary Clinton. Obama is far more concentrated on seeing the problems fixed than on imposing any specific plan. Despite talk of ObamaCare from the right, the details are actually being worked out in Congress.
The unfortunate reality is that there is no perfect fix to health care. Every conceivable plan has its problems, but we need to compare plans under consideration with the problems we now face, now with a perfect world. The House Democratic plan (with all details not yet determined) has many aspects which I do not like but it is preferable to doing nothing. The plan is certainly not like it is being distorted by many scare stories from the right.
One question still out there is whether the House plan is our only option or whether other possibilities will be raised. There are still some supporters of a single payer system but that appears to be a dead end politically in this country. The Republicans talk of offering a plan but they generally speak in generalities which are easier to support while they avoid answering the hard questions. There is one wild card remaining. Senate Finance Committee Chairman Max Baucus is still working on a plan which might achieve bipartisan support and nobody knows where he is going with this. A key difference from the Clinton years remains that, should his committee come up with a viable alternative, it would have a chance of being considered.