The wrong answer is 'because of the Republicans.' Please read the whole article before responding. Due to DU rules, I could only include but a small portion of the analysis. Vicente Navarro was the sole advocate (the token) of single payer allowed onto Hillary's 500 member health care task force. Vicente Navarro is Professor of Health and Public Policy at the Johns Hopkins University, U.S.A., and of Political Sciences in the Pompeu Fabra University, Spain.
The answer 'It was the Republicans fault that Hill's plan failed' isn't just wrong, it's stupidly and ignorantly wrong. It's just parroting propaganda at it's worst. This article, in it's entirety, should be mandatory reading before anyone opens their mouth with an opinion as to why Hill failed.
November 12, 2007
Getting the Facts Right
Why Hillary's Health Care Plan Really Failed
By VICENTE NAVARRO
http://www.counterpunch.org/navarro11122007.htmlsnip...
Let's start with some corrections to Starr's assumptions. The commitment of the Democratic Party and candidate Bill Clinton to universal health care coverage for all citizens and residents started much earlier than Starr suggests. It began in the presidential primary campaigns of 1988, when Jesse Jackson (for whom I was senior health advisor), running for the Democratic nomination, made a commitment to universal, comprehensive health care benefits coverage a central component of his platform. This proposal was dismissed by the Democratic Party establishment as "too radical," but it had already mobilized large sectors of the party's grassroots (especially labor unions and social movements) to support Jackson, with more than 40% of the delegates at the Democratic Party Convention in Atlanta. This shook the Democratic establishment and stimulated responses from Governor Clinton, Senator Al Gore, and Congressman Richard Gephardt to block this rise of the left in the Democratic Party, which they did by establishing the Democratic Leadership Council, among other interventions. (Gore and Gephardt have changed since then; Bill Clinton hasn't.) (I describe these effects of Jackson's health proposals on the Democratic Party in "The 1988 Presidential Election," in The Politics of Health Policy: The U.S. Reforms 19801998, Blackwell, 1994. pp. 99-110.) To control this growth of the left, something had to be done. And as liberals always have done when faced with the left, they recycled its progressive proposals, adopting much of their narrative but emptying them of their content. This is what Clinton did in his 1992 campaign. He used the title, narrative, and symbols of Jesse Jackson's campaign, calling his platform "Putting People First" (the title used by Jackson in 1988) and including the call for universal health care benefits. As the perceptive Financial Times wrote, "Clinton extensively from Jesse Jackson 1988. He sounds like a Swedish social democrat." While borrowing the language and the symbols, however, Clinton changed the content dramatically.
Whereas Jackson had called for a single-payer program similar to that in Canada, Clinton chose the opposite pole of the political spectrum: managed care competition. Managed care competition basically meant the insurance companies exercised full control over health care providers, with doctors working in group practices called Health Maintenance Organizations (HMOs). As stated by Paul Elwood, a leading member of the White House task force, "insurers-controlled HMOs, under managed care competition will stimulate a course of change in the health care industry that would have some of the classical aspects of the industrial revolution--conversion to larger units of production, technological innovation, division of labor, substitution of capital for labor, vigorous competition and profitability as the mandatory condition of survival" ("Heath Maintenance Strategy," Medical Care, 9 (1971), p. 291). This industrial revolution in medical care would indeed have revolutionized the practice of medicine.
It is important to note that the idea of managed care competition was first proposed as a solution to the irrationality of the U.S. health care sector by Alain Enthoven, personal advisor to U.S. Secretary of Defense Robert McNamara during the Vietnam War. Enthoven was in charge of developing the "body count" as an indicator of military efficiency. After the Vietnam fiasco, Enthoven retired to the Rand Corporation, choosing to focus his intellectual efforts on the reform of U.S. health care. A strong ideologue and market fundamentalist, and completely ignorant of the mechanics of the medical care sector, Enthoven thought the best way to control out-of-control costs in the health sector was to increase competition in the sector, letting health insurance companies compete for consumers--meaning patients--based on the price of services. The problems with such a naïve and unrealistic scenario are many. First, patients do not determine the cost or price of medical care services. Second, patients have very little choice in the U.S. health care sector: employers choose which plans are available to employees. Third, the market does not exist in the health care sector. Fourth, the insurance industry's financial viability depends on its ability to discriminate against heavy care-users. I could go on and on detailing just how wrong Enthoven's proposals were.
Not surprisingly, managed care was the proposal chosen by the insurance industry and by employers. As Bill Link, Executive Vice President of Prudential and one of the highest-paid CEOs in the country, stated: "for Prudential, the best scenario for reform--preferably even to the status quo--would be enactment of a managed competition proposal." Link envisioned the corporatization of U.S. medicine, breaking the long dominance of health care providers in the medical care sector. As Enthoven wrote in an article co-authored with Richard Kronick, another leader of the White House health care reform, "what about traditional fee-for-services individual and single specialty group practices? We doubt that they should generally be compatible with economic efficiency. . . . Some would survive in private solo practice without health plan contracts, serving the well-to-do." It could not have been put more clearly: managed care competition was corporate assembly-line capitalism for the masses and their health care providers, with free choice and fee-for-service medicine for the elites.
Much more at the url
http://www.counterpunch.org/navarro11122007.htmlVicente Navarro is Professor of Health and Public Policy at the Johns Hopkins University, U.S.A., and of Political Sciences in the Pompeu Fabra University, Spain.
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