Wednesday :: Jul 12, 2006

Bandaging The Bandages

by pessimist

Back in 1993, Hillary Clinton was charged by her husband, then-President Bill Clinton, with revamping the medical care system in America. The regulatory and organizational nightmare that she and her committee came up with - dubbed 'Hillarycare' by critics - died a painful death, and left a hole the size of Dick Cheney's ego in an already wounded country.

What didn't help her prospects back then was that her proposals reflected only the needs of the organizers, who saw an opportunity to grandstand before a public in serious need of medical cost relief while ignoring those needs (and wants!) of the powerful and more organized healthcare industry itself. Their opposition was, in part, driven by the fact that none of their concerns were being addressed by Hillarycare.

Say what you will about Hillary, she does learn from her mistakes - if only to make new ones.

I, for one, have been fairly vocal about my opposition to her plans to be the first female American president, and I will state again for the record that her gender isn't the reason for my opposition. What I do oppose is her blind ambition, that take-no-prisoners approach the inspires a win-at-any-cost strategy.

America has had quite enough of that under King George. We can't afford a second imperious leader, nor can we afford another who is so openly beholden to corporate interests:

Once an Enemy, Health Industry Warms to Clinton
July 12, 2006

When she tried to overhaul the nation’s health care system as first lady, Hillary Rodham Clinton alienated some people and institutions in the health care industry by championing a huge expansion of the federal role. She provoked a fierce reaction from the industry, which mocked her proposal in television advertisements and dispatched lobbyists who ultimately helped kill the plan.

But times change. As she runs for re-election to the Senate from New York this year and lays the groundwork for a possible presidential bid in 2008, Mrs. Clinton is receiving hundreds of thousands of dollars in campaign contributions from doctors, hospitals, drug manufacturers and insurers. Nationwide, she is the No. 2 recipient of donations from the industry, trailing only Senator Rick Santorum of Pennsylvania, a member of the Republican leadership.

Think about this comparison for a moment. Hillary only trails Man-Dog-Sex Santorum in medical care industry donations? What does this say about these corporate donors?

Santorum is one of the more religiously-beholden candidates, openly opposed to many initiatives such as stem cell research that could bring about major profit-making opportunities for the healthcare industry, yet they support him heavily. Are they trying to buy his support when he's so 'religious'?

On the other hand, Hillary supports stem cell research. Just for this reason alone one can see why the medical industry would be interested in supporting Hillary.

But what changed compared to 1993? What is it that is allowing the industry to allow bygones to be bygones and financially support someone against whom they spent millions of dollars?

The financial support is an intriguing turn of events for a political figure who became a pariah for many in the health care industry after President Bill Clinton appointed her to head the Task Force on National Health Care Reform. The rapprochement partly reflects how Mrs. Clinton has moderated her positions from more than a decade ago, proposing legislation to increase Medicare payments or stave off cuts in payments to doctors, hospitals, nursing homes, managed care companies and home health agencies.

Ah, yes! That ol' Profit Debbil! The one aspect of the 1993 medical plan that was lacking completely! Hillary has since learned to take care of business:

She has introduced a bill to lower the cost of malpractice insurance for doctors who disclose medical errors to patients. With strong support from the industry, she has pushed legislation to promote the adoption of health information technology. Providers and consumers praise her efforts to expand insurance coverage for mental health care and to finance long-term care for older Americans living at home.

As a result, business leaders have taken on a more concilliatory and respectful posture when discussing Hillary:

Charles N. Kahn III, a Republican who was executive vice president of the Health Insurance Association in 1993 and 1994, now works with the senator on some issues as president of the Federation of American Hospitals, a lobby for hospital companies like HCA and Tenet. He describes his battles with the first lady as “ancient history,” and he said health care executives were contributing to her now because “she is extremely knowledgeable about health care and has become a Congressional leader on the issue.”

Kenneth E. Raske, the president of the Greater New York Hospital Association and a Clinton fund-raiser, said the relationship between Mrs. Clinton and some industry leaders got off to a “rocky start” in the early 1990’s. But, he said, many now believe that she was right in what she said [in 1993] about problems plaguing the industry, and think she is in a strong position to take a lead on the issue once again.

“I think right now the issue of health insurance and the worries of the American public about losing insurance are a political gold vein waiting to be tapped,” Mr. Raske said. “You have to think health care is going to be a major issue in ’08.”

“If the usual rules apply,” Frederick H. Graefe, a health care lawyer and lobbyist in Washington for more than 20 years, said, early donors will “get a seat at the table when health care and other issues are discussed.” Mr. Graefe said, “People in many industries, including health care, are contributing to Senator Clinton today because they fully expect she will be the Democratic presidential nominee in 2008.”

Tellingly, one of her fund-raisers in the industry is a Republican, William R. Abrams, executive vice president of the Medical Society of the State of New York.

And remember that Vast Right Wing Conspirator Rupert Murdoch is also raising funds for Hillary's campaign. He must also sniff a change in the political winds.

I agree with Mr. Raske that medical issues are going to be a major issue, and quite soon. I've been researching the shortage of medical personnel and what can be done about it, and the picture isn't pretty. Nations are literally stealing each other's medical professionals to cover staffing shortages - a problem that has gotten so bad that Britain's National Health Service issued a ban on recruiting foreign junior nurses. This article is also a good nutshell example of the rationalization offered by one nation's medical professionals for the 'need' to blithely take staff away from other nations.

But that is a topic for another post.

Hillary is taking the sackcloth-and-ashes route to corporate-sponsor acceptance:

“We tried to do too much too fast 12 years ago, and I still have the scars to show for it,” she said in an address in March before the annual conference of the Federation of American Hospitals.

But that approach isn't changing the view of some of her critics:

Tracey Schmitt, a spokeswoman for the Republican National Committee, questioned the sincerity of Senator Clinton’s new, more pragmatic approach on health care.

“This reveals that Hillary Clinton is a politician more concerned with campaign contributions than policies she claims to support,” Ms. Schmitt said of the senator’s efforts to court the health care industry. In fact, during her 2000 Senate campaign, she sharply criticized her opponent, Rick A. Lazio, as being beholden to the pharmaceutical industry for taking donations from drugmakers.

Senator Clinton has received $150,600 in contributions
from insurance and pharmaceutical companies,
which she accused in 1993 of “price gouging” and “unconscionable profiteering.”

It isn't often that I would lean toward agreement with the RNC on anything, but as I see Hillary's ambition ruling everything she does, in this instance I do. Considering the contribution records, I can't refute the charge levelled at Hillary by Ms. Schmitt:

With about four months left before Election Day, Senator Clinton has already raised more money in this campaign from the health care industry than she did in her 2000 run. While the health care industry was among her top supporters in her 2000 Senate race, the trend has accelerated in 2006 as her political prominence has grown and as she has become an important legislative player on health care issues.

Senator Clinton has received more money from health care providers than from insurers, in part because she has been more outspoken in support of the providers, while criticizing insurers from time to time. Contributions to Senator Clinton over the last 18 months include more than $431,000 from doctors and other health care professionals and more than $142,000 from hospitals and nursing homes.

But the fact that she has received tens of thousands of dollars from insurance companies and their employees underscores the shift in their view of her. For example, she has received $1,000 from America’s Health Insurance Plans, the main lobby for insurers; $1,000 from the Blue Cross and Blue Shield Association; $7,770 from Pfizer and its employees; $10,500 from Roche Group and its workers; and a total of $16,000 from three big companies that manage prescription drug benefits under Medicare and private health plans: Caremark Rx, Express Scripts and Medco Health Solutions.

Beyond that, Mrs. Clinton, a member of the Senate Committee on Health, Education, Labor and Pensions, has been helpful to insurers in New York, responding to their concern that they were not being adequately paid for their participation in Medicare.

There's dat Ol' Profit Debbil again!

Also, hospital executives now say they welcome Senator Clinton’s attention to the plight of the uninsured — a problem that has severely strained the finances of many hospitals. Carol A. McDaid, a health care lobbyist in Washington, said she recommended that clients consider making contributions to Mrs. Clinton because the senator had been a champion for health care providers and the people they served.

Such an assessment is raising certain eybrows:

State Senator Kemp Hannon, a Long Island Republican who is chairman of the Health Committee in Albany, expressed surprise at the amount of money that the industry, particularly insurers, had pumped into Senator Clinton’s campaign coffers. But upon reflection, he said, it makes sense, given that many in the industry regard her as an authority on health care who can help advance the industry’s agenda. “She’s already paid the intellectual dues of struggling to learn the system,” he said.

In other words, she's learned who to kiss - and who to kiss up to:

Mr. Abrams said that Senator Clinton now “understands that change is incremental,” compared with her stance in the 1990’s, when she proposed immediate and sweeping changes. Of Senator Clinton’s image within the health care industry, Mr. Abrams said, “To the degree skeptics were there, I think she has dispelled any of the skepticism.”

“Regardless of any future office she may seek, she will be a player on the national scene for as long as she wants to be,” said Mr. Abrams, the executive at the New York medical society.

And he knows - because he's helped her to get there:

Last year Mr. Abrams and Mr. Raske, the head of the hospital association in New York, held an event in New York City that raised tens of thousands of dollars for Senator Clinton from dozens of prominent doctors and hospital executives.

As I pointed out above, healthcare issues are going to become a major topic of contention, and it's obvious that the corporate interests are going to be looking to recruit their champions.

But who is there to protect those consumers of those services? That was the role Hillary bungled back in 1993, a failure which had a hand in the takeover of the House by the Republicans that year.

Voter polling indicates that healthcare is already a major concern, and the problems are only going to get worse. Massachusetts and Utah are considering changes to their state constitutions to declare healthcare a basic right. In Albuquerque, Latino voters consider access to healthcare a moral issue.

Thus, there is a growing support base for a brave champion of the needs of the people - which as David Sirota notes - are in short supply in Congress. It's all been bought and paid for - even Hillary:

Hillary Clinton is in a terrific position to make the powerful point that she was right to have tried to seriously address the issue in the early 1990s, she makes no apologies for it, and she will redouble her efforts as a Senator and as president (if she runs).

Such a stand would transcend the health care issue and help her build up credibility on the intangible character issue. It would show that she has courage, because she would be making no apologies for an effort that she has been unfairly attacked for throughout the years.

Instead, she seems so caught up in Washington's pay-to-play culture and so unconcerned with the hostile takeover of our government by Big Money interests that she is actually going out and apologizing for her previous courage. Not only is that unfortunate policy-wise, but it is a huge political mistake, because all it does is reinforce the image of Democrats having their thumb in the wind, and their hand out for the next big campaign contribution.

Sirota says it's nothing personal:

In case any of you think I am just an obsessive Hillary basher, think again. I have repeatedly praised her when she has been true to the progressive movement (here and here are just two examples).
The point is not to attack Sen. Clinton personally -
it is to question her behavior as it relates to key public policies.
If we as a progressive movement don't ask these questions of BOTH parties, then we will never get the kinds of policies we want when our politicians are in power.

I have to agree. We all know that needing to meet campaign expenses is how candidates lose their political souls and succumb to corporate control of their votes, for The Golden Rule will be applied to those who accept corporate funds. The path that Hillary (and just about every other elected politician) is now following is only going to suck her deeper into the mire. She will become useless to those who need someone like her the most.

On this and so many other issues that face Americans, we are going to have to grow up and make some tough choices, for the costs of not doing so will be far more expensive than we will want to pay. We are going to have to get tough with those who are abusing our system for their own gain. We are going to have to decide which government services we wish to keep - and be willing to pay for, whether through taxes or user fees - and which we will no longer support or use.

Without some kind of leadership, however, the only result would be chaos, as regional differences dictate differing solutions for the same problem set. It is that very leadership which we lack, and the corporate opportunists would love nothing better than for the people to demand leadership at any price.

We as a nation have been dancing at the party for a long time, and the patient piper will soon put down his instrument and demand payment, for his fee has become massive - maybe more than we can afford - and he won't be willing to play beyond that for which we can pay.

It's enough to make you sick!

Just don't do so - you won't be able to afford it, no matter what Hillary is currently saying.

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pessimist :: 11:24 AM :: Comments (18) :: TrackBack (0) :: Digg It!