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Hillary Files – The First “Hillarycare” Fiasco

Some extended excerpts about Hillary Clinton’s first foray into health care, from Barbara Olson’s tremendous book, "Hell To Pay," pp 253-62:

The Blue Light Special

A particular meeting of minds occurred over the issue of health care. James Carville could attest to the power of the health care issue, having used it as a keystone of Pennsylvanian Harris Wofford’s successful campaign for the U.S. Senate against former U.S. Attorney Richard Thornburgh.

Another health care advisor with a profound impact on Hillary’s thinking was Vincente Navarro, professor of health policy at Johns Hopkins University. "Has Socialism Failed?" is the title of a Navarro article published in the International Journal of Health Services in 1992. You might guess the answer was obviously "yes!" But not to Dr. Navarro, who wrote "contrary to what is widely accepted today, the socialist experience (in both its Leninist and its social democratic traditions) has been, more frequently than not, more efficient in responding to human needs than the capitalist experience."

With advisors like Magaziner and Navarro, Hillary was determined to sweep aside the best medical delivery system in the world and to reshape 14 percent of America’s economy by enacting a national health care plan.

She announced that the plan would be put together within one hundred days. The president pledged to pass it into law in 1993. That seemed like plenty of time. After all, the Lord had taken only seven days and had even rested on the seventh.

The effort began as soon as the Clinton While House opened for business. President Clinton immediately named his wife to head his Health Care Reform Task Force, and Ira Magaziner was brought in as director.

Hillary’s task force grew to gargantuan size but operated in near total secrecy and without participation from private-sector health care companies, which were consciously excluded.

The task force experts were joined, however, by more than two hundred detailees from executive branch positions. The amalgamation of policy "wonks" eventually swelled to five hundred. Participants were not available to be interviewed; indeed, the White House refused to release their names lest they be compromised somehow by exposure to the American people. Not even a directory of members was published; someone would surely leak it to a conspiring world.

It was not long before the task force got bogged down. Snafus of every sort developed. They began with the simple logistics of holding meetings, and ended with management practices that explored the outreaches of asininity.

Task force members found themselves waiting in long lines to be cleared in by the Secret Service, day after day. There were meetings, which led to consensus conclusions, that were painstakingly reviewed at "tollgate" meetings that could last half a day, during which time Magaziner would review, evaluate, and correct recommendations before letting them proceed onward. One such tollgate lasted past 2:00 AM on a Sunday morning. One member of the task force revealed to Time that this was "Ira’s own heuristic process. This is the way Ira decides things. He gets as many people in a room and talks as long as everyone can stand."

When challenged to reduce the plan to a two-page memo, Magaziner refused. There was too great a danger, he said, that details would leak out. This plan had to spring fully grown from Hillary’s forehead.

Meanwhile, Hillary lobbied Capitol Hill to the applause of Democratic representatives flattered by the first lady’s attending on them. The tone of press coverage was no less spellbound…

It soon became apparent on the Hill and to Clinton’s cabinet that the only real function of the task force was to feed facts into Ira Magaziner’s head like a stream of digits flowing into a supercomputer. Otherwise, it was utterly superfluous. As with the series of school reform meetings held by Hillary in Arkansas and as with much of the Watergate staffwork under John Doar, it was all so much window dressing.

"Ira Magaziner has mesmerized Hillary," complained Donna Shalala, Secretary of Health and Human Service.

"How can I advise the president on a plan Ira Magaziner won’t let me see?" asked Robert Rubin, then chairman of the National Economic Council.

Sara Singer, aide to health task force advisor Alain Enthoven, said that Hillary and Ira Magaziner would seem receptive to an idea, then "the next day Alain would hear from someone else with totally opposing ideas that they had seemed equally receptive to them. I think what they were doing was creating the illusion of participation."

Whenever trouble erupted, Hillary diligently went to the Hill. Her talent for soothing egos and smoothing over disagreements was undermined by her absolute unwillingness to negotiate. She refused to come to terms with Democratic Congressman Jim Cooper and Democratic Senator John Breaux, who had plans of their own, and who were supported by moderate Democrats and some Republicans.

In truth, Congressman Cooper offered Hillary a great vehicle—congressional support that would have allowed her to negotiate from a position of strength and receive much of what she wanted. Saul Alinsky advocated asking for 100 percent, and settling for 30 percent in the knowledge that this is 30 percent more than you have. Hillary made it clear that 99 percent was unacceptable. "You can’t fix part of this problem," she told Dick Morris. "If you do this over here, it causes this bad reaction over there. You’ve got to do it all or nothing."

From start to finish, Hillary refused to acknowledge that compromise was possible. Rather than negotiate with Cooper, Hillary tried to marginalize him, just as she had marginalized Bill Clinton’s cabinet. "We were met with a cold shoulder," Cooper said, in words not too different from the complaints of Shalala and Rubin, which they tactfully directed at Magaziner.

When cabinet secretaries were finally allowed to see a rough first draft of the plan in mid-August, they had reason to be aghast. It filled more than 1,300 pages. It proposed to expand Medicare and absorb Medicaid in a new system of universal coverage. Employer mandates would open a rich new vein of wealth transfers, making American jobs as expensive to maintain as European jobs, without explicitly raising taxes (though the admitted costs would be tagged at $400 billion over a few years).

The centerpiece of the plan was a system of bureaucratic regional alliances from which consumers would have to choose their insurance plans. The alliances would, in the words of the Congressional Budget Office, serve as purchasing agents, contract negotiators, welfare agencies, financial intermediaries, collectors of premiums, developers and managers of information systems, and coordinators of the flow of information and money.

This level of control would necessarily involve public policy makers in the minutiae of medical care, with Ira Magaziner at the apex personally counting out the number of cotton swabs per jar. "I have never read an official document that seemed so suffused with coercion and political naiveté — with its drastic prescriptions for controlling the conduct of state governments, employees, drug manufacturers, doctors, hospitals, and you and me," concluded the University of Virginia’s Martha Derthick.

"What happens when you cross the worst management consultant blather with paleoliberal ambition?" asked the New Republic. "For starters, 268 boxes of paper and 1,300 pages of a health care bill."

The "Jackson Hole Group" of congressional moderates, who had entered into the task force deliberations with great enthusiasm, now bitterly denounced the plan.

Daniel Patrick Moynihan, a liberal Democrat and a man who had, through the various twists and turns of a brilliant career, proved himself to be Congress’s most prescient thinker, was clearly astonished by what Hillary and Ira Magaziner had thrown in front of the Congress…

Moynihan criticized the plan for proposing to limit the supply (hence the costs) of medicine by cutting the number of doctors by 25 percent and the number of specialists in half.

"If you have fewer doctors you have fewer doctor bills," Moynihan said. "But you don’t associate it with improving medicine." …

The obsessive secrecy of the plan was its worst political shortcoming, one that drew a rebuke early on. In March 1993, U.S. District Judge Royce C. Lambeth ruled on a lawsuit filed by the Association of American Physicians and Surgeons, finding that Hillary and the top-tier, twelve-person task force had blatantly violated "open-meeting" laws. The White House was in a bind. Hillary could avoid the law if she were deemed a federal employee, but that would constitute nepotism. If she were not such an employee, she and her cohorts were acting illegally. The White House counsel’s office chose instead to argue that Hillary was neither fish nor fowl, just the "functional equivalent" of a federal employee.

Judge Lambeth scolded President Clinton for deliberately ignoring the open meeting laws. "While the court takes no pleasure in determining that one of the first actions taken by a new president is in direct violation of a statute enacted by Congress, the court’s duty is to apply the laws to all individuals," he said. Even after receiving an order to post advance notice of meetings, the White House chose to disobey. In time, Magaziner (who confided to friends that the secrecy rules were forced on him) became the scapegoat, and lived for some time under investigation and fear of an indictment. The first federal judge to experience the contempt with which the Clintons treat subpoenas and testimony under oath, accused the White House of being "dishonest with the court." He added, "Some government officials never learn that the cover-up can be worse than the underlying conduct."

Hillary went into high spin. She played some defense, ridiculing the notion that her plan was "socialist," telling readers of Parade magazine how scared she had been by the visions of Aldous Huxley in Brave New World and George Orwell in 1984. "I find it so amusing when people think that I’m in favor of big government or big anything, because I’m not." She sprang into "war room" mode. Hillary instigated a mean-spirited campaign of call-in critics to blast Congressman Cooper when he unveiled his own alternative plan on radio talk shows. Hillary allies Senator Harris Wofford and Tom Daschle of South Dakota ridiculed Cooper’s plan as "rock-bottom Wal-Mart."

The Democratic National Committee ginned up a campaign to save Hillary’s plan, with Hillary working overtime as an editor of political copy and videotape. Hillary’s aides lobbied the House Ways and Means staff so ferociously that Democratic chairman Dan Rostenkowski called them "paranoids." Rostenkowski had little patience with Hillary’s "with us or against us" style of negotiating. Ultimately, Hillary tried to revive her plan with an outright campaign of vilifying insurance and pharmaceutical companies. Industry, predictably, did not take this lying down.

They produced and aired the "Harry and Louise" ad campaign that undercut and subtly ridiculed Hillarycare. The ads fomented public opposition far beyond the health care plan itself. It crystallized disgust with liberal Democrats, a building anger that would eventually end their forty-plus years of rule in the House of Representatives, making Hillarycare one of the most self-destructive political maneuvers committed by liberal Democrats in this century.

Hillary handled the growing public reaction against her plan by trying to create a new set of villains. She branded the insurance industry as liars: "It is time for… every American to stand up and say to the insurance industry, `Enough is enough. We want our health care system back.’ She lashed out at Representative Cooper. She flew around the country and was astonished to find hecklers in the audience. At a rally in Seattle, demonstrators carried "Heil Hillary" signs. She had to turn up the microphone and shout to be heard over the protestors.

Hillary saw enemies everywhere, and saw any dissent as a Republican put-up job. "She’s a glib speaker," noted a retired family practitioner who had seen her up close. "She can really rattle off the answers. But she doesn’t like you to argue with her. When a health insurance agent asked the perfectly reasonable question of what would happen to his job under her plan, Hillary answered, "I’m assuming anyone as obviously brilliant as you could find something else to market." Then she added, just for fun, "I can’t go out and save every undercapitalized entrepreneur in America."

It did not seem to occur to Hillary that hecklers were prompted by her own tendency to attack, and counterattack, that her biggest problem was her own thin skin. Hillary’s moral standing to take on corporate medicine was also compromised when it was revealed, in the spring of 1994, that she was profiting from her attacks as her hedge fund shorted her health stocks.

It soon became apparent that the health care campaign was a frantic race into oblivion.

Her desperation showing, Hillary now saw opposition to her plan as nothing less than an assault on American democracy. "This personal, vicious hatred that for the time being is being aimed at the president, and, to a lesser extent, myself, is very dangerous for our political process," she said…

It was George Mitchell who performed the act of mercy, sitting down with the Clintons in August 1994 to tell them that no version of their plan could pass the Senate. A few months later, the American people went to the polls and took out their frustrations on Democratic members of Congress, most of whom were actually opposed to her plan. Democrats not only lost control of the House, but major Democrats like House Speaker Tom Foley, New York Governor Mario Cuomo, and Texas Governor Ann Richards were tossed out of office.

Hillary’s poll numbers confirmed that she was at the center of voter dissatisfaction. Five months before the election, an NBC–Wall Street Journal poll found that 51 percent of respondents felt that the first lady had too much influence.

Depressed, Hillary absented herself from political and strategy meetings in the White House. Her co-presidency had slammed into a retaining wall.

"Remind me," she asked an aide, dripping with self-pity. "Have I ever done anything right in my life?"

That’s a good question.

This article was posted by Steve on Tuesday, September 18th, 2007. Comments are currently closed.

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