Tuesday, May 01, 2007

SAM SMITH, 'SHADOWS OF HOPE,'

1994 - 
During the first months of the
Clinton administration, one of the biggest national policy changes of
the past fifty years was being forged by a secret committee led by Mrs.
Clinton under procedures that periodically defied the courts and the
Government Accounting Office and whose public manifestations consisted
of highly contrived media opportunities, carefully staged "town
meetings," and similar artifices.
Despite the contrary evidence of public opinion polls, the concept of
Canadian-style single-payer insurance was dismissed early. Tom Hamburger
and Ted Marmor in the Washington Monthly tell of a single-payer
proponent being invited to the White House in February 1993. It was, he
said, a "pseudo-consultation;" the doctor was quickly informed that
"single payer is not politically feasible." When Dr. David Himmelstein
of the Harvard Medical School pressed Mrs. Clinton on single payer, she
replied, "Tell me something interesting, David."
In other words, write Hamburger and Marmor: "Fewer than six weeks into
the Clinton presidency, the White House had made its key policy
decision: Before the Health Care Task Force wrote a single page of its
22-volume report to the President, the single payer idea was written
off, and "managed competition" was in."
If there was any popular, grassroots demand for "managed competition" it
never appeared. Managed competition had not been tested anywhere.
Nonetheless, reported Thomas Bodenehimer in Nation:
"Around Hillary Rodham Clinton's health reform table sit the
managed-competition winners: big business, hospitals, large (but not
small) commercial insurers, the Blues, budget-worried government leaders
and the 'Jackson Hole Group,' the chief intellectual honchos of the
managed competition movement. . . Adherence to the mantra of managed
competition appears to be the price of a ticket of admission to this
gathering. "
What was finally proposed involved a massive transfer of the American
health industry - by some accounts now larger than the
military-industrial complex - to a small number of the largest insurance
companies and other major corporations. These were companies that had
the assets to play the game being offered - a medical oligopoly that
would dispense health-care under the rules of the Fortune 500 rather
than according to those of Hipprocrates.
http://desmoinesregister.com/apps/pbcs.dll/article?AID=
/20070312/NEWS09/703120330/-1/politics&template=printart


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