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Ralph Nader > In the Public Interest > Clinton’s Health Care Plan and Special Interests

Watch out folks, the strategy of the Clinton task force on health care reform is becoming all too clear.

Racing to meet a self-imposed May 1, 1993 deadline for the White House’s proposal to Congress, dozens of White House staff, directed by Hillary Clinton, and hundreds of consultants are weaving a restructuring of one-seventh of our national economy. That is $925 billion in health care bills in 1993 alone. The White House is proceeding on two tracks here. One track ostentatiously declares that the task force will not meet with special interest groups. Hillary and the cameras go out around the country to meet the people and hear their complaints and desire for universal health care coverage. Back at the White House, academics from universities and think tanks go to and fro consulting. Look Ma, no lobbyists invited.

Clinton’s track two is far less flamboyant and media-drenched. The name, shape and nourishment of Clinton’s emerging plan comes from Jackson Hole, Wyoming Group. There for many months members of the upper crust have been privately meeting, deciding, then fanning out and spreading their proposal called “managed competition” to the business, academic, political and media worlds.

They virtually own the New York Times editorial position through a staff writer who was a protege of one of the Jackson Hole crowd.

Let the president of Consumers Union, Rhoda H. Karpatkin, describe what the Times called “Hillary Clinton’s Potent Brain Trust:” “The list of 35 key participants reads like a “Who’s Who” of health special interests: top executives of six insurance companies, three pharmaceutical companies, two hospitals, three H.M.O.’s, physician groups, four business groups, a data processing giant and a pacemaker manufacturer. In addition, there are five academics — three with medical degrees — and five political leaders. Prominent are the heads of the American Medical Association and the Pharmaceutical Manufacturers Association.”

“Whatever differences may exist among its members,” Ms. Karpatkin says, “the Jackson Hole Group has a powerful, shared interest in preserving as much as it can from the existing, discredited system.”

“Managed competition” envisions the formation of giant health insurance purchasing cooperatives, composed of businesses and individuals, which would connect with a giant health care provider (like HMOs) to provide a minimum health care packages. If you want more, you pay more. Everybody by the end of the decade would be covered and billions of dollars to cover the poor will come from taxes, such as sin taxes (tobacco, alcohol, etc.).

The Jackson Hole group believes that these big buyer-big seller negotiations will incite market competition and greater efficiencies.

Without going into the ailments of this plan (a later column will do that), it is interesting to observe how the major corporate and professional players are falling in line. Among others, the American Medial Association, the Pharmaceutical Manufacturers Association and most recently, a group of employers calling themselves HEAL, are openly signing on to “managed competition.”

These vested interest want to preserve the essence of the status quo and, in turn, Clinton wants all these players on board behind his May 1st plan. That would make passage of the plan through Congress quicker and Clinton can say he kept his campaign promise. But at what price to consumers?

Already Clinton is offering the supportive vested interests sweeteners. In an obvious leak to the New York Times earlier this month, the White House let it be known that in return for limits on doctors’ fees (a sine quo non anyway for any kind of reform to contain costs), the Clinton Administration would propose restrictions on medical malpractice lawsuits.

Nothing in the leaker documents to the Times recognized the need to do something about preventing medical malpractice which takes over 80,000 lives a year just in hospitals (extrapolation from a recent landmark Harvard study of New York hospitals).

The focus instead was on making it harder for the most seriously harmed patients to secure adequate compensation for their pain, suffering and long term expenses by capping arbitrarily from Washington what damages state juries and judges can award.

Nothing was said in these documents about limiting the almost embarrassing profits of the medical malpractice insurance companies who are gouging physicians with high premiums and paying out proportionately less and less to victims.

Get ready for a disappointment on May 1st or get ready for a grass roots reaction by people everywhere that spells the following message to the Clintons — “no more con jobs in the name of reform.”