Back to the Future With Hillary and Healthcare

From the WebMD Archives

Feb. 5, 2001 (Washington) -- She's baaaaaaack! After a spectacularly failed effort to reform the nation's healthcare system in the early 1990s, Hillary Clinton has health in her sights again -- from her new seat in the U.S. Senate.

People seem to love or hate Hillary. A role model to many, she's the first First Lady to win election to the Senate. At the same time, conservatives especially revile her. One web site is devoted to her as a "wicked witch," among a number that pillory her controversial past.

But now Sen. Clinton (D-N.Y.) has a plum spot on the chamber's Health, Education, Labor, and Pensions (HELP) Committee, which is responsible for passing health insurance and public health legislation. This week, the committee will review patient privacy regulations.

The Senate is sometimes referred to as the ultimate old boys' club, and newly elected senators aren't usually movers and shakers there.

Clinton has, nevertheless, drawn plenty of news cameras, thus far, to her Senate comings and goings. And she's got a full plate of healthcare proposals.

Her healthcare history is still fresh in many minds. Soon after President Clinton took office, Hillary became pilot of the infamous White House's healthcare reform task force, which crafted -- behind closed doors -- a major overhaul of the nation's health financing and delivery structure.

But not only did Congress fail to pass any health reform measure, a federal court also slapped several hundred thousand dollars in penalties on the Clinton White House for failing to keep the task force's meetings and records public.

Jane Orient, MD, executive director of the Association of American Physicians and Surgeons, which successfully sued the task force for its lack of openness, tells WebMD, "Her plan would have potentially either outlawed private medicine or made it virtually impossible to obtain it. She would have had the government dictating everything about what care could be offered, who could get it, and how much could be spent on it."

According to Orient, "She's learned more about how to get her way, but she hasn't changed her opinion about her ultimate goal. I would not underestimate her at all."

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But the memory of the failed health reforms failed to crush Clinton's ambitions for the Senate. During her rough-and-tumble campaign for the seat, GOP opponents unsuccessfully tried to use that past against her. New York's conservative party ran TV ads that asked, "If you trust Hillary Clinton, maybe you should see your doctor, while you still can."

Was that then, and this now? Joe Karpinski, GOP spokesman for the HELP committee, tells WebMD, "Those are old things. We are sort of like a team at the beginning of the football season. What you did before is statistical. It's out there; it's known. But you are really judged on what you do this year.

"I haven't detected any dread or disparaging words," Karpinski says of the Republican senators on the committee. "After all, the Clintons lost that [healthcare] battle pretty soundly, and there are some historians who would say that that contributed to Republicans taking control of Congress in the 1994 elections."

Grace-Marie Arnett, executive director of the Galen Institute, a free-market research institute, tells WebMD, "A lot of us are watching to see what she does propose and hoping that she begins to move more in a market direction rather than the direction of more and more government."

And Clinton, for her part, says she's changed her approach towards healthcare reform. "I come from the school of smaller steps now. ... Smaller changes, incremental changes that will help some people, are better than walking away and saying there is nothing we can do."

But according to Orient, that means, "You get that opening wedge in, and just drive it in further and further and further."

Clinton is calling for a prescription drug benefit for everyone in Medicare -- a step beyond the low-income-targeted proposal from President Bush. She's also interested in finally passing a federal "patients' bill of rights," and upping enrollment in the Children's Health Insurance Program (CHIP) while permitting parents to be covered under the program.

That's not all. Among other steps, Clinton says she'll push for parity for mental health insurance coverage, protections for individual genetic information, and an early buy-in to Medicare coverage.

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In a health speech in January to the consumer advocacy group Families USA, Clinton concluded by saying she had not given up on universal coverage. "This is a battle we've been waging together for quite some time," she said. "I remain just as committed as I ever have been, even more so."

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