Hilary Clinton's Take on Health Care

Dr. Mark Borigini Health Guide
  • Recently, President Bush and his Health and Human Services Secretary Michael Leavitt aggressively argued against the proposed renewal of the State Children's Health Insurance Program (SCHIP). They were concerned that the bill was too expensive and threatened the private insurance market. Democrats failed to override a presidential veto; perhaps an example of why the approval rating of Congress is less than the dismal approval rating of the president.

     

    And we Americans are left with the thought that if there cannot be consensus on giving health care to the children of this country, it follows that there will be no meaningful health care reform for all of us in the near future.

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    But maybe all the pessimism is unwarranted.

     

    The perception is that comprehensive health care reform disappeared from the national agenda after Hillary Clinton's failed attempt at such as first lady in the early 1990s. At that time, many felt that the Clinton plan was a step closer to socialized medicine. And this was the type of argument Mr. Bush used in explaining his veto of SCHIP: "Their SCHIP is an incremental step toward the goal of government-run health care for every
    American."

     

    But we should listen carefully, and try to filter out all the political rhetoric regarding issues such as SCHIP and socialized medicine. There are some nice noises out there.

     

    Secretary Leavitt sees a future which allows families access to prices and treatment outcomes of hospitals and doctors so that they might shop around for the best health care. Ten group practices around the country have been measuring the outcomes of different treatment models for common afflictions. Medicare is reimbursing these health care providers based on the health outcomes-the results of the care provided-of the patients. Medicare will further track the results of care recorded by these providers and compare this data to what they compile. It is hoped that national standards can come from this work, and disseminated to all practitioners so that care can be given with the most cost-effective approach.

     

    However, like the good Republican the Secretary is, he wants these "national standards" to be controlled locally. National groups of physicians and economists would define so-called "best practices," and local committees would rate the doctors and hospitals. Leavitt envisions the coming together of business, labor, physicians and hospitals in communities across the country. Eventually these local groups will become linked in a network, providing the national standards for assessing and providing health care in this country.

     

    The philosophical basis behind these proposals rests on the government organizing the health care marketplace, not owning it. Competition will take care of the rest.

     

    Much of this plan is very similar to one put forth by Mrs. Clinton as she runs for president. And by the way, she is a Democrat.

Published On: January 14, 2008