People’s Concerns about Affordable Healthcare and the 1992 Presidential Election
People’s concerns about affordable healthcare were heightened in the run-up to the 1992 presidential election. As a result, the subject of health care became the deciding factor in how Americans choose their President. The problem with the healthcare sector had taken precedence over other critical issues such as education (Moffit, 2017).
Clinton's Prioritization of Health Care Reform
Clinton then made health care reform one of his top priorities, which helped him win the presidency of the United States. After being elected President, Clinton addressed the American people about his aspirations to change the healthcare industry. The President then chose his wife, Hillary Clinton, to lead the task committee charged with driving healthcare reform (Dilly, 2003).
The Goal of the Clinton Health Care Plan
The main goal of the work group was to develop the plan that was affordable and comprehensive such that all Americans would be virtually covered. A long time passed before any substantial plan being presented and many deadlines passed. When the plan was finally elaborated, it was rejected before being taken to a vote. Thus, the paper will discover the major features of the Clinton health plan of 1993. It will also indicate the causes for the Plan to fail. The study will discuss the effects on governmental entities and interest groups, as well as reveal the lessons to be concerned from the collapse of the Plan.
Features of the Clinton Health Care Plan
Clinton had emphasized the need for freedom from red tape and simplicity throughout his administration. However, the healthcare plan offered everything but modesty and liberty from bureaucratism (Dilly, 2003). The product of the task force headed by Hillary Clinton was the 1,342-page complex Bill. It was designed such that it entailed a top down control and command system that would govern and control literally all the aspects of financing and delivery of health services to Americans (Moffit, 2017; Dilly, 2003). The Bill would control the insurance industry such that there were certain health care benefits that insurers had to provide. It also has some stipulations for firms concerning their contribution towards health insurance of their workers.
A National Health Board
Clinton according to the Plan would form the presidentially appointed state agency that would control the American healthcare sector and system. The agency was to control various health care aspects such as the pricing of insurance premiums, the benefits to be included in the standardized health plan and enforcement of private and public spending restrictions both at the state and national levels (Moffit, 2017). It would lead to a situation whereby no change would have been implemented in term of medical treatments, health benefits without congressional actions and prior approvals of the federal agency.
Regional Health Alliances
Due to the Health Plan, a new and state-based health insurance cooperative system was to be formed. Such corporative would influence various healthcare aspects such as the implementation of healthcare budgets, availability of healthcare plans, and collection of insurance premium, enforcing of the national insurance rules and regulations and enrolling employees and employers in the new system (Moffit, 2017). It would result in a complete overhaul of the system through which the healthcare insurance providers had been operating. The Plan also had a compulsory health benefits package that covered major healthcare services, eye and ear examinations, elective abortions and costly treatments for drug and alcohol abuse. The standardized medical package was tax-free and tax would only be paid by families in case that they required other health benefits not included in the compulsory medical package.
Employer Mandates
The Plan required employers to enable their employees with at least the health standard package and to fund a minimum of 80 percent of the cost of the state’s standardized medical benefits package. It was to provide firms with subsidies that had joined regional cooperation so that their premium payment would be limited to 3.5 of their payroll expense for small businesses and 7.9 percent for large firms (Moffit, 2017). Moreover, firms that had employees exceeding had to pay the provided the standard package as a minimum. However, they had the option of opting out and instituting their own regulated and controlled cooperatives.
Government Spending Caps and Budgets
Prior to the formulation of the Plan, the President Clinton had reiterated that he aimed at limiting price controls. Nevertheless, one of the key features of the 1993 Healthcare Plan Act was price controls. The Plan did not have competitive price controls but a rigid and complex system of spending caps on private and public medical insurance (Moffit, 2017). It also had fee controls for medical doctors that provided charges for service practices. States were also encouraged by the federal government through the Plan to establish state monopolies through which they would control all the elements of the healthcare sector. In addition, the Plan was to oversee a yearly suppression of the health care expenses increase, until it was at par with the inflation growth rate as was indicated by the consumer price index (CPI).
Cause of the Plan to Fail
With the aforementioned features, the Plan was headed for a failure as the chances that the Congress would pass were minimal. It would result in an increase in government controls and such inspections were going to be very costly (Moffit, 2017). Despite the talks that the government would eliminate bureaucracy, the Clinton health care plan highly restricted personal responsibility and choice through the formulation of panels, commissions, boards and alliances (Moffit, 2017). Government control and regulation is the key method of containing medical costs and providing medical services. However, with the standardized package, the government was going to eradicate the option of benefits and promote a managed health care. Consequently, it would limit the personal selection of doctors and make it nearly impossible for Americans to take advantages of specialized or new healthcare services and products (Moffit, 2017). Moreover, the regional healthcare cooperatives was a stepping stone towards the establishment of giant, regional and geographically established medical insurance cartels.
The Second Reason for the Failure of the Plan
The second reason that led to the failure of the Plan was that it would have resulted in reduced freedom for both patients and doctors. It would cause a situation whereby the ability of all medical doctors to treat patients based on their independent professional opinion would be highly diminished. For instance, the establishment of the National Health Board would bring the establishment of national guidelines for ascertaining which treatment plans to be adopted in the standard government medical insurance package (Moffit, 2017). The government through the body would also regulate the intervals for the approved treatments and which tests are to be conducted. In addition, the Plan would trigger the case where the doctors in a fee-for-service plan being controlled by the government.
Denial of Medical Services and Freedom of Choice
The Plan would also drive Americans in situations whereby they are denied the option of medical doctors and access to medical specialists of their choice. Private medical practice would be greatly affected as it would become the last alternative and mostly for the wealthy (Moffit, 2017). Americans would therefore be forced to pay for medical services on an out-of-pocket basis if they were to seek medical treatments and tests that were not included in the standard medical plan. The driving force that led to the formation of the Clinton medical plan was the increased cost of medicare (Moffit, 2017). However, with the Plan seeking to contribute to affordable healthcare to all Americans, the government was intended at ratcheting down the growth rate of medical discharges. It would hence result in the government rationing of medical services or limit the provision of such services at some point. The American government has various spending caps in place and it lessens all the public expenditures both at the federal and state levels. The Bill would subsequently result in the denial medical services to Americans if such services would comprise government exs beyond the set caps.
The Unclear Cost of the Clinton Health Plan
The cost of the Clinton health plan was unclear for both the public and the administration. For many parties like the Congress, there was no way that the Clinton plan would provide a universal medicare, subsidies to small businesses and cover prescription drugs and still reduce the budget deficits as their goal without raising taxes. It was eventually a guarantee that the government would be forced to increase the taxes, the factor that would lead to the high level of opposition from Americans (Moffit, 2017).
Effects of the Plan on Government Entities and Interest Groups
The Clinton plan would greatly affect the American population. Although attractive, the plan would have a vast effect on American families. The plan would affect the manner in which Americans pays for and received Medicare (Kraus, 2017). Americans would, therefore, lose their freedom of choosing where to seek medical services and the types of treatments to pursue. The Republicans having being been against the elections of Clinton to office were busy looking for a way to make Clinton’s administration irrelevant and outdo it in the next term (Kraus, 2017). The success of the bill would, therefore, prove them wrong hence the need to ensure its failure. In order to be inclusive, Hillary Clinton has held a meeting with the Republicans and presented them with a sketched plan of the bill. This resulted in the proposed bill lacking transparency and certainty hence the opposition from the anti-government conservatives.
The Impact on the Middle-Class Society
The bill would also have a huge impact on the middle-class society. Managed competitions that would be created by the plan would result in large health insurance buying corporative made up of individuals and businesses that are connected with giant health care providers to avail medical services. It would mean that the poor would have been pushed to pay higher taxes (Kraus, 2017). Historically, American workers and citizens have remained happy by benefiting from the expenses of the federal government, and reimbursing taxes to funds such generous charges that helps citizens and privileged groups have never been an issue. It is due to the fact that such accounts has always been administratively streamlined, a feature that the Clinton plan lacked.
The Impact on Doctors and Private Medical Practice
Moreover, small medical insurance firms would have been denied the opportunity to compete freely in the market by having equal opportunity as large insurance companies. Many doctors have their own private practice while the others are workers in various private practices. Furthermore, they are able to provide their services for a fee (Kraus, 2017). It has remained possible due to Americans having the longest time been able to freely choose the practices, doctors and treatments methods they prefer. It would have therefore interfered with the free will of doctors and compromised their source of livelihood.
Effects on Insurance Firms and the Pharmaceutical Industry
The Bill also affected insurance firms. The insurance industry was not represented in the task force. The insuring then started to mobilize its own lobby efforts to kill the Clinton health care plan. The outcomes of their effort were damaging media commercial on how the Bill would come up with the rationing of health services.
The Bill would also affect the pharmaceutical industry. The task force has also been based on a secrecy and there was no valid basis on which it was formed (Kraus, 2017). The work group led by the first lady had broken the law of secrecy thus bringing about a lawsuit by the Association of American Physicians and Surgeons (AAPS). It was ruled that the task group had been a violation of the Federal Advisory Committee (FACA) thus triggering its disbarment.
Lessons from the Collapse of the Clinton’s Plan
The timing of the Bill was perfect and it would have received the full support of Americans administratively streamlined. The Bill was sketchy and could not be fully explained even when it was presented to the Republicans (Dilly, 2003). It was indicative that for it to be effective all its aspect should be addressed in terms of administration and funding. The Clinton bill was not clear regarding how it would have been financed. Its implementation would have eventually resulted in tax raise, a contentious issue that often led to policy failure unless approached with full disclosure (Dilly, 2003). The health care Bill would cause a lot of pressure on both the state and the federal government. It was a large entity with no sustainable mechanism of funding it. Moreover, it would have produced a complete overhaul of the way healthcare was being financed and provided.
The Importance of Inclusion and Transparency
Other interest groups such as insurers, doctors and the pharmaceutical industry were not represented in the task force. It eventually led to their interest not being incorporated in the Bill. Consequently, they were pushed to fully lobby against the Clinton healthcare plan (Dilly, 2003). As a lesson, the formation of the task group to formulate the Bill and its drafting should be inclusive of all stakeholders for the success of such a Bill. Drafting of sensitive bills should be handled with care. Following the lawsuits, the accused were almost made to spend amounts exceeding the $300,000 that was budgeted for.
Understanding the Limits of Political Mandate
Another lesson learned from the failure of the Clinton bill is that it is suicidal to assume political mandate. Winning an election is just one of the steps in acquiring the confidence of Americans and on its own does not guarantee a mandate to institute a health reform. Lastly, for a health bill to be successful, it requires a balance between competition and regulations to be established to ensure that the interest of all the stakeholders.
Conclusion
To conclude, the Clinton health care bill of 1993 failed, since it did not include the interest of all the stakeholders. The document was to result in a complete change in terms of how health services are being provided and funded. The implementation of the Bill would have therefore affected pharmaceutical companies, insurers, citizens, and other stakeholders in various ways. In order to reform the American healthcare fully, a more inclusive and dynamic bill should be adopted and refer all the problems as was in the Clinton healthcare bill addressed.
References
Dilly, G.A. (2003). The failure of the Clinton administration’s health care reform: A matter of substance or process?. Washington, DC: National Defence University, National War College. Retrieved from http://www.dtic.mil/dtic/tr/fulltext/u2/a442073.pdf
Kraus, C. (2017). Clinton’s heath plan: Interest groups; Lobbyists of every stripe turning to the grass roots on health care. The New York Times. Retrieved from http://www.nytimes.com/1993/09/24/us/clinton-s-health-plan-interest-groups-lobbyists-every-stripe-turning-grass-roots.html?pagewanted=all
Moffit, R. (2017). A guide to the Clinton health plan. The Heritage Foundation. Retrieved from http://www.heritage.org/health-care-reform/report/guide-the-clinton-health-plan
