Monday, April 09, 2007

Alternative History, or One Reason People Like Hillary

by Ken Houghton

Via Brad DeLong, Ezra Klein in the Los Angeles Times indirectly explains one reason why people like Hillary. Doing some selective but not inaccurate editing:
It wasn't so long ago that President Clinton's proposed reforms suffered a catastrophic defeat at the hands of moneyed interests and Republican opportunists.

The initiative was placed under the control of Hillary Rodham Clinton and Ira Magaziner. Neither had the political experience to safely shepherd a reform of this magnitude.

It's worth saying here that although the U.S. has a very inefficient healthcare system when evaluated with traditional metrics such as the health outcomes of the populace or the costs of care, it is unquestionably the finest in the world at generating profits. There's a lot of money sloshing around, and quite a bit of profit to protect.

So the face of Health Care Reform was basically Hillary Clinton. And she lost to the "alternative," Managed Care:
Today, of course, it's clear that managed care has failed. After cost growth was effectively arrested in the mid-1990s, patients rebelled against being managed, and insurers decided that passing on the costs of unlimited care was less trouble than holding them down. Moreover, the same anxieties over spending growth and the precariousness of coverage that first burst onto the scene during the 1991-92 recession are now constant companions, even in periods of economic expansion. Since 2000, health premiums have shot up by 87%. Wages, of course, have not followed.

That may be why a recent New York Times/CBS poll found that 90% of Americans said they thought that the healthcare system needed either "fundamental changes" or to be "completely rebuilt." The last time the poll recorded such desire for reform was in January 1994. Indeed, according to the poll, 62% report themselves willing to pay higher taxes for universal coverage.

So what we have, in the collective memory, is an initiative led by Hillary that looks a lot better than what we have now.

In short, it appears that Hillary was ahead of her time.

People may not have long memories about policy details, but they remember the Grand Ideas. And they especially remember them when the alternative has been as dystopic as the current system.

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