Clinton revisits health-care ideas | Chicago Tribune

Clinton revisits health-care ideas Chicago Tribune: "Clinton revisits health-care ideas" Reform push in '90s had lessons, she saysBy Jill ZuckmanWashington BureauPublished May 25, 2007 WASHINGTON -- For Sen. Hillary Rodham Clinton, the problems of the American health-care system have been a political danger zone since she unsuccessfully tackled the issue as first lady in the early 1990s.Health insurers and conservatives vilified Clinton for her efforts then, and Congress reacted coolly to her presentation of a universal health-care plan as a fait accompli after months of secret meetings. The "Harry and Louise" commercials, aired by the insurance industry, mocked her effort, and the plan's perceived complexity made it a laughingstock in some quarters. On Thursday, as a candidate for president, Clinton (D-N.Y.) returned to the complicated and contentious topic, acknowledging mistakes and promising that she had learned from the experience."Now, I've tangled with this issue before, and I've got the scars to show for it," she told an auditorium packed with medical students and doctors at George Washington University. "But I learned some valuable lessons from that experience. One is that we can't achieve reform without the participation and commitment of health-care providers, employers, employees and other citizens who pay for, depend upon and actually deliver health-care services."Shaped by '90s experienceClinton delivered a proposal Thursday focused on reining in health-care costs. Two other proposals are in the offing -- one to improve health-care quality and the other to insure all Americans. She has already introduced legislation to expand health-care coverage to every child in the U.S.These ideas represent the senator's best effort to confront the fact that to many of her doubters, Clinton's 1993-94 health reform push represents much of what they dislike about her -- an imperiousness, a belief in big government and a seeming certainty that she knows best.A recent Kaiser Family Foundation survey showed that health care ranks second in voters' minds as the most important problem for government to address, following the Iraq war. Republicans, Democrats and independents all gave health care the same weight. Previous polls had shown the issue tied with or slightly behind the economy.Drew Altman, president of the Kaiser Family Foundation, a national, independent health philanthropy, said voters are having trouble identifying which presidential candidate would best address their concerns on health care. But in a twist, Clinton has a head start, he said."Even though there was a great failure in the '90s, voters associate her with the issue and know she cares deeply about the issue," Altman said.Next Tuesday in Iowa City, Sen. Barack Obama (D-Ill.) will lay out his vision for lowering health-care costs and expanding coverage. Former Sen. John Edwards of North Carolina has proposed insuring all Americans, including the 45 million who are uninsured, by 2012.Put focus on preventionAt George Washington, Clinton delivered facts and figures to back up her contention that health-care costs are out of control: Premiums have almost doubled since 2000; the nation spends 16 percent of its gross domestic product on health care; 30 percent of the cost increase is related to the doubling of adult obesity the last two decades; and administrative costs in the U.S. are the highest in the world."If we spend so much, why does the World Health Organization rank the United States 31st in life expectancy and 40th in child mortality, worse than Cuba and Croatia?" she asked.As president, Clinton said, she would focus on prevention, keeping people well rather than spending more later on treatment when they are sick.She noted that only 38 percent of adults are screened for colorectal cancer and about 20 percent of children don't get immunized against preventable diseases.The senator said she would require all insurers who participate in a federal health program such as Medicare or Medicaid to cover prevention, paying for such procedures as cancer screening and immunizations.Clinton said she wants individuals and small businesses to have access to larger insurance pools to lower costs and stop insurance companies from discriminating against those with pre-existing conditions. "The whole point of insurance ... is to spread risk across a group of enrollees," she said.Medicare should be able to negotiate for lower drug prices, she said, a proposal that has failed to gain traction in Congress. And she cited medical malpractice reform as another avenue for reducing costs.Political candidates often cite "eliminating waste" to produce a windfall, but it is unclear how much money could be saved. And some of the items Clinton proposed -- such as malpractice reform and drug negotiations -- have proven difficult to enact.----------jzuckman@tribune.com Copyright © 2007, Chicago Tribune