Bill Clinton on Health Care President of the U.S., 1993-2001; Former Democratic Governor (AR)

ObamaCare has already insured millions and reduced costs

1. Individuals and businesses have already gotten more than $1 billion in refunds from insurance companies because the new law requires 80% of your premium to go to your health care, not profits or promotion.
2. More than 3 million young people between 19 and 25 are insured for the first time because their parents' policies can cover them.
3. Millions of seniors are receiving preventive care
4. Soon the insurance companies will have millions of new customers, many of them middle-class people with pre-existing conditions who never could get insurance before.
5. For the last two years, health care costs have been under 4% in both years for the first time in 50 years.

Compromise on delivery methods to preserve full healthcare

A: What the Democrats have to understand is, if they want to preserve a health care program for people who need it and the benefits of Medicare, we have to be willing to chang the delivery system. We're spending too much on the way we finance health care and the way we pay for it. [Just like] the Republicans can't be completely allergic to taxes, the Democrats can't be completely allergic to changes in health care delivery.

Failure in 1993 echoed Truman's failure in 1945

President Bill Clinton might have uttered those words in 1993, but he didn't. It was Harry Truman, in 1945, promoting his own, doomed plan to guarantee health care to every American. Like Clinton, Truman had reason to be confident. But both presidents underestimated the strength of the forces arrayed against them. Special-interest lobbyists--led by doctors in Truman's time, and insurance companies in Clinton's--fanned the public's fear that government bureaucrats would come between doctors & patients. And when the Republicans triumphed in the subsequent midterm elections in 1946 & 1994, health-care reform was effectively dead.

Helped provide antiretrovirals to developing nations

Last year, in the Bahamas, the first country to participate in our effort, I had a reunion with 5-year-old twin girls who were desperately ill when I first met them but are healthy now because of the low-cost medicine purchased through our project. I have held orphans in Cambodia who are receiving lifesaving medicine through our AIDS initiative. Our program now works in 25 countries to diagnose, test, and care for people with HIV/AIDS, and 44 more nations are able to buy low-cost drugs and testing materials under our contract. As of 2007, about 750,000 more people are receiving treatment purchased under CHAI agreements, representing about a third of all those in the developing world receiving treatment today.

Citizen action on childhood obesity & overweight adults

Co-led bipartisan effort against child obesity

Today, 12.5 million American children are obese, an additional 13 million are overweight, and more and more of them are developing problems normally found only in adults--high blood pressure, high cholesterol, and Type 2 diabetes, which can lead to heart attacks, strokes, blindness, and loss of limbs. If childhood obesity continues to increase, this young generation could be the first in American history to have shorter lives than their parents. I asked Gov. Mike Huckabee (R-AR) to co-lead the effort with me because he was a great example: he lost 110 pounds, got off his diabetes medicine, and ran his first marathon at age 49. After Huckabee left office, Gov. Arnold Schwarzenegger (R-CA), who also has aggressively tackled the childhood obesity issue, became the Alliance co-leader.

2002: Signed on 69 nations to buy generic HIV/AIDS medicine

We worked with ten major generic producers to negotiate a price reduction from $300 to $139. The manufacturers and suppliers of essential ingredients agreed to shift from a low-volume, high margin, uncertain-payment business to a high-volume, low-margin, certain-payment one.

Today our foundation's AIDS initiative includes 69 countries, which are now able to treat 2 to 3 times as many people with the same amount of money. As I write this, almost 750,000 people are receiving treatment with drugs purchased under our contract terms.

1993: Advisers urged scaling back Hillary’s healthcare role

Ira Magaziner and his aides were well along in drafting the legislation, and he and Hillary had told the president that he had to make some final choices about the bill’s content so it could arrive on Capital Hill when Congress returned after Labor Day. Before leaving, the president had been besieged by advisors who continued to warn that the deficit would be in danger of exploding if he listened to Hillary. They saw the plan she was developing as too big and too costly. The Clinton presidency would historically succeed, they advised, only if he would scale back his wife’s grandiose ideas about reform and settle on a more manageable and incremental approach. Clinton had said he would make a final decision after his vacation.

1990s plan: affordable, competitive, universal healthcare

"I didn't get that," Hillary says now. I read these newspapers. I sort of figured that what we read was a fact. I was shocked to find out otherwise."

1995 health plan lost on politics, not on substance

That was not a fair assessment, Clinton protested, because their health care plan was going largely to help people who were working. Clinton insisted that the problem with the health care plan was not the substance. He had lost the communications and the political war. That was the screwed-up part.

Universal coverage would reduce bureaucratic costs

Loosen eligibility for disability benefits

Security,simplicity,savings,choice,quality, & responsibility

Under our plan, Americans would be able to choose their own health plan and keep their own doctors, choices that were vanishing for more and more Americans whose insurance was carried by health maintenance organizations (HMOs).

If the system I had proposed had been adopted, it would have reduced inflation in health-care costs, spread the burden of paying for health care more fairly, and provided health security to millions of Americans who didn't have it.

1992 campaign: “It’s the economy, stupid” but healthcare too

Bill and expert advisers began developing ideas about how to tackle health care. Bill previewed those plans in a campaign book entitled Putting People First and in a speech. The reforms he outlined included controlling spiraling health care costs, reducing paperwork and insurance industry red tape, making prescriptions more affordable to those in need, and, most important, guaranteeing that all Americans had health insurance. We knew that trying to fix the health care system would be a huge political challenge. But we believed that if voters chose Bill Clinton on Nov. 3, it meant that change was what they wanted.

Allowing patients to choose doctors is non-negotiable

The best model was the Federal Employees Health Benefit Plan, which covered nine million federal employees and offered an array of insurance options to its members. Prices and quality were monitored by the plan's administrators.

Under managed competition, hospitals and doctors would no longer bear the expense of treating patients who weren't covered because everyone would be insured through Medicare, Medicaid, the veterans and military health care plans or one of the purchasing groups.

Perhaps most important, the system would allow patients to choose their own doctors, a non-negotiable item in Bill's view.

Despite reform failure, smaller reforms helped millions

On balance I think we made the right decision to try to reform the whole system. By 2002, with the economy in trouble again and the financial savings of managed care in the 90s having leveled out, health insurance costs were again rising, the number of people without insurance was going up and seniors on Medicare still didn't have prescription drug coverage. Someday we will fix the system. When we do it, it will be the result of more than 50 years of efforts by Richard Nixon, Jimmy Carter and Bill and me.

OpEd: Opposition to reform are "theologically-held" opinions

The historical odds were against Bill because attitudes about health care reform were diverse, even among Democrats. As one expert put it, opinions are "theologically held"--this impervious to reason, evidence or argument. But Bill felt he had to show the public and the Congress that he had the political will to move forward and make good on his campaign promise to take immediate action on health care. Reform was not only good public policy that would help millions of Americans. It also was inextricably tied to reducing the deficit.

Preferred healthcare vouchers in 1994

Focus National Efforts on an AIDS Vaccine

As of June 1998, researchers have evaluated 27 vaccine candidates. And in February 1999, NIH-supported investigators initiated the first AIDS vaccine trial in Africa.

Patients' Bill of Rights: right to know all medical options

Now, I've ordered these rights to be extended to the 85 million Americans served by Medicare, Medicaid, and other Federal health programs. But only Congress can pass a Patients' Bill of Rights for all Americans. Now, last year, Congress missed that opportunity, and we must not miss that opportunity again. For the sake of our families, I ask us to join together across party lines and pass a strong, enforceable Patients' Bill of Rights.

Managed care plans save money & improve care

160 million of our fellow citizens are in managed care plans. These plans save money, and they can improve care. But medical decisions ought to be made by medical doctors, not insurance company accountants. I urge this Congress to reach across the aisle and write into law a consumer bill of rights that says this: You have the right to know all your medical options, not just the cheapest. You have the right to choose the doctor you want for the care you need. You have the right to emergency room care, wherever and whenever you need it. You have the right to keep your medical records confidential. Traditional care or managed care, every American deserves quality care.

Protect children from the epidemic of teen smoking

OpEd: single-payer advocates opposed 1990s healthcare

Yet, without enthusiasm, I've decided to support Bill Clinton for president. If Bob Dole were to be elected president, there would be an unparalleled war against working people.

Do more for health insurance

But we have to do more. First, we should provide assistance to unemployed workers to help them keep their health insurance until they find a new job. We also need to make it easier for small businesses to buy into insurance risk pools that are large enough to make it possible to offer coverage at a reasonable cost.

We cannot get deficit to zero until we address health costs

Managed competition, not socialized medicine

CLINTON: Mr. Bush made that charge. Bush is trying to run against Lyndon Johnson and Jimmy Carter and everybody but me in this race. I have proposed a managed competition plan for health care. You cannot control health care costs simply by cutting Medicare. If you don't control the health care costs of the entire system, you cannot get control of it. Look at our program. We've set up a national ceiling on health care costs tied to inflation and population growth set by health care providers, not by the Government. We provide for managed competition, not Government models, in every State, and we control private and public health care costs.

BUSH: Gov. Clinton failed to take on the malpractice suit people, these frivolous trial lawyers' lawsuits that are running costs of medical care up by $25 billion to $50 billion. He refuses to put any controls on these crazy lawsuits

Establish "report cards" on HMO quality of care.

Promote Universal Access and Quality in Health Care
That more than 40 million Americans lack health insurance is one of our society’s most glaring inequities. Lack of insurance jeopardizes the health of disadvantaged Americans and also imposes high costs on everyone else when the uninsured lack preventive care and get treatment from emergency rooms. Washington provides a tax subsidy for insurance for Americans who get coverage from their employers but offers nothing to workers who don’t have job-based coverage.

Markets alone cannot assure universal access to health coverage. Government should enable all low-income families to buy health insurance. Individuals must take responsibility for insuring themselves and their families whether or not they qualify for public assistance.

Finally, to help promote higher quality in health care for all Americans, we need reliable information on the quality of health care delivered by health plans and providers; a “patient’s bill of rights” that ensures access to medically necessary care; and a system in which private health plans compete on the basis of quality as well as cost.

Goals for 2010
• Reduce the number of uninsured Americans by two-thirds through tax credits, purchasing pools, and other means.
• Create a system of reliable “report cards” on the quality of care delivered by health plans and providers.