Health Care

WomenMatter will continuously post updates on all this and other issues as we monitor the continuing philosophical and practical debates nationwide. Please check back often for updates. Past updates are available for reference on the Healthcare Archives page.

Hillary on Health Care: A Review

On April 18, 2004, The New York Times magazine published an article about healthcare by Hillary Rodham Clinton.

At the substantial length of 5000+ words, many women didn’t have the time to read the piece, so WomenMatter has decided to provide a summary. Though WomenMatter remains nonpartisan and therefore does not endorse Senator Clinton or any other office holder or candidate, we at WM report daily on positions taken by knowledgeable people in and out of government. We feel it is important for our readers to be aware of Senator Clinton’s comprehensive analysis. She has examined the problems we all face when we take our child, parent, or selves to the doctor, and her conclusions are worth consideration.

Senator Clinton calls both sides to the table and proposes new ways to approach health care issues. She encourages Democrats and Republicans to have fresh and creative attitudes and to begin a dialogue based on common goals.

Identifying the problem

To Clinton, the current focus is all wrong: insurance companies are trying to limit risk by refusing the sick and insuring the healthy while doing little to promote healthy lifestyles

Senator Clinton identifies a variety of problems with our health care system. Primarily, she outlines the ways in which it is out of date with our current health needs and health care technology.

In one of many examples, she explains how scientific innovation has led to greater understanding of genetic information. That information has the potential to aid in the prevention of disease, but instead, genetic profiling is often used to prevent access to health insurance. Clinton notes that many people decline genetic testing for fear of higher insurance premiums, though testing could help a patient and her doctor better manage her health.

New technologies also provide us with improved ways to administer and store information. She points out that such technology, like the Internet, has not yet been utilized in the management of medical records. According to Clinton, the current system is inefficient. For example, millions of dollars are spent on redoing tests because previous results were unavailable.

She further underscores the disconnect between technological innovations and medical treatment when she cites a government study that discovered that it takes 17 years for a medical breakthrough to make its way to medical treatment. "Why not 17 seconds?" she asks.

Further, technology has created a new lifestyle that the old health care system is struggling to sustain. Clinton argues that computers, cars, appliances, and other conveniences have helped to create a sedentary culture. Junk food, pollution, risky behaviors like unprotected sex, and the fast pace of contemporary life are contributing to a rash of modern epidemics, like obesity, asthma, AIDS, and mental illness, respectively. Clinton says that the health care system is not doing much in terms of prevention, though all of the above illnesses can be prevented to some extent.

Approaching a solution

Senator Clinton recognizes that there is no single solution to the host of problems with current health care. However, she offers new approaches to several problems that have gone stale in Congress.

1. Change health care delivery. Clinton suggests restructuring health care so that it is patient-focused and health-focused, not provider-focused. One way to do this, she says, is to “shift toward rewarding doctors and health plans that treat patients with their long-term health needs in mind and rewarding patients who make sensible decisions about maintaining their own health."
2. Change health care records. Clinton proposes a "personal health record" controlled and utilized by the patient to track her own health as well as the latest health information available. Clinton sees the Internet as an invaluable but unused tool and notes that Newt Gingrich agrees (and they seldom agree) that technology could make the administrative side of health care more efficient. Modernizing health care records could limit errors and malpractice suits, she says.
3. Change of focus: prevention. "We tend to address health care - as a nation and as individuals - after the sickness has taken hold, rather than addressing the cause through public health." Clinton promotes public health programs to slow preventable disease. She believes that preventing disease is an individual’s responsibility, but disease prevention must be reinforced through national policy.
4. Change the environment. Clinton recommends that the government track pollutants and contaminants and study cancer clusters in various communities. She believes that government should be testing chemicals before they are available to consumers, instead of after consumers develop related illnesses. Further, she is in favor of protecting open spaces because the natural environment promotes good health. (i.e. outdoor recreation, access to grass, trees, a little sunshine!)
5. Change the system. Ultimately, Clinton proposes a universal health care system in which every American would have health insurance and access to health care. This, of course, is one place where she diverges from Republican opponents and enters into a common party-line debate. However, her defense of universal health care is inventive in that she cites globalization as a reason for change. Clinton explains that our economic rivals have national health care systems that are tremendously efficient when compared with our employer-based system. She recognizes that there is no clear and direct connection between employment and health care, and that linking the two may actually put American businesses at a competitive disadvantage. Clinton also remarks on the connection between racial and ethnic minorities and lack of health coverage, an under-emphasized point in the health debate. Clearly, a universal health system would help to detach health from jobs and race from health care.
6. Change how we view risk. Clinton comments on the way that different perspectives of risk result in different perspectives of health care. When the price for health coverage reflects individual risk, those who are at high risk for health problems (those who need coverage the most) are out priced. When healthier people pool their risks with unhealthier people, those who need health care are more likely to afford it, seek it, and receive it, and will be less likely to resort to emergency care (the most expensive form of care). To Clinton, pooling risk means greater health security.

The last two proposals are likely the most controversial, but taken together, her list of suggestions sketches out a meeting place for legislators.

Clinton emphasizes the health care accountability of the individual, but also encourages a bridge of responsibility between individual and government, a partnership that uses technology and prevention to promote wellness.

Discuss Hillary Clinton’s ideas with other WomenMatter readers. Log on to one of our online forums. Sign up for an e alert if health care is important for you. And don’t forget to register to vote and contact your representatives!

Posted on: 4/26/2004

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