Hillary Clinton on Health Care

Democratic Jr Senator (NY)

Health care initiatives are her first priority in Senate

In her first address from the Senate floor, Hillary Clinton offered an agenda of health care initiatives, casting herself as a moderate on the very issue that resulted in one of her most embarrassing defeats as first lady. The Clinton administration’s failed attempt to overhaul the nation’s health care system was widely derided at the time as big-government liberalism. She said that the experience [taught her] “the importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done,“ she said.

She called for expanding eligibility for the government-run Children’s Health Insurance Program. Her plan, she said, would enable roughly five million more children to enroll. Clinton also proposed financial bonuses as a reward to states that aggressively enroll more children in the program. And she called for establishing a new national health insurance program for low-income families that is modeled after a NY program. She offered no details in her speech.

Source: NY Times, p. A22 Feb 13, 2001

Health goal is affordable coverage for all

Q: Would you support a universal health care bill?

CLINTON: We need to take step-by-step progress toward providing insurance for every American. I’d expand the Children’s Health Insurance Program. I’d allow people between 55 and 65 to buy into Medicare. I want to see mental health considered on parity. He’s opposed the “patients’ bill of rights” that is supported in a bipartisan coalition, as well as by 300 medical and health groups. And he’s gone for the GOP version of the prescription drug benefit, which wouldn’t cover 650,000 New Yorkers.

LAZIO: Mrs. Clinton’s plan in 1993 would have been an unmitigated disaster. No New Yorker would ever have written a bill that would have led to 75,000 jobs being destroyed, health care rationing and the destruction of many of our teaching hospitals. I have supported doubling the amount of money that we spend on health care research. I have voted for deductibility for those employees who are not covered by an employer’s plan.

Source: Senate debate in Manhattan Oct 8, 2000

Fund teaching hospitals federally because market fails

Q: In 1993, why did you recommend measures that would have hurt New York’s teaching hospitals?

CLINTON: Senator Moynihan was absolutely right to propose a piece of legislation that would guarantee that our teaching hospitals will be funded to perform the functions that they do which can not be performed within the market at a profit, namely, training our doctors and nurses and providing health care for the sickest of the sick and doing the research we all benefit from.

LAZIO: You know, a New Yorker would never have made that proposal. Mrs. Clinton has had two opportunities - two opportunities to make policy: One on health care and one on education. And on health care it was an unmitigated disaster. It would have led to health care rationing. It would have destroyed teaching hospitals. It would have led to all types of unintended consequences, perhaps. But the bottom line is it would have been terrible for New York.

Source: Clinton-Lazio debate, Buffalo NY Sep 13, 2000

Learned lessons on health care; but hasn’t given up goal

You may remember I had a few ideas about health care. I’ve learned a few lessons since then. But I haven’t given up on the goal. That’s why we kept working step by step to insure millions more kids through the Children’s Health Insurance Program. And that’s why it’s time to pass a real Patients’ Bill of Rights and provide access to affordable health care for every single child and family in this country.
Source: Address to the Democratic National Convention Aug 14, 2000

Regulate tobacco; fine of $3000 for every underage smoker

By regulating tobacco products, we can make sure that the tobacco industry is not allowed to target our kids with their deadly products. If elected, I would work on legislation to regulate tobacco. I would also assess the Tobacco Industry $3,000 for every underage smoker if youth smoking is not lowered by 50% by 2004.
Source: Remarks at New York City Annual Kick Butts Day Apr 5, 2000

Smaller steps to progress on health care

In 1993, Hillary chaired the Task Force on National Health Care Reform. After months of meeting with families & health care professionals, the Task Force recommended the Health Care Security Act of 1994. “I am disappointed we were not able to make more progress.” Hillary said. “Now I’m from the school of smaller steps, but I believe we must continue to make progress. It’s still important that we increase access to quality health care for working families.”
Source: www.hillary2000.org “About Hillary” Jan 1, 2000

Health care reform is key to a “new politics of meaning”

[In 1993, in her first speech following her father’s funeral], Hillary grappled with questions raised by medical technology: When does life start? When does life end? Who makes those decisions? Moving into policy questions: How do we get rid of regulation & bureaucracy, and substitute instead human caring, concern & love? She cast health care reform as critical to a broader search for a “new politics of meaning” in a society she said had failed to confront technological change & spiritual decay
Source: Hillary’s Choice by Gail Sheehy, p.234 Dec 9, 1999

Universal coverage, cost containment, & managed competition

In 1993, Hillary’s Health Care Task Force was running into major obstacles. The first one was self-inflicted. Given Hillary’s penchant for secrecy, doctors were shut out of the task force’s deliberations, as were lobbyists and journalists. Behind closed doors, Hillary began working toward her vision: universal coverage, cost containment, more primary care physicians, managed competition, and global budgeting. In effect, Hillary was attempting to reform a system larger than the entire economy of Italy.
Source: Hillary’s Choice by Gail Sheehy, p.235 Dec 9, 1999

Proposed Natl Health Board to oversee employee cooperatives

Hillary’s 1993 plan for managed competition would band employers and employees into huge cooperatives with the bargaining power to challenge the insurance industry. It would force doctors, hospitals, and insurers to form partnerships in order to compete in offering the highest-quality health care at the lowest cost. The new competitive health marketplace would be overseen by a National Health Board.
Source: Hillary’s Choice by Gail Sheehy, p.240-241 Dec 9, 1999

Be prepared with defenses against infectious disease

We need to be as well prepared to defend ourselves against public health dangers as we should be to defend ourselves against any foreign danger. The Republicans are sending a message that we don’t need to be prepared. for early detection of infectious outbreaks like encephalitis or the West Nile-like virus.
Source: Remarks at Fordham University, Armonk Oct 14, 1999

Medicare should be strengthened today

We must extent Medicare’s life by an additional decade and offer a prescription drug plan. We have the means to do it today.
Source: Remarks in Great Neck, Long Island Sep 14, 1999

Work toward affordable universal health care

There are 41 million people without health insurance. Who will take care of these people in the future? How will we pay for their care? How will we pay for the extra costs that come when someone is not treated for a chronic disease or turned away from the emergency room? The job of health care reform cannot be done when access to care depends on skin color or the neighborhood they live in or the amount of money in their wallet. Let’s continue to work toward universal affordable, quality health care.
Source: Harvard Medical School Address Jun 4, 1998

Medicare is biased against nursing home alternatives

The problem for Americans in the Medicare program is there is no support for alternatives to nursing home care. We want to provide long-term care options, so that families will not be forced to put their family members in nursing homes.

Providing a home health aide, giving some respite to the full-time caretaker of an Alzheimer’s patient, that is all much cheaper than putting the person in a nursing home. Let’s enable older people to live with dignity.

Source: Unique Voice, p.161: Speech at Washington University Mar 15, 1994

Stupid to spend on administration rather than on doctoring

We have the finest doctors and hospitals in the world. We spend money on paperwork, we spend money on bureaucracy, that we shouldn’t have to spend. What the president’s plan is designed to do is to put doctors back in charge of the system, where they can be making the decisions, not insurance company executives or government, which is the way it is too often today.
Source: Unique Voice, p.154: Speech to American Legion Conference Feb 15, 1994

Guaranteed benefits & focus on prevention

I know no way to attempt what we are doing; to achieve universal coverage, to guarantee a comprehensive benefits package, to begin to simplify a system that has become much too cumbersome, bureaucratic, and overregulated, to attempt to begin to achieve savings and eliminate inefficiencies, but at the same time to enhance quality, to guarantee choice.

We should build on the employer system. The employers contribute, those who work contribute, and all of us are thus paying our fair share.

Source: Unique Voice, p.165: Speech at Institute of Medicine Oct 19, 1993

Americans want system with quality & choice

We have looked at every other system in the world. We have tried to talk to every expert whom we can find to describe how any other country tries to provide health care. We have concluded that what is needed is an American solution for an American problem by creating an American health care system that works for America. Two of the principals that underlie that American solution are quality and choice.
Source: Unique Voice, p.149: Speech to American Medical Association Jun 13, 1993

Voted NO on limiting medical liability lawsuits to $250,000.

A "cloture motion" cuts off debate. Voting YEA indicates support for the bill as written, in this case to cap medical liability lawsuits. Voting NAY indicates opposition to the bill or a desire to amend it. This bill would "provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system." It would limit medical lawsuit noneconomic damages to $250,000 from the health care provider, and no more than $500,000 from multiple health care institutions.
Reference: Medical Care Access Protection Act; Bill S. 22 ; vote number 2006-115 on May 8, 2006

Voted YES on expanding enrollment period for Medicare Part D.

To provide for necessary beneficiary protections in order to ensure access to coverage under the Medicare part D prescription drug program. Voting YES would extend the 6-month enrollment period for the Prescription Drug Benefit Program to the entire year of 2006 and allows beneficiaries to change plans once in that year, without penalty, after enrollment. Also would fully reimburse pharmacies, states and individuals for cost in 2006 for covered Medicare Part D drugs.
Reference: Medicare Part D Amendment; Bill S Amdt 2730 to HR 4297 ; vote number 2006-005 on Feb 2, 2006

Voted YES on increasing Medicaid rebate for producing generics.

Vote on an amendment that removes an increase in the Medicaid deduction rebate for generic drugs from 11% to 17%. The effect of the amendment, according to its sponsor, is as follows: "This bill eliminates the ability of generic drugs to be sold using Medicaid. Over half the prescription drugs used in Medicaid are generic. Because we have raised the fees so dramatically on what a generic drug company must pay a pharmacy to handle the drug, pharmacies are not going to use the generic. In the long run, that will cost the Medicaid Program billions of dollars. My amendment corrects that situation." A Senator opposing the amendment said: "This bill has in it already very significant incentives for generic utilization through the way we reimburse generics. Brand drugs account for 67% of Medicaid prescriptions, but they also account for 81% of the Medicaid rebates. This is reasonable policy for us, then, to create parity between brand and generic rebates. This amendment would upset that parity."
Reference: Amendment for Medicaid rebates for generic drugs; Bill S Amdt 2348 to S 1932 ; vote number 2005-299 on Nov 3, 2005

Voted YES on negotiating bulk purchases for Medicare prescription drug.

Vote to adopt an amendment that would allow federal government negotiations with prescription drug manufactures for the best possible prescription drug prices. Amendment details: To ensure that any savings associated with legislation that provides the Secretary of Health and Human Services with the authority to participate in the negotiation of contracts with manufacturers of covered part D drugs to achieve the best possible prices for such drugs under Medicare Part D of the Social Security Act, that requires the Secretary to negotiate contracts with manufacturers of such drugs for each fallback prescription drug plan, and that requires the Secretary to participate in the negotiation for a contract for any such drug upon the request of a prescription drug plan or an MA-PD plan, is reserved for reducing expenditures under such part.
Reference: Prescription Drug Amendment; Bill S.Amdt. 214 to S.Con.Res. 18 ; vote number 2005-60 on Mar 17, 2005

Voted NO on $40 billion per year for limited Medicare prescription drug benefit.

S. 1 As Amended; Prescription Drug and Medicare Improvement Act of 2003. Vote to pass a bill that would authorize $400 billion over 10 years to create a prescription drug benefit for Medicare recipients beginning in 2006. Seniors would be allowed to remain within the traditional fee-for-service program or seniors would have the option to switch to a Medicare Advantage program that includes prescription drug coverage. Private insurers would provide prescription drug coverage. Private Insurers would engage in competitive bidding to be awarded two-year regional contracts by the Center for Medicare Choices under the Department of Health and Human Services.Enrolled seniors would pay a $275 deductible and an average monthly premium of $35. Annual drug costs beyond the deductible and up to $4,500 would be divided equally between the beneficiary and the insurer. Beneficiaries with incomes below 160 percent of the poverty level would be eligible for added assistance.
Reference: Medicare Prescription Drug Benefit bill; Bill S.1/H.R.1 ; vote number 2003-262 on Jun 26, 2003

Voted YES on allowing reimportation of Rx drugs from Canada.

S. 812, as amended; Greater Access to Affordable Pharmaceuticals Act of 2002. Vote to pass a bill that would permit a single 30-month stay against Food and Drug Administration approval of a generic drug patent when a brand-name company's patent is challenged. The secretary of Health and Human Services would be authorized to announce regulations allowing pharmacists and wholesalers to import prescription drugs from Canada into the United States. Canadian pharmacies and wholesalers that provide drugs for importation would be required to register with Health and Human Services. Individuals would be allowed to import prescription drugs from Canada. The medication would have to be for an individual use and a supply of less than 90-days.
Reference: Bill S.812 ; vote number 2002-201 on Jul 31, 2002

Voted YES on allowing patients to sue HMOs & collect punitive damages.

Vote to provide federal protections, such as access to specialty and emergency room care, and allow patients to sue health insurers in state and federal courts. Economic damages would not be capped, and punitive damages would be capped at $5 million.
Reference: Bill S1052 ; vote number 2001-220 on Jun 29, 2001

Voted NO on funding GOP version of Medicare prescription drug benefit.

Vote to pass an amendment that would make up to $300 billion available for a Medicare prescription drug benefit for 2002 through 2011. The money would come from the budget's contingency fund. The amendment would also require a Medicare overhaul.
Reference: Bill H Con Res 83 ; vote number 2001-65 on Apr 3, 2001

Invest funds to alleviate the nursing shortage.

Clinton sponsored the Nurse Reinvestment Act

Source: Bill sponsored by 39 Senators 01-S706 on Apr 5, 2001

Let states make bulk Rx purchases, and other innovations.

Clinton signed a letter from 30 Senators to the Secretary of HHS

To: The Honorable Tommy G. Thompson, Secretary, Department of Health & Human Services

Dear Secretary Thompson:

As you know, prescription drug costs have been surging at double-digit rates for the last six years. The average annual increase 1999 through 2003 was a massive 16%, seven times the rate of general inflation.

These increases fall hardest on senior citizens and the uninsured. Their health needs are often great, and their low incomes often make these products unaffordable. They have no ability to use their combined purchasing power to negotiate reasonable prices. Taxpayers pay tens of billions of dollars for the purchase of drugs by Medicaid—an expense that could be reduced significantly if states are permitted to negotiate for the best prices from drug manufacturers.

As you know, the Supreme Court has just ruled that Maine's innovative program to reduce prescription drug costs for the uninsured and senior citizens is not a violation of the Medicaid law. As a result of this decision, Maine can use the combined buying power of Medicaid and individuals purchasing drugs on their own to negotiate lower prices with drug manufacturers. Twenty-nine other states supported the position taken by Maine, and there is broad interest in many states in initiating similar programs.

The Supreme Court's ruling, however, left open the possibility that if the Department of Health and Human Services makes a finding that the Maine program violates the Medicaid statute, the Department's action would be upheld by the Court. We urge you not to intervene to block Maine's program or similar statutes in other states that achieve savings for taxpayers, the elderly, and the uninsured. Such programs must be carefully implemented to assure that the poor are not denied access to needed drugs, but there is no justification for the federal government to deny states the ability to negotiate lower drug prices on behalf of their neediest citizens.

Source: Letter from 30 Senators to the Secretary of HHS 03-SEN6 on May 20, 2003

Rated 100% by APHA, indicating a pro-public health record.

Clinton scores 100% by APHA on health issues

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. APHA is concerned with a broad set of issues affecting personal and environmental health, including federal and state funding for health programs, pollution control, programs and policies related to chronic and infectious diseases, a smoke-free society, and professional education in public health.

The following ratings are based on the votes the organization considered most important; the numbers reflect the percentage of time the representative voted the organization's preferred position.

Source: APHA website 03n-APHA on Dec 31, 2003

End government propaganda on Medicare bill.

Clinton signed a letter from 6 Senators to Directors of Television Networks

Recently, the U.S. Department of Health and Human Services (HHS), through a public relations firm, distributed Video News Releases (VNRs) to numerous local television news stations across the country. These VNRs contain pre-scripted news story packages and B-Roll designed to influence local news station to run stories complimentary of the new Medicare law recently signed by President Bush. However, these VNRs may mislead many news stations because they do not identify that they are produced by the government. In addition, these materials are currently being evaluated to determine whether they are illegal "covert propaganda."

We urge you to immediately warn stations not to use these materials and pull any stories that use them.

These tapes can be identified as follows: Two English-language versions begin with B-Roll of video slides promoting the new Medicare law, followed by interview soundbites from Tommy Thompson, Secretary of the Department of Health and Human Services and Leslie Norwalk, Acting Deputy Administrator of the Centers for Medicare and Medicaid (CMS). Following these soundbites, a complete television news package is run, with a voice-over by a fictional reporter named "Karen Ryan." Following the news package, more B-Roll is provided, including scenes of President Bush's rally at the signing of the bill, scenes from a pharmacy and scenes of seniors playing table games.

It is critical to the credibility of an independent news media that covert government propaganda be rejected for use by news organizations. We also believe that honest government should not resort to such deceptive tactics, and it is our belief that these materials violate the above-mentioned Federal law. Thank you for your cooperation with this request.

Source: Letter from 6 Senators to Directors of Television Networks 04-SEN3 on Mar 15, 2004

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