EVERYBODY learned from Hillary's mistakes. That doesn't mean squat. What matters is this: Will she try to push for a transformative reform, or is one of the lessons she learned that that just doesn't work?

Edwards and Obama have indicated they're ready to go for a major overhaul. They may fail. But we can't compare these candidates until she puts a real plan on the table, so that we can judge them all on both policy and political grounds.

She also needs to get across to the American public just how evil the drug companies are:

This week health secretary Alan Johnson announced that he wasn't going to stick by the pharmaceutical price regulation scheme that lines the pockets of the drugs industry. You only have to say those words to trigger my favourite three-minute dinner party package: how evil is big pharma?

In the UK, the pharmaceutical trade is the third most profitable activity after finance and - this will surprise you if you live here - tourism. We spend £7bn a year on pharmaceutical drugs, and 80% of that goes on patented drugs - medicines released in the last 10 years. In 2002, the 10 US drug companies on the Fortune 500 list had combined international sales of $217bn (£106.6bn).

They spent only 14% of that money on research and development, but 31% on marketing and administration. They are very careful not to let anyone see how much goes on marketing and on administration. Whenever you hear the drug companies explaining why they have to charge so much for their products - perhaps as they are denying their lifesaving Aids drugs to the 20 million HIV-positive people in Africa - the plea is that they need money to develop new drugs. That's not true if they spend twice as much on marketing as on research and development. This unhappy collision of facts makes them look very evil indeed.

They also charge this money in slightly evil ways. Drugs have 10 years "on patent." Loratadine is an effective antihistamine drug that does not cause drowsiness. Before the patent ran out, the price of this drug, by Schering-Plough, was raised 13 times in the US in just five years, increasing by over 50%. This is not a price rise in keeping with inflation. This is evil.

The reason I mention this is that one of the longtime knocks against Hillary Clinton has been the failure of her 1994 healthcare plan, for which she deservedly gets plenty of blame.

Really? Since when? Seriously, except on the right, I've not seen much criticism of her for the 1994 plan or its failure.

I've seen her more often knocked by Democrats for being a big recipient, now, of health insurance industry cash than for anything related to 1994.

It's not enough to have a plan, you need to have a political strategy, too.

Obvious, but just as true when reversed: a political strategy without a good plan gets you nowhere.

It's imperative that as we go forward we put together a coalition of as many groups who'll be affected — doctors nurses, hospital administrators, etc — as possible, and steel them to withstand the incredible blowback we'll get from the drug companies and insurers. In other words, you need a proactive, sympathetic coalition able to create a counterweight to industry forces.

Well, no, the only affected group you need to get behind you is healthcare consumers. The others may or may not be of instrumental utility in doing so, but getting those other special interests behind it is of secondary importance.

I learned a lot about the tactical end of things. I don't have the time in 90 seconds to tell you of all the mistakes I made, but being in the Senate has taught me an enormous amount about how to marry my proposal with the process.

This would be a lot more reassuring if there was evidence to hold up from her Senate career of her moving forward progressive programs against resistance, but succeeding because of her mastery of the process.

This will be my highest domestic priority.

And yet, its not even the number 1 domestic issue on her website "Issues" list; if it was her highest domestic priority, why wouldn't it be? Could she be telling the YKos audience what she thinks they want to hear?

And, anyhow, she provides no clue about what she would do about this "highest domestic priority", just the empty assurance that she is better at strategy than anyone else. She has set herself up to attack any substantive plan without offering anything.

Like Nixon and the secret plan to end the war in Vietnam, Hillary's discovered at least one well-worn truth of political strategy: its hard to attack a plan that isn't revealed (or doesn't exist).

Edwards and Obama both both have put forward plans of what they would do to make healthcare more accessible.

Hillary offers nothing of what she would do, only points to the past and makes claims of experience and bipartisanship and readiness to lead.

Well, if she is ready to lead she should start leading and stop just hanging back and sniping. But if she won't risk the criticism that the outline of a plan would provoke during a campaign, what would make anyone believe she would risk the criticism that an actual effort to enact a real, substantive plan would provoke when she was in office?

You as if she's gun shy and afraid to push the issue again, and I say show me a reason to believe that she isn't. She's the only serious Democratic candidate without even the outline of a plan. How else do you explain that?

But we can't compare these candidates until she puts a real plan on the table, so that we can judge them all on both policy and political grounds.

Sure we can. We can compare the candidates that have a plan to offer with the one that has nothing but platitudes.

Didn't HRC say she won't tackle health care until her second term(provided she wins either)?

The United States will never have single-payer health care. The multinational corporations won't allow it, and our government became dominated (i.e. corrupted) by corporations sometime for good in the '70s-'80s. It is too late to undo the damage now -- hundreds of thousands of deaths of the uninsured do not even matter, the poor don't matter, and the lower-middle class do not matter. This is now a country where only the upper-middle class and above can prosper, and until we get up the courage to overthrow the whole stinking, fucking bunch via a revolution -- unlikely anytime soon -- the US is no longer a place for the common person. It is now a parody of unregulated capitalism, a place for thieves and the unethical and the emotionally dead, and the sooner you accept it the quicker you will be able to escape. Stop pretending the Democrats will do anything differently -- they did not in the 90s, they are not doing so now in Congress, they are part and parcel of the corruption and disgusting shitpile that this country has become. Get out while you still can.

I was formulating a response when I came across Douglas' post and I think he has the full measure of the problem. I support single payer health care reform, but I see no way that the insurance companies, or the drug companies for that matter, will ever allow such a radical reformation in my lifetime. I do see some large corporations backing a national health care proposal of some sort, but I suspect it would be nothing more than a lite version of universal health care.

I watched Sicko and I also followed the dust-up between Michael Moore, CNN, and Sanjay Gupta and I checked my figures for the past 2 years and I found that Moore's numbers were, for my situation, almost spot on.

Say what you will, but the 40Mil or so uninsured is a travesty. Mandating insurance will not help if people cannot afford the premiums, and I think that this would be the case. I use a health savings account and it works well for me, but I am able to set aside $150/month to fund the account. I'm not convinced that lower wage earners could do this.

Mmmm, the topic of the high cost of drugs will wait for another day, but this is another area which is ripe for change.

Douglas, so why are you still here?

What cmdicely said.

Why should we believe anything Hillary says? It's a conundrum. The fact that the wife of a former President believes she is the best candidate for President is sufficient evidence that her judgment is flawed.

Venture capital, eh? That's creative.

It sounds like Kevin is as eager to make excuses for Bill Clinton's wife as the Weekly Standard is for George Bush. And they're the same kind of excuses -- no, what happened wasn't what we wanted, mistakes were made, but our heroine has learned, and will do whatever it is she decides to do so much better than she did the first time.

The excuses are convincing, at least to those who already believe, they concede responsibility without accepting blame -- and they're renewable resources! They can be used over and over again, because learning just never stops. And they will be, over and over again.

Was it 80 0r 90 percent of congressman who voted against Hillary's bill said that they had not read it.
Remember when William Kristol or Newt Gingrich or both said that under no circumstances let the Democrats pass a health plan.
Remember the wonderful reception Hillarty received in Congress until the word came down
KILL IT.

The United States will never have single-payer health care. The multinational corporations won't allow it, and our government became dominated (i.e. corrupted) by corporations sometime for good in the '70s-'80s. It is too late to undo the damage now -- hundreds of thousands of deaths of the uninsured do not even matter, the poor don't matter, and the lower-middle class do not matter. This is now a country where only the upper-middle class and above can prosper, and until we get up the courage to overthrow the whole stinking, fucking bunch via a revolution -- unlikely anytime soon -- the US is no longer a place for the common person. It is now a parody of unregulated capitalism, a place for thieves and the unethical and the emotionally dead, and the sooner you accept it the quicker you will be able to escape. Stop pretending the Democrats will do anything differently -- they did not in the 90s, they are not doing so now in Congress, they are part and parcel of the corruption and disgusting shitpile that this country has become. Get out while you still can.

You read my mind, Douglas.

doc wrote:
> Douglas, so why are you still here?

Doc, it is not trivial to leave one's homeland. There is family to consider, and friends, and traditions that matter, and moving abroad involves lots of applications and (esp.) money and it not trivial for even the middle class. And I am poor.

But a guy can dream, can't he?

Just sitting here admiring the frankness of "I don't have the time in 90 seconds to tell you of all the mistakes I made".

Awaiting the Republican partisan crowd who appreciates one of their own saying the same thing (should one of their candidates admit it).

...chirp...chirp...chirp...

Interesting! Her highest domestic priority.

If I really believed that, I'd vote for her despite all the other reasons I don't want to vote for her.

But I don't believe it.

It's both interesting and telling that she apparently left unions out of the list of groups required to pass health care legislation. During the last hundred years there were few, if any, progressive laws dealing with economic issues that ever passed without support from labor (i.e., minimum wage, Medicare, Medicaid, Social Security and civil rights in the non-economic arena).

Maybe this means she's taking them for granted? If so, it's not too wise.

Her highest domestic priority.

Unfortunately I think most of the 2009-2012 period will be spent dealing with the mess in the Middle East. A great many controversial domestic initiatives will be sacrificed unless the Dems get a landslide in the 60/40 range, along with at least 5 more senators and 20 more representatives.

It could happen, though. Bush show no signs of relenting on his program of Screwing Up The Known Universe.

She also needs to get across to the American public just how evil the drug companies are:

This is just silly. Drug companies are NOT evil.

They just happen to demonstrate some attributes that have undesirable consequences, such as making some medications very expensive, while other attributes (developing substances that save lives and cure disease) that are most welcome. It's not their fault that the US has a dysfunctional healthcare delivery system that renders America their principal global profit center.

well, if she is ready to lead she should start leading and stop just hanging back and sniping.

i couldn't agree more. her constant bickering w/obama, instead of pointing out the problems that the republicans are creating, has turned me off of any chance that i might consider her as a candidate.

It would be interesting if ALL the Dem candidates agreed and adopted the SAME single-payer plan and let the voters choose between them only on their *other* policy differences-to provide a *unifying* message of hope to the country to overturn the cynicism. I think if you had that kind of PARTY UNITY then you could get this done.. That would help break the deadlock and show a commitment by the Democrats. It also wouldn't hurt if you got a few TV/Radio/etc ads from the Democratic party that pushed that COMMON MESSAGE. Come on people! You could use the Beatles "It Won't Be Long" for background music. It would be killer.

The world and our challenges have moved far beyond the 1990's. It is time to move beyond the illusion that we can go forward by reaching backward. The idea of continuing the vicious circle of Bush, Clinton, Bush, Clinton is so arthritic and stagnant that it smells.

What cmdicely said. (It's usually hard to go wrong with those words, but this time s/he is particularly on target.)

Despite her assurances, Hillary acts like she's still gun-shy from 1994. She's been the epitome of caution ever since.

This includes her current campaign, where she's put forth almost nothing in the way of solid proposals about our major problems.

Hillary's running on being Hillary. She seems to be intent on saying as little as possible that could be criticized from the right, in particular. It's almost a stealth campaign in plain sight.

Hillary's new plan seems to be "if you can't beat 'em, join 'em".

Not a big HRC fan. But I just wish someone would point out to me what the "value-added" is that private health insurers bring to the table. Seems like all the "serious" proposals end up being some rube-goldbergian contraption built around the idea that these firms have to be involved. Far as I can see, they add administrative overhead without adding value. Quite the opposite, in fact, since their only motivation is to limit people's access to care in order to maximize profits. If they did this in a way that limited costs throughout the system, that would be a value. But they don't--our costs are higher than anybody's. Nor do they streamline access to care--we already have massive "rationing" going on (millions are uninsured, and even those who are face delays), so that's not a consideration. "Do you want a gubmint bureaucrat administrin' your health care?" is the big scare question. But yes, I do. Because I've currently got a corporate bureacrat adminstrin' it for somebody else's profit, whose motivation is only to say No, and I won't even have access to that system if I lose my job. And I'm a Type I ("juvenile") diabetic, so it's just about impossible for me to get for-profit insurance on my own. Scares hell out of me. The GOP's "plan" is, in short, F*** Off And Die. The "moderate" plans amount to something somewhat short of that. But only somewhat.

The hybrid plans I've seen--such as the one here in Massaclueless--are massively overcomplicated attempts to keep the privates in the system as the primary source for everyone, simply for the benefit of, well, keeping the privates in the system. I never see anyone in the major media's discussions of this ask the question head on: Why? What value do they add? Does anyone really believe a coporate bureaucrat is better than a gubmint one?

Sorry for the back-to-square-one kind of post, but I get so infuriated by the discussions even on NPR that just never seem to address this question. Sigh.

It really would be nice to see a lot of documentaries on the networks or cable-news that delve right into the issue of private health insurers-60 minutes with few commercials-NOT fast food 20-second bits on CNN or Fox. If the universal health care issue was as hot in the '70s as it is now, it would have been all over the TV and radio then. I remember Dick Cavett, Phil Donahue and Tom Snyder back then-they seriously tried to cover the issues of the day in depth. Dick Cavett's hosting of the debate between John Kerry and that Swift Boat lawyer (can't remember his name) in 1971 was absolutely priceless. He went so far to keep the debate as fair as possible that they divided up the audience into two halves of supporters. Coulter gets an entire audience of supporters to herself on Leno.. WTF?

Briefly, aside from whether Hillary is the one trying it out or not: Can't we make something better than what we have for healthcare, without specifically just copying what they do in blank country and the associated weaknesses thereby? There has to be a better new alternative, right?

Neil B., I think we actually will end up crafting something a bit different than anybody else. I would give a near zero chance that we will adopt something like Britain's NHS-i.e., the government will not be in the business of *providing* the care. I also strongly doubt that we will do much to limit physician's fees and will prefer instead to increase the *supply* of general care providers specifically and more physicians and P.A.'s generally through student loan repayment tweaks.

The big elephant in the room is what proportion will the public/private mix of insurers be? Single-payer/single-plan, Opt-in to Medicare for everybody, Medicare for older workers, private insurance only with mandates, regulation, etc? Once the involvement of public insurance is decided-then it's a question of how much GDP are we going to burn. Keep it at 16% and have better care for everybody, or perhaps cut it to 12% and have about the same care for less cost, etc... ?

Have you checked out the plan over at EPI put together by Jacob Hacker? It's called Healthcare for America.
http://www.sharedprosperity.org/bp180.html

Although I am a single payer all-the-way type, and I still think that would be the best way to go, Hacker's proposal makes alot of sense. It gets us moving in the right direction, it doesn't further entrench the insurance cos. or big pharma, and it affordably covers everybody.

Crucial: get started on creating a national insurance pool:
-it creates a big national insurance pool (approx half the pop) immediately, (basically everyone who doesn't have good coverage at work) and a good, basic set of benefits without regard to prior conditions, etc

Affordable, portable
-it allows employers to either cover their employees with private insurance that must be at least as good as the national basic benefit or they must enroll their employees in the national system and help pay for it through payroll taxes. Employees pay $0 if they are at or below 200% of the poverty line and modest amounts, up to eg $18/week for singles once they hit 300% of poverty line and that is the top rate.

Although it's true that the whole economy still has to bear the 15% of GDP we use on health care, it won't all show up on the federal budget in one step.

People only pay if they have an income stream. And, people who have good plans at work, can still keep their tax free benefit. People who lose their private coverage for any reason, will be covered in the national plan.

-it allows complete choice of providers, ie you pick your doctor, and puts strict limits on out-of-pocket costs

-the plan is NOT byzantine, it's straightforward and understandable

-it is NOT coercive, ie go after people with big fines if they don't enroll; rather it will encourage the states to enroll people if they have no insurance

-the plan helps to control costs through admin efficiency (the large pool will have low overhead) and the use of buying (bargaining) power for drugs, etc The plan also targets well-child screenings and other preventive efforts.

I have to confess that I was skeptical of a non-Single Payer plan, but it sounds very reasonable to me, and it's self-reinforcing in the direction of a large insurance pool.
Go check it out.

"... how to marry my proposal with the process. This will be my highest domestic priority."

Her highest priority will not be health care reform, it will be "how to marry her proposal with the process".

She just wants to be able to get legislation through. She isn't really bothering to tell us what exactly she might want to do. She'll read the polls and listen to the focus groups and follow their lead.

If America wants LEADERSHIP, forget Hillary.

She's got name recognition and the media seem okay with that. They only mention Edwards in passing and now they're trashing Obama. No favoritism there, eh?

America doesn't seem to have Democracy. If we did it wouldn't always be the candidate who receives the most corporate money and all the corporate media airtime who has the best chance to win.

They keep making it harder and harder for me to believe in the myth of Democracy. Sigh...

Living in Iowa now and taking advantage of the opportunity to see and hear from (almost) all of the candidates as they stump through the state, I have to say that HRC impressed me the LEAST... and it's the infuriating vagueness described above that kills that buzz the fastest.

She gets up, runs trippingly through her stump speech, signs autographs in a cocoon flanked by her SS detail and leaves. No questions, no extemporaneous ramblings, no details.

It was 40 minutes of vapor (We deserve health care, we need to rethink the Iraq situation, I'm a leader dammit) but seriously... they all say those things. The difference is that some candidates (like Edwards and Richardson) actually drill down to explain how to get from A to B. And if I have to listen to a candidate tell us "rural folks" how charming and hard-working we are without bothering to mention policy issues and solutions I'd like to do it without the Hillary sticker so I don't feel cheap.

Even setting aside Bush> Clionton> Bush> Clinton for a second... what was so outstanding the first go-round about your contributions in the white house that you are what we need now?

I remember Sen Clinton's attemp at Health Care Reform very well. Her mistake was in trying to actually worw'wilth' the Insurance industry to accommodate their 'needs'. After the plan was agreed upon by all parties, including the Insurance mercenaries, and Ms Clinton began to roll it out, the Insurarance Bastards harpooned her with the series of 'Harry and Louise Ad's' dricryng 'Socialized Medicine'
It was a total set-up! Never mind what Big Phama's hand in the whold thing was. YES, the give money to her campaign now because they are probably SCARED TO DEATH SHE IS READY TO GET EVEN!!! I personally hope she wraps a live electrical cord around their collective balls and drags them underwater. Ah but this is the stuff of dreams