MANAGED CARE October 2000. ©2000 MediMedia USA
True, there are more uninsured now than there were seven years ago. True, health care alliances and employer mandates failed to materialize. True, no National Health Board was ever created to monitor the functioning of employer health alliances.
Yet, yet...
A caption under the photograph of President Clinton on this month's cover could easily read "Gottcha!" Much of what he and Mrs. Clinton tried to push through Congress in the Health Security Act has squeaked through states and the public sector, as our cover story [1] by Contributing Editor Michael Levin-Epstein makes clear. The plan is being enacted minus the bureaucracy, but also minus the spirit of competition and universal coverage.
Those who decried the effort as just so much sound and fury may not have been too far off the mark. The sound and fury points to the debates that raged around the effort. But while Mrs. Clinton lost, parts of her proposal have a life of their own.
As Rep. John Cooksey of Louisiana says, Mrs. Clinton deserves credit for getting many serious issues into play. She may be as responsible as anyone for any movement on health care policy that is taking place.
She may, also, be responsible for the slow pace of change. Mrs. Clinton got burned, as they say, and her name and health reform are often joined as a pejorative.
America clearly doesn't want a government-imposed system.
Unless, of course, managed care's track record forces the issue. A recent report by the Institute of Medicine says that each year 50,000 to 70,000 adults are killed by diseases that could be prevented or mitigated by vaccines. Here's where managed care can really step in and, through disease management, make a difference.
It should be remembered that "HillaryCare" was killed by fear and that is an emotion that cuts both ways.