Despite the contrary evidence of public opinion polls, the concept of Canadian-style single-payer insurance was dismissed early. Tom Hamburger and Ted Marmor in the Washington Monthly tell of a single-payer proponent being invited to the White House in February 1993. It was, he said, a “pseudo-consultation;” the doctor was quickly informed that “single payer is not politically feasible.” When Dr. David Himmelstein of the Harvard Medical School pressed Mrs. Clinton on single payer, she replied, “Tell me something interesting, David.”
In other words, write Hamburger and Marmor: “Fewer than six weeks into the Clinton presidency, the White House had made its key policy decision: Before the Health Care Task Force wrote a single page of its 22-volume report to the President, the single payer idea was written off, and “managed competition” was in.”
If there was any popular, grassroots demand for “managed competition” it never appeared. Managed competition had not been tested anywhere. Nonetheless, reported Thomas Bodenehimer in Nation:
“Around Hillary Rodham Clinton’s health reform table sit the managed-competition winners: big business, hospitals, large (but not small) commercial insurers, the Blues, budget-worried government leaders and the ‘Jackson Hole Group,’ the chief intellectual honchos of the managed competition movement. . . Adherence to the mantra of managed competition appears to be the price of a ticket of admission to this gathering. “
What was finally proposed involved a massive transfer of the American health industry – by some accounts now larger than the military-industrial complex – to a small number of the largest insurance companies and other major corporations. These were companies that had the assets to play the game being offered – a medical oligopoly that would dispense health-care under the rules of the Fortune 500 rather than according to those of Hipprocrates.
Tony Snow, 1994 – [HRC] set out to redesign the American health-care system and convened a panel that drafted its plan secretly — in violation of federal law …. The plan prescribed some eye- popping maximum fines: $5,000 for refusing to join the government- mandated health plan; $5,000 for failing to pay premiums on time; 15 years to doctors who received “anything of value” in exchange for helping patients short-circuit the bureaucracy; $10,000 a day for faulty physician paperwork; $50,000 for unauthorized patient treatment; and $100,000 a day for drug companies that messed up federal filings …. When told the plan could bankrupt small businesses, Mrs. Clinton sighed, “I can’t be responsible for every undercapitalized small business in America.” When a woman complained that she didn’t want to get shoved into a plan not of her choosing, the first lady lectured, “It’s time to put the common good, the national interest, ahead of individuals.” As for privacy, forget it: Her plan would have required people to carry national identification cards that embedded confidential patient information on computer chips.