THE doctor whose ideas formed the basis for the 1993 Clinton health-care proposal blames “know-it-all” Hillary Rodham Clinton’s arrogance, hunger for recognition and ideological rigidity for dooming the plan he’d worked on over two decades.
From the barricades of the Hillary-care revolution, Dr. Paul Ellwood picked up a hard-knocks education in the way the temperamental first lady handles public-policy matters.
“Blame the other side for your own failings, arrogantly approach things that you don’t necessarily know anything about and be pretty much for greater government control of things rather than having the private sector involved in solving problems,” he says.
“The Bush campaign likes to call the plan a government takeover of America’s health-care system,” Dr. Ellwood says. “It wasn’t when it was handed to the Clintons.”
Dr. Ellwood, a physician who describes his political leanings as “obsessively independent,” came to the project with more than 20 years of full-time experience thinking about and debating health-care policy. He had worked on health policy with every presidential administration since Lyndon Johnson’s.
In 1970, he began convening meetings of professionals from various branches of the health-care industry at his Wyoming condominium. They became known as the Jackson Hole Group.
“This group reached a market-oriented consensus on an approach to health care that was called ‘managed competition,'” he says. “There was pretty much agreement that everybody was going to have to make some sacrifices if we were going to proceed in that direction.”
The Jackson Hole Group first came to Bill Clinton’s attention during the 1992 Democratic primaries, when a New York Times reporter (!) phoned Dr. Ellwood and asked him to send some material to the Arkansas governor, who felt politically vulnerable on the health-care issue. Dr. Ellwood did as he was asked, and never heard back from the campaign.
Five days after Clinton was inaugurated, he appointed his wife to head a task force charged with developing and selling a proposal to rein in health-care costs and give medical coverage to all Americans.
“Then the next thing we heard was that they were going to appoint this massive committee, and anybody connected with the health-care industry was going to be excluded,” he says.
“We were the enemy. We needed to be reformed. You cannot imagine how insulting this was.”
The committee Mrs. Clinton eventually assembled was packed with opponents of managed competition, Dr. Ellwood asserts.
“That was a warning. Managed competition really moved health care toward the market, to the right. These advisers were the people who didn’t want it that way. They wanted it to be all Medicare.”
After first being rebuffed, Dr. Ellwood and several allies got the opportunity to meet Mrs. Clinton to explain their concerns, including those about rumors the Clintons wanted to impose price controls on the health-care industry.
“One of the points I tried to make in the meeting was that health-care costs were moderating, and if they wanted to turn the health-care system against them, they should push the price-control idea,” he says.
“When I said that prices were moderating, Mrs. Clinton said ‘You’re wrong about that!'” he says, still incredulous. “Aside from being a doctor, I had been working on health-care policy for 25 years.”
How did Team Hillary mangle the Jackson Hole plan?
“They moved it to the left. They’ve had much more in the way of public controls and intervention in the plan,” says Dr. Ellwood.
“Furthermore, they proposed using price controls as the way of saving money if the market didn’t work. We would never have done that. And they were unwilling to go along with any of the bipartisan approaches.”
Mrs. Clinton’s unwillingness to collaborate with members of Congress – which the Democrats controlled – is what sticks most in the doctor’s mind from those days.
“She found it difficult, I think, to share power and the limelight with other members of Congress.”
Although he won’t take sides in the New York Senate contest, the physician says he suspects Rick Lazio would be a more bipartisan, collaborative senator.
“He’s much less ideological, and that’s certainly what’s needed if we’re going to make any progress on health care, or anything else in the Senate.”
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