> Date: Tue, 24 Aug 1999 18:40:05 -0400 > From: Wojtek Sokolowski <[EMAIL PROTECTED]> > Two points. First, Christopeher Hitchens argues that Hillary's "reform" > was, in fact, a move designed by big insurance firms and received a > relatively mild oppsotion from smaller guys in the insurance biz. So it was > hardly a propaganda blitz that "killed" that initiative. Au contraire, the > whole "initiative" was a scham never intented to be implemented as advertised. Is this true? The small insurance folk put out endless inane commercials which (U.Penn Annenberg School media researchers convincingly show) tipped the public consciousness-balance. The small business lobbyists beat up on wavering members of congress. It was quite a revealing war; there's a debate between Skocpol and Navarro about how to interpret it. I think the Clinton folk wanted a relatively universal coverage plan that would at least have got some 95% into 'coverage,' but under the rubric of a handful of big national plans marketed by the Jackson Hole group of big insurance companies (led by Aetna, Prudential, etc). That would have been most profitable for the Jackson Hole firms, with respect to the mix of cross-subsidies and access-limited health services that would maximise both insurance premium/investment profits and health-system utilisation profits (a completely contradictory mix, of course, which managed care has brought into the same organisation). >... > I do not think that cost-efficiency should be of primary concern to the > Left for a number of good reasons, chief among them being that insurance > companies can take of that. But they don't. They cut access and quality dramatically in the process of destroying overaccumulated health capital, but the share for admin keeps going up (to pay for expensive MBAs who sit between physicians and patients, saying the latter can't get the specialty care the former recommend because the averages don't justify it). Surely outrageous CEO salaries are surface evidence of massive overhead loading? There are plenty of studies on this, including by the Harvard group who lobby for a national health system. > A much better strategy is to focus on universal coverage - which as I have > argued - can be achieved by institutional arrangements that are not limited > to a single payer public insurance scheme. Do you want Hillary's big insurance co's running everything? Putting them out of business through a single-payer is surely the first necessary if insufficient step towards more thorough-going reform of capitalist health care? (Sorry I missed you in Baltimore last week, Wojtek... no transport left me less flexible than I thought.) Patrick Bond email: [EMAIL PROTECTED] * phone: 2711-614-8088 home: 51 Somerset Road, Kensington 2094 South Africa work: University of the Witwatersrand Graduate School of Public and Development Management PO Box 601, Wits 2050, South Africa email: [EMAIL PROTECTED] phone: 2711-488-5917 * fax: 2711-484-2729
