home *** CD-ROM | disk | FTP | other *** search
- <text id=94TT1264>
- <title>
- Sep. 19, 1994: Health Care:Tales from the Crypt
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1994
- Sep. 19, 1994 So Young to Kill, So Young to Die
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- HEALTH CARE, Page 42
- Tales from the Crypt
- </hdr>
- <body>
- <p> White House documents made public last week suggest that the
- Clinton health-care plan was in trouble from the start, even
- in the eyes of its designers. In a search for hidden clues about
- what went wrong, a team of TIME correspondents spent more than
- 100 hours sifting through 250 boxes of papers, memos and other
- documents created by Ira Magaziner's secretive health-care working
- group. Some highlights:
- </p>
- <p> The Start-Up Memo. Magaziner, the reform architect, knew reform
- would be an uphill struggle. In his initial memo to Mrs. Clinton,
- dated Jan. 26, 1993, he listed "likely criticisms" that the
- plan would generate: "Cost containment would be ineffective
- and have perverse results...Limiting spending on health-care
- through global budgets will lead to service rationing, and interfere
- with quality improvements and consumers' traditional freedom
- to spend...Universal coverage would involve redistribution
- of income and disrupt satisfactory arrangements for many Americans."
- To this Magaziner added an ironic warning to himself, which
- he apparently would forget: "The task force should plan serious
- outreach activities. The policy work cannot be done in a vacuum."
- </p>
- <p> The Land-Mines Memo. Magaziner was fond of listing the many
- political obstacles the plan would face in Congress. In early
- 1993 a memo, entitled simply "Landmines," fully anticipated
- the most potent arguments made against the plan. The employer
- mandate, the memo noted, would be criticized for "destroying
- jobs, driving many small companies into bankruptcy, fueling
- inflation, compromising competitiveness and forcing people to
- buy insurance when they may not want to do so." Similarly, it
- warned, the plan to create health-care alliances would be attacked
- as a "poor people's pool" and likened to "another layer of government
- bureaucracy interfering with the market." The guaranteed-benefits
- package, the memo warned, would be dismissed as "an unaffordable
- Cadillac."
- </p>
- <p> The Ukockis Papers. Few of the documents are as revealing of
- the process that produced the Clinton plan as the memos of James
- Ukockis, a senior economist at the Treasury Department's Office
- of Policy Analysis. Ukockis assisted Magaziner in analyzing
- proposals for cost control--when he could. On Feb. 22, 1993,
- after briefing Magaziner on various cost-control proposals,
- Ukockis recalled that Magaziner "was not interested in a balanced
- evaluation...What he wanted was for someone to make the
- best possible case for a specific price-control program."
- </p>
- <p> At times, task-force work bordered on the absurd. On March 16
- he recalled that amid the frantic pace, Magaziner sent a memo
- to group leaders noting that 5,000 letters were arriving daily.
- "We need your help," Magaziner wrote. "Our goal is to answer
- this mail before our May deadline." On April 2, 1993, after
- being asked for details of savings from various price-control
- proposals, Ukockis participated in another silly session. "We
- sat around the table making guesstimates of the savings to be
- realized. It was an appropriate exercise for April Fools' Day."
- </p>
- <p> The Straight-Talk Directive. In June 1993, Bob Boorstin, the
- task-force spokesman, urged colleagues to use plain language
- when explaining the plan. "The public cares less about the mechanics
- of ((health-care reform)), and when you talk to them, they want
- to know in English what will happen to them. Talk to them less
- like Ira," Boorstin advised, "and more like Roseanne."
- </p>
- </body>
- </article>
- </text>
-
-