White House Hubris

March 07, 1993

A word of caution to Hillary Rodham Clinton: Go easy on th arrogance. If Americans at last are going to get a national health plan that offers access to all citizens and holds down skyrocketing costs, the cooperation of key players in the medical industry is essential. Yet the First Lady and her super-secret task force have been shunning meaningful input from organizations that represent doctors and other practitioners, while leaving drafting of the health plan to government officials, academicians, economists and certain favored groups with special entry to the White House.

Mrs. Clinton has an understandable concern that "powerful lobbies and special interests are already lining up to defeat any plan we develop." But there is a danger that her current tactics of exclusion could increase the volume of opposition and the danger of backlash when her recommendations are unveiled in May.

Democrats in Congress can hardly want to be caught between their loyalty to President Clinton and the back-home pressures they will get from dissatisfied doctors, hospitals, health insurers, Medicare recipients and others.

This past week the American Medical Association, fearful of being left out of the action, announced it would drop its formidable opposition to some of the major proposals favored by the Clinton task force. In return, it asked that practicing doctors be represented on the task force and that AMA views on certain issues be heard as they come up.

The White House response next day was a gratuitous rebuff, an assertion by press secretary Dee Dee Myers that the medical industry and consumer groups could express their views but not participate directly in the process of sifting proposals. In other words, those most affected -- providers, payers and patients -- would have to wait until they are presented with a final report.

All this is part of the Clinton White House's obsession with secrecy and control. There will be a series of public forums in the next few weeks to ventilate health care concerns, but Mrs. Clinton and her top aides will keep tight rein on who will participate. A New York Times report said "it is easier to find out who is in charge of military intelligence for the Joint Chiefs of Staff than to find out who is designing cost controls for President Clinton's health-care plan."

If the president had any doubts how difficult it will be to get a health care plan through Congress this year, he could shed them after Chairman Dan Rostenkowski of the House Ways and Means Committee said it might be a two-year undertaking. That would be unfortunate. We remain sympathetic with the strategy of putting both the president's economic recovery plan and his health care plan in one big reconciliation package because both are essential to combating the deficit. But if one of the greatest social reforms in the nation's history is to come to fruition, a little more tact and openness would help the First Lady's cause.

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