HA540 Healthcare Operations: Examining Hillary Care and its Impact

This report provides an in-depth analysis of the Health Security Act of 1993, also known as Hillary Care, a healthcare reform initiative proposed during Bill Clinton's presidency. The report details the comprehensive scope of the proposed legislation, which aimed to overhaul various aspects of health...Read More

Running head: HEALTHCARE OPERATIONS
HEALTHCARE OPERATIONS
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Contents
Introduction......................................................................................................................................2
Hillary care, the Health Security Act of 1993.................................................................................2
What led to Hillary care?.................................................................................................................5
Failure of the Hillary care................................................................................................................6
Expected interplay between demanders and suppliers, interest groups and analyze the public
policy environment..........................................................................................................................8
Conclusion.......................................................................................................................................9
Reference.......................................................................................................................................10

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Introduction
The Health Security Act of 1993 is also known as the Hillary care and this was the
healthcare bill proposed during the president ship of Bill Clinton. However, it is important to
note that this plan failed to pass through the congress. The draft consisted of the all the aspects of
healthcare delivery, and financing of the healthcare services for the American citizens. It is
important to highlight that the each and every aspect of the health care systems would be affected
by this legislation. Hundreds of pages of the draft consisted of the dozens of basic changes;
standard benefits package consisting of the auto insurance, and coordination of the worker
compensation; commissions, advisory boards and new panels; tax subsidies costing billions of
dollars; prescription drug benefits that will cover the local and state government workers
(Daschle & Su, 2017); significant changes in the Medicare program, new type of penalties to
combat the abuse and fraud, anti-trust reform; malpractice reform; long term care program; rural
health programs; new assessments and programs; establishment of the solvency funds, guarantee
new federal loans, public health initiatives; model information system creation; training of the
physicians; medical education; quality of the healthcare services; a national quality management
program; insurance requirement of the firms; control of the health insurance industry; assurances
of the precise benefits (Mitchell & Dowe, 2019). This study will be based on understanding of
the Clinton’s Health Plan and why it was not successful and the healthcare plan will be opposed.
Hillary care, the Health Security Act of 1993
Hillary care was introduced in the year 1993 and it included the health care reform
initiative. The President Bill Clinton proposed the healthcare so that the healthcare becomes
affordable for all the Americans. The main objective was to reduce the rising health care costs of
the government. President Clinton realized that the health care reform will be critical and it will

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be reducing the government budget because both the Medicaid and the Medicare are the vital
parts of the budget. The main head of the task force was Hillary Clinton and the task force as a
whole developed the entire bill. Hillary Clinton was the director of the task force. Hillary Clinton
became the face of the Clinton's healthcare reforms and healthcare efforts. The health security
act of the Hillary Act was managed by the competition strategy and the aim was to achieve the
purposes. One of the aspects of the healthcare act was that the government would be controlling
the insurance premiums and the costs of the doctor bills (Connolly, 2014). While at the same
time the insurance companies will be competing to provide lowest and best cost health packages
to the individuals and companies. This is entirely different from the Medicare and within this the
government maintains contracts directly with the health providers, hospitals, and the doctors.
While it is also important to mention that the Medicare is also known as the single-payer-system.
The Hillary Care will be implementing the objective of the health care through the national
health board, regional health alliances, and universal coverage (Oberlander, 2016).
Universal coverage- Universal coverage is a proposal that ensures that each and everyone
has a health insurance. While at the same it became evident that the insurance companies will no
longer be able to deny health insurance coverage to anyone that has any pre-existing conditions.
Therefore, to make this work for the health insurance companies it meant that each and every
one was required to have his or her own health insurance and it includes the Americans residents
as well as the resident aliens (Rhode & Dejmanee, 2016). It is important to mention that the
majority of the employers get their insurance plans from their employers and it was also
mandatory that each and every employer must be providing health insurance coverage to each of
its employees. The employers have a choice to use the custom designed benefit package or a
preferred provider organizations or health maintenance organizations. Therefore, the health

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insurance companies will be competing for their business. While it is also important to mention
that the people without the jobs could be purchasing the health insurance themselves from their
regional health alliances. The Federal government will be subsidizing the low income people
(Daschle & Su, 2017).
Regional health alliances- Regional Health Alliances can be described as the purchasing
groups that are state-based health insurance entities. The federal government will be funding the
states so that they can be administered. Moreover, the alliances could be even a state government
agencies or a private non-profit. They would be acting as a intermediaries for the contract and for
the consumers along with the health insurance providers that will be providing the plans for their
areas. The cost would be controlled by the alliances by setting the prices of the prices for the
healthcare providers and it was based on the fee- per -service. The alliances would set the price
for the premiums would be collected by the alliances. The companies that have more than 5000
full time employees would be able to provide their own insurances and it be different from the
ones provided by the alliances (Lichtenstein, 2017).
National health Board- It was a new federal agency at that time. the national health
board set a cap on the total health care spending to the nation. This means that the national health
board controlled the health insurance premium. Just for the individuals, it can set limits on a
maximum annual out of pocket costs. The national health board determined the requirements for
minimum coverage. It also includes a lot of preventive services and like immunization along
with the cholesterol screening and pap smears. Moreover, it would also cover the periodic
medical examinations, blood tests and he mammograms. The cost of health care reduces by
undertaking the preventive care procedures as well as properly identifying as well as treating the
chronic illness when the patients move to an emergency room (Howrigon, 2017).

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The Hillary care bill proposed the following:
 To control the healthcare spending, a national health Board would be established and will
also function to establish new regulations, oversee state cooperatives.
 All of the health insurance plans will be having a minimum standard and it will be set by
the federal government and it would be required to cover the insurance companies that
would not be allowed to present any discrimination between any pre-existing conditions
(Healthaffairs.org, 2019).
 it became a mandatory that all the Americans will be obtaining a health insurance. A
citizen if chooses to not to enrol within the health insurance would automatically be set
under the state cooperative and such citizens would be charged double the normal
premium.
 The part time employees, self- employed and the unemployed would provide with the
subsidies so that they can purchase insurance from the cooperatives.
 The cooperatives that are state based would be selling health insurance plans that are
approved to the consumers and the same time regulate the insurance companies
(Healthaffairs.org, 2019).
What led to Hillary care?
Back in the year 1991 and 1992, major alternatives came forward and in went into the
national debate due to the health care reform. At those time the market oriented reforms that did
not aim for the cost control and the universal coverage were actually identified with the
Republicans and this meant that the republicans had very little appeal for the democrats. While
few health policy experts, sizable group of congressional democrats, advocacy groups, the
democratic presidential have shown willingness for the single payer scheme that was prevalent in

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Canada and also for the displacement of the private health insurances (Olszanecka-Marmola &
Marmola, 2018). The single payer scheme has the capability ot save money and at the same time
it could have retained the autonomy of the providers as well as the autonomy of the patients as
well. While the politicians of the United States feared that the single payer model will lead to
switching from the private insurance premiums or employer provided insurance to an explicit
payroll or general taxation. Therefore, it is important to note that the Bill Clinton rejected the
single payer approach and he was determined to win the votes of the middle class for the purpose
of gaining a democratic ticket. At those time the Bill Clinton was running a campaign that were
based on the promises of reduction of taxes from the everyone except the rich and all this
occurred in the midst of an economic slowdown (Saldin, 2015).
Failure of the Hillary care
according to the political scientists, the first reason emanates from the fact that Presidents
actually do not control their own agenda. Soon after Bill Clinton introduced the health care
reform, Clinton got diverted and he started to deal with the various other foreign and domestic
policy crisis. While another major reason due to which the proponents of the health security bill
took it for granted are the key elements like the premium caps and the mandatory alliances and
later on this could have been bargained away. In the summer time of the year 1993, the budget
plan was criticised by the media as a waffler when backed done from sticking to his own words
that he presented originally (Mitchell & Dowe, 2019). The obvious reason was that the Bill
Clinton and his advisors were unwilling to face the criticism from the media. Thus, it became a
critical situation where he was in a dilemma of whether to support an altered health reform bill.
The 1342 paged bill was drawn up so that CBO can make an estimate of the costs as it was
required by the law. However, it was seen that the president was proclaiming himself to be

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flexible regarding the mechanisms of the plan and this later on provided room for the
congressional modifications. Therefore, unwillingly the president delved out the mechanisms so
that the critiques could attack. While it is important to note that the administration was unable to
mobilize on the mechanisms that was already mentioned before (Commonwealthfund.org, 2019).
If the situation is looked in more closely, it can be said that the democrats were in a
uncomfortable situation where the means of political communication was weak. It is important
to mention that the democratic party lacked the allied groups, locally and nationally rooted
infrastructure. These were vital because the grass root political campaigns were carried out
through these infrastructures. While it is important to mention that the conservative had such an
infrastructure in the form of Rush Limbaugh Style talk radio and Christian Fundamentalist
groups. Throughout, the year of 1993 to 1994, the politicians that were reform minded were
unable to reunite in the democratic party and were even divided regarding the features of the
health reform (The Balance, 2019).
The other reasons that became highlighted with the failure of the Hillary care are as
follows:
 The doctors became worried about the being forced into the insurances that were ran by
HMOs. The doctors feared that they would be complettely loose control of the treatment,
care, pricing. Instead the Hillary Care has provisions in which the insurance companies
would be dictating on who would be covered and at the same time, who would be
receiving the care. That's the reason the AAPs sued the Task Force for Federal Advisory
Committee Act violation (Healthaffairs.org, 2019).
 The congress was only concerned about the benefit quantity and they through that it
would be putting an extra pressure on the budget deficit.

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 While at the same time, the American people were not interested about the cost of the
healthcare of 1993 because people were going back to work and the recession was over.
 The labour unions did not support the initiative and the they were angry on the President
for signing the NAFTA. Due to this the members of the labour unions lost jobs when the
manufacturers moved to the low cost Mexico (Pear, 2019).
Expected interplay between demanders and suppliers, interest groups and analyze the
public policy environment
Practically, the Clinton administration had ignored a lot of progressive forces from the
beginning of the mandate. It is important to mention that the President Clinton has made it a
priority to reduce the federal deficit (this policy was not even included in to the program). While
it is important to mention that Bill Clinton approved the North American Free Trade Agreement
and ti was a big blow to the Bill Clinton presidency because the decision was against the AFL-
CIO, majority of the democratic party and social movements (ballotpedia.org, 2019). It is
important to mention that the when Bill Clinton approved the NAFTA, he signed a death
certificate on to the health care plan. It is a highlighting fact that the people that voted for the
year 1994 was no larger than the ones in 1990. The bigger difference lied in the Democratic vote.
The voters in the working class moved away from voting the Democrats and this is the reason
Democrats lost their majority to the congress. It is important to mention that love of the country
is measured to a extent to which it promotes the policies, supports the quality of life and well-
being of the population. More importantly, the working middle classes and the working classes
made up the vast majority of the population. An important section to highlight is that the
insurance controlled system failed because the it had imposed a lot of pain on the population
(Moffit, 2019). While it is important to mention that it is not just that 46 million people that will

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be without the health insurance, however the system failed a large number of people that have
insufficient coverage and will be unable to discover until they need it. It is needless to say that
the cruel system of healthcare insurance is that it is supported by a large number of employees
and along with it the employers get a lot of control over the labor force. therefore, when worker
lose their job, they not only lose their income but also their healthcare coverage for their family
as well as for themselves. The larger number of the employers and insurance can both be
considered as the root cause of the problem (Healthaffairs.org, 2019).
Conclusion
After Bill Clinton became the President, he inaugurated and established a task force that
will be leading by the first lady Hillary Clinton. According to the Bill Clinton, the healthcare
legislation was sent to the capitol hall and it was considered to be breathtaking. Bill Clinton took
hold of majority of Americans by highlighting that the current healthcare system is wasteful and
bureaucratic. He altogether urged a new healthcare reform that will be of 1 trillion dollars and it
will be taking into account of one seventh of the American population. Retrospectively, the
health care reform was based on the personal responsibility, quality, choice, savings, simplicity
and security. Bill Clinton has highly stressed on the need of a simple and independent from the
bureaucratic elements and his legislation of Clinton health plan provided just that.

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Reference
ballotpedia.org. (2019). "Hillarycare" (The proposed Health Security Act of 1993) - Ballotpedia.
Retrieved from https://ballotpedia.org/%22Hillarycare
%22_(The_proposed_Health_Security_Act_of_1993)
Commonwealthfund.org. (2019). Hillary Clinton's Health Care Reform Proposals: Anticipated
Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit |
Commonwealth Fund. Retrieved from
https://www.commonwealthfund.org/publications/issue-briefs/2016/sep/hillary-clintons-
health-care-reform-proposals-anticipated
Connolly, C. (2014). Messaging, Medicine, and Obamacare. In The Affordable Care Act as a
National Experiment (pp. 99-107). Springer, New York, NY.
Daschle, T., & Su, P. N. (2017). Leading by Example: Why Oregon Matters in the National
Health Reform Discussion. In Health Reform Policy to Practice (pp. 313-332). Academic
Press.
Healthaffairs.org. (2019). The Clinton Health Plan: Historical Perspective | Health Affairs.
Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.14.1.86
Healthaffairs.org. (2019). The Rise and Resounding Demise of the Clinton Plan | Health Affairs.
Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.14.1.66
Howrigon, R. (2017). How Did We Get Here?. The Journal of Medical Practice Management:
MPM, 33(1), 5.
Lichtenstein, N. (2017). Who Killed Obamacare?. Dissent, 64(2), 121-129.

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Mitchell, J. L., & Dowe, P. K. F. (2019). Dissecting Perceptions: Exploring the Determinants of
Health‐Care Reform Preferences. Social Science Quarterly, 100(1), 245-258.
Mitchell, J. L., & Dowe, P. K. F. (2019). Dissecting Perceptions: Exploring the Determinants of
Health‐Care Reform Preferences. Social Science Quarterly, 100(1), 245-258.
Moffit, R. (2019). A Guide to the Clinton Health Plan. Retrieved from
https://www.heritage.org/health-care-reform/report/guide-the-clinton-health-plan
Oberlander, J. (2016). From Obamacare to Hillarycare—Democrats’ Health Care Reform
Agenda. New England Journal of Medicine, 375(14), 1309-1311.
Olszanecka-Marmola, A., & Marmola, M. (2018). Negative TV Advertising in the 2016 US
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Pear, R. (2019). CLINTON'S HEALTH PLAN: The Overview; CONGRESS IS GIVEN
CLINTON PROPOSAL FOR HEALTH CARE. Retrieved from
https://www.nytimes.com/1993/10/28/us/clinton-s-health-plan-overview-congress-given-
clinton-proposal-for-health-care.html
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Forum (Vol. 13, No. 1, pp. 83-103). De Gruyter.

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The Balance. (2019). Why Did Hillarycare Really Fail? How It Affects You Today. Retrieved
from https://www.thebalance.com/hillarycare-comparison-to-obamacare-4101814