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WASHINGTON PERSPECTIVE
WASHINGTON PERSPECTIVE
arranged somewhat differently.
Clinton the "Comeback Kid"
Association, tainted by
There’s
After the months of awkward delays and rising doubts about competence, it was the political equivalent of a perfect launch. The President’s health speech to a joint session of Congress on September 22 has drawn enthusiastic reviews, with few quibbles about its goal: guaranteed irrevocable health care for all Americans. However, the realism of his intricate scheme for paying for it is increasingly in dispute. v The Clinton sales campaign is carefully tuned to public sensitivities and perceptions. Thus the regional organisations that would collect insurance premiums and bargain for thrifty,
trical productions inspiring either saccharine grovelling before a popular figure in the witness chair, or targeting for the jugular. With the nation’s most celebrated unelected political personage in the spotlight, the members were overcome with desire to genuflect. The House Ways and Means
Committee, a hardboiled tax-writing body heretofore easily and always in control of its emotions, gave her a
standing ovation. Mrs Clinton displayed a virtuoso knowledge of the minutiae of the health-care system and the plan developed under her leadership for high-quality services, once labelled totally bringing our nearly trillionhealth insurance purchasing coopera- dollar-a-year health industry under tives, have since been given a friendlier strict, federally mandated regulation. title: regional health alliances. : The various hearings produced a bit of The speech and the follow-up v fencing about the financial realism of drum-beating by Clinton and Com- the Clinton plan and the economic pany have been so skilful in dominat- impact of requiring all employers to ing news media attention that his contribute to insurance for their political future has been whisked away workers. The real Congressional from the undertakers. Over the past probings on these and other fine defew months, Clinton has been widely tails will come later, when the advodismissed as a bumbler, a bush-league cates and backroom experts are governor unable to cope with the brought in for questioning. It’s genintricacies of the presidency, another erally agreed that a lot of coalition one-term president. The day after the building and legislative work needs to speech to Congress, a report in the be done, and that Congress probably
American a
Medical
regressive
image, and not the power it used to be when it invoked the spectre of socialised medicine and throttled Harry Truman’s proposal for national health insurance. The AMA has declared itself in favour of health-care reform, but says it "staunchly opposes the setting of any national budget" for health spending. This was later softened by the AMA’s Executive Vice President, James Todd, who generously conceded that the AMA wishes to cooperate with Clinton and Con: gress, "even to the extent of doctors sharing in financial sacrifices". The Pharmaceutical Manufacturers Association warns that restrictions on drug prices would raise the "risk of losing world leadership in biotechnology to competitors in Europe and Japan". The Coalition for Oral Health approves of the plan to provide dental services for persons under age 18, but urges acceleration of the timetable for expanding coverage beyond that age. The American Society of Hospital Pharmacists "is very pleased that the President has proposed to include outpatient prescription medications" in the benefits package. But it seeks assurances that under the reform plan, "pharmacists-the nation’s drug-use experts-are called upon to help people make the best use of medications". : To impress this concern upon Con-
New York Times characterised him as will not act until late next year. the "Comeback Kid". : While the issues are simmering, the On the up-and-down meter of the many specialised interests that make presidency, he can be expected, sooner up the health-care industry are camor later, to tumble again. But the paigning to protect their territory. In forecasts are generally favourable for a their public pronouncements, massive reorganisation of the health- virtually all endorse health-care reform, then proceed to explain why, in care system to assure universal coverage. The details are negotiable, the their sector, matters should be president has stressed, even to the extent of allowing states to opt for rules : single-payer systems. been follWhile the president has owing his customarily freneticThe’Supreme Court of Canada has denied a schedule of radio talk shows, town- 43-year-old woman suffering the final hall meetings, and frequent chats withstages of amyotrophic lateral sclerosis the press, his field commander in the (ALS) the right to a physician-aided suihealth campaign, Hillary Rodham cide. In a precedent-setting, but slim 5-4 : Clinton, has carried the campaign to majority decision, the conservative dominated Supreme Court ruled on Sept 30 that v Capitol Hill. Within a few days after his speech, Mrs Clinton appeared v Victoria-area ALS sufferer Sue Rodriguez does not have a right to physician-aided before five separate, standing-roomsuicide because that would compromise only House and Senate committees as "our fundamental conception of the sancthe star witness for the Clinton health of life". "Given the concerns
Court
the
gress, 60
pharmacists went to Capitol Hill the day after the president’s address "to take a pharmaceutical care message to the representatives". And this is just the beginning. Daniel S
Greenberg
against physician-assisted suicide
interest in protecting the vulnerable and is reflective of fundamental values at play in our society", wrote Justice John Sopinka in the majority decision. Too disabled to take her own life, Rodriguez pleaded with the court last May to allow her physician to create a device that would administer a lethal dose of a medication at the push of her finger. The request ran contrary to a Criminal Code prohibition against assisting or counselling suiabout cide, on penalty of 14 years in prison. But tity plan. Ideally, Congressional hearings abuse and the great difficulty in creating lawyers for Rodriguez argued the prohiare matter-of-fact informationbition violated three provisions of the appropriate safeguards, the blanket prohigathering proceedings. But, under the bition on assisted suicide is not arbitrary or Canadian Charter of Rights and TV cameras, they often become thea- unfair. The prohibition relates to the state’s Freedoms-ie, the right to life, liberty, and
918
arranged somewhat differently.
Clinton the "Comeback Kid"
Association, tainted by
There’s
After the months of awkward delays and rising doubts about competence, it was the political equivalent of a perfect launch. The President’s health speech to a joint session of Congress on September 22 has drawn enthusiastic reviews, with few quibbles about its goal: guaranteed irrevocable health care for all Americans. However, the realism of his intricate scheme for paying for it is increasingly in dispute. v The Clinton sales campaign is carefully tuned to public sensitivities and perceptions. Thus the regional organisations that would collect insurance premiums and bargain for thrifty,
trical productions inspiring either saccharine grovelling before a popular figure in the witness chair, or targeting for the jugular. With the nation’s most celebrated unelected political personage in the spotlight, the members were overcome with desire to genuflect. The House Ways and Means
Committee, a hardboiled tax-writing body heretofore easily and always in control of its emotions, gave her a
standing ovation. Mrs Clinton displayed a virtuoso knowledge of the minutiae of the health-care system and the plan developed under her leadership for high-quality services, once labelled totally bringing our nearly trillionhealth insurance purchasing coopera- dollar-a-year health industry under tives, have since been given a friendlier strict, federally mandated regulation. title: regional health alliances. : The various hearings produced a bit of The speech and the follow-up v fencing about the financial realism of drum-beating by Clinton and Com- the Clinton plan and the economic pany have been so skilful in dominat- impact of requiring all employers to ing news media attention that his contribute to insurance for their political future has been whisked away workers. The real Congressional from the undertakers. Over the past probings on these and other fine defew months, Clinton has been widely tails will come later, when the advodismissed as a bumbler, a bush-league cates and backroom experts are governor unable to cope with the brought in for questioning. It’s genintricacies of the presidency, another erally agreed that a lot of coalition one-term president. The day after the building and legislative work needs to speech to Congress, a report in the be done, and that Congress probably
American a
Medical
regressive
image, and not the power it used to be when it invoked the spectre of socialised medicine and throttled Harry Truman’s proposal for national health insurance. The AMA has declared itself in favour of health-care reform, but says it "staunchly opposes the setting of any national budget" for health spending. This was later softened by the AMA’s Executive Vice President, James Todd, who generously conceded that the AMA wishes to cooperate with Clinton and Con: gress, "even to the extent of doctors sharing in financial sacrifices". The Pharmaceutical Manufacturers Association warns that restrictions on drug prices would raise the "risk of losing world leadership in biotechnology to competitors in Europe and Japan". The Coalition for Oral Health approves of the plan to provide dental services for persons under age 18, but urges acceleration of the timetable for expanding coverage beyond that age. The American Society of Hospital Pharmacists "is very pleased that the President has proposed to include outpatient prescription medications" in the benefits package. But it seeks assurances that under the reform plan, "pharmacists-the nation’s drug-use experts-are called upon to help people make the best use of medications". : To impress this concern upon Con-
New York Times characterised him as will not act until late next year. the "Comeback Kid". : While the issues are simmering, the On the up-and-down meter of the many specialised interests that make presidency, he can be expected, sooner up the health-care industry are camor later, to tumble again. But the paigning to protect their territory. In forecasts are generally favourable for a their public pronouncements, massive reorganisation of the health- virtually all endorse health-care reform, then proceed to explain why, in care system to assure universal coverage. The details are negotiable, the their sector, matters should be president has stressed, even to the extent of allowing states to opt for rules : single-payer systems. been follWhile the president has owing his customarily freneticThe’Supreme Court of Canada has denied a schedule of radio talk shows, town- 43-year-old woman suffering the final hall meetings, and frequent chats withstages of amyotrophic lateral sclerosis the press, his field commander in the (ALS) the right to a physician-aided suihealth campaign, Hillary Rodham cide. In a precedent-setting, but slim 5-4 : Clinton, has carried the campaign to majority decision, the conservative dominated Supreme Court ruled on Sept 30 that v Capitol Hill. Within a few days after his speech, Mrs Clinton appeared v Victoria-area ALS sufferer Sue Rodriguez does not have a right to physician-aided before five separate, standing-roomsuicide because that would compromise only House and Senate committees as "our fundamental conception of the sancthe star witness for the Clinton health of life". "Given the concerns
Court
the
gress, 60
pharmacists went to Capitol Hill the day after the president’s address "to take a pharmaceutical care message to the representatives". And this is just the beginning. Daniel S
Greenberg
against physician-assisted suicide
interest in protecting the vulnerable and is reflective of fundamental values at play in our society", wrote Justice John Sopinka in the majority decision. Too disabled to take her own life, Rodriguez pleaded with the court last May to allow her physician to create a device that would administer a lethal dose of a medication at the push of her finger. The request ran contrary to a Criminal Code prohibition against assisting or counselling suiabout cide, on penalty of 14 years in prison. But tity plan. Ideally, Congressional hearings abuse and the great difficulty in creating lawyers for Rodriguez argued the prohiare matter-of-fact informationbition violated three provisions of the appropriate safeguards, the blanket prohigathering proceedings. But, under the bition on assisted suicide is not arbitrary or Canadian Charter of Rights and TV cameras, they often become thea- unfair. The prohibition relates to the state’s Freedoms-ie, the right to life, liberty, and
918