While at work the other day, I stumbled across an old issue of the journal Health Affairs. I picked it up with interest, noting that it was a special issue on “The Clinton Plan: Pro and Con” from the Spring of 1994.
I was only 13 years old when that issue was published. Suffice it to say that health care reform wasn’t on my personal agenda. In fact, it would be another decade–as a masters student in health policy at George Washington University–before I learned the details of the failed Clinton health reform effort. In fact, I was fortunate enough to take courses with some of the architects of that plan like Sara Rosenbaum and Jeanne Lambrew and get the “inside baseball” edition of events.
While President Clinton’s plan failed, he was able to push the State Children’s Health Insurance Program (S-CHIP) through successfully representing the largest expansion in coverage since the creation of Medicare and Medicaid in 1965. After Clinton, President Bush managed to expand funding for community health centers and enact drug coverage for seniors, but Medicare Part D has come under heavy criticism and the Bush administration also oversaw major budget cuts for Medicaid and other health care programs.
All of that brings us today, with the recently elected President Obama making the first attempt at comprehensive health reform in the last 15 years. Although I’m relatively new to the scene, many of those involved during the failed Clinton effort are prominent players in the current push for reform. But in the course of three different Presidential administrations, just how far have we come? To answer that question, I took a look at the topics in the Spring 1994 issue of Health Affairs, and here’s what I found: nothing much has changed. In fact, the only issue raised in the journal that has been addressed to date is drug coverage for seniors. Issues of universality, cost-control, choice, quality, simplicity, and shared responsibility are still central in today’s debate.
This week, I’m going to take a look at some of the historical trend data on health care spending, growth in the economy, and personal income and wealth. I’m also going to one-up CBO by making some very long-term projections beyond the usual 10-year window. It should be fun.