Academic journal article The Cato Journal

Just Gotta Learn from the Wrong Things You Done

Academic journal article The Cato Journal

Just Gotta Learn from the Wrong Things You Done

Article excerpt

I have long had an interest in health policy. But I first became passionate about health care during the epic battle over Clinton Care in 1993 and 1994. I still regard that victory as one of the finest hours for Republicans in Congress. And I take a certain satisfaction in the role a certain chart played in that victory--the chart I created with my staff, depicting the plan's dozens of new bureaucracies. We captioned it: "Simplicity Defined." One of Mrs. Clinton's comments after the defeat of Clinton Care was, "We never overcame the chart."

People don't realize how close we came to passing the Clinton Plan in the summer of 1994. What could have been a catastrophe for America turned out to be a catastrophe for the Democrats. The fact that they proposed it is the biggest reason we took control of Congress that year. Had it passed and become law, I doubt President Clinton would have been reelected two years later.

Winning the majority in 1994 gave us a chance to put our own stamp on health policy, and the Health Insurance Portability and Accountability Act (HIPAA) was the first health legislation we passed. It started out as a modest little bill, claiming to make coverage portable from job to job. It grew to become a whole package of reforms, most of them having nothing to do with portability.

The Unintended Consequences of HIPAA

HIPAA is a classic example of legislative panic. We passed it mostly as a way to make the political point that our new majority could govern and be compassionate at the same time. The fact is that HIPAA was a mistake. It was oversold. It had unintended consequences.

It turned out that HIPAA did little to make insurance more portable, but it did set a dangerous precedent for the federal regulation of health insurance. We thought we were cracking down on Medicare fraud. Instead, we turned doctors into criminal suspects, with armed federal agents seizing their filing cabinets. We felt confident that we had guaranteed medical privacy and paperless billing, but HIPAA appears to have expanded bureaucrats' access to our medical records without a search warrant.

To be sure, we actually made HIPAA better than it might have been. We did manage to get Medical Savings Accounts (MSAs) attached to it. When we brought

HIPAA through the House, I was seduced by the hope for MSAs. I voted for HIPAA, but I got too much HIPAA and too little MSAs. We need to try to go back and fix those things.

Looking back now, it seems undeniable that the first health care law after Clinton Care was, to some extent, the first installment of Clinton Care.

On the other hand, the Left learned its lesson in the wake of the defeat of Clinton Care. Since then, they have worked step by step to obtain what they could not get all at once. HIPAA, it turns out, was their first step. Next came Kid Care. Just last year, the Senate passed a so-called Patient's Bill of Rights that would vastly expand federal regulation of health insurance and swell the ranks of the uninsured. The liberals are so sure of that bill's eventual passage that they are waiting in the wings with their next steps. For instance, Senator Kennedy (D-Mass.) has unveiled a bill to let parents into Kid Care. And Rep. Pete Stark (D-Calif.) wants to put all kids on Medicare. It does not take a crystal ball to see where this process is headed.

It is ironic that the Democratic Party poses as the great enemy of HMOs, since it was Senator Kennedy who wrote the first federal HMO law in 1973. And it was Democrats who tried to herd all Americans into HMOs in 1994. This amazing turnaround is proof, as David Horowitz (2000) notes in his book, The Art of Political War and Other Radical Pursuits, that "the resurgence of the Democratic Party" has occurred largely "through its appropriation of Republican rhetoric and policy." Unfortunately, in health care, they have appropriated a lot more rhetoric than policy. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.