When potential Democratic Party voters in New Hampshire, Iowa, Nevada and South Carolina think about who would be the best presidential candidate to address the health-care crisis in America, 35 percent say Hillary Clinton's name comes to mind.
Even Republicans appear to sense the New York senator's leadership on the issue. Eighteen percent of Republicans surveyed by the Washington, D.C.-based Lake Research Group for the Service Employees International Union named the former first lady as the candidate who is speaking most about health care.
During a telephone interview with Herald Sunday on Thursday, Clinton said those numbers are an indication of her discussions of health care during this presidential campaign and her history of advocacy.
"I think a lot of people are aware of what I've done in the last 10 years on this issue," Clinton said. "Most of the plans being discussed by candidates this year are based on the work I did in 1993 and '94 during the first Clinton administration."
She said the reason the plan she helped develop during those years failed was that most residents of the country were covered by employer-paid health insurance plans.
"People were concerned that bringing in the uninsured would decrease the amount of coverage they had," she said. "And that was certainly a valid concern."
However, times have changed and Clinton said she believes there is a better chance for an all-inclusive health-care system in the country, because more people are without insurance and many of those with coverage are under-insured.
Clinton said she sees only two possible solutions to the problems associated with the current health-care system, but believes there is no one plan that has the necessary congressional support.
The two approaches are:
- Build on the employer-based system with a provision for a government-sponsored program that would act as a safety net for those who could not get insurance through their employers.
- Develop a single-payer approach, funded publicly, but delivered privately.
Clinton congratulated the N.H. House for passing a resolution in support of U.S. Rep. John Conyers' National Health Insurance Act, which advocates for the single-payer approach using the current Medicare system as the basis for the process.
"More states have to make their desires known or create their own health-care programs, like Massachusetts has done, in order to keep up the pressure on this issue," she said.
Clinton said while she recognizes changes to the way health care is administered require a comprehensive approach that addresses things such as drug costs, insurance company practices, physician education debt and delivery systems, the realities of the political process need to be taken into consideration.
"We have to approach it comprehensively, but it may be more politically feasible to phase in the solutions," she said. "We need a solid base in the Senate."
She said 60 votes are needed in that body to make any substantive change to the system, and that is just the beginning of what is required.
"We need to develop a political will that can withstand the onslaught of the special interests and the ideologues who believe the government should not play a role in providing health care," she said.
However, Clinton said there are some things that can be done immediately. The first might be to bring the existing health-care system back to where it was prior to the Bush administration taking control.
"There is a lot of repair work to do," she said. "This administration has been particularly bad at handling this issue," she said.
Another step that can be taken immediately is the implementation of a national electronic medical records system, which has been estimated to save about $100 million in paperwork costs. That money could be used to cover more people, Clinton said.
New Hampshire is in the process of establishing such a system, but, the senator pointed out, when a patient leaves the state, the ability to transfer his or her medical information disappears.
Clinton believes the fact that nearly half the Republican voters surveyed by Lake Research could not name a candidate from their own party addressing health care is because of ideological differences between the two parties.
"During their primary, health care is not an issue because many of their candidates are ideologically opposed to federal involvement in health care, preferring to allow the market to set the standards," Clinton said. "I think that is unrealistic, and in the general election it will certainly be one of the major differences between me and the candidate they chose."
With the Lake study indicating health care has emerged as the No. 2 issue overall in this campaign, and the top domestic issue, the candidate offering the best approach to dealing with this issue is expected to have a leg up. Clinton agrees with that assessment.
"Health care is definitely going to be one of the defining issues in this campaign," she said.