At a meeting with a small group of progressive bloggers at the Clinton Foundation headquarters in Harlem this afternoon, President Bill Clinton held forth on climate change and building retrofitting, access to AIDS medicines in the developing world, and education standards, but came alive when discussing prospects for health care reform.
The former President observed that the country, emerging from a
"post-9/11 emotional straitjacket" has become "more communitarian" — and that President Obama has fewer budget issues, and less Republican opposition, to content with when attempting reform. But, most importantly, "everything is worse now" — health care spending
has doubled, more are uninsured, and disposable income, adjusted for inflation, is down. Clinton pointed out that for health care reform to stick,
the delivery system has to change. While single-payer "rationally
should be the best system," it is in fact mixed public-private systems,
as in France, that were most successful, Clinton argued. (The American
Medical Association, with whom Obama met today, has publicly denounced
a public plan; Clinton argued that the problem with Medicare —
physicians’ template for a public option — does not have a problem
with reimbursements but rather with inefficiencies.) "I’d be surprised if we don’t get [health care reform] this year," he said.
The President also discussed access to AIDS medication and foreign aid reform in depth. "AIDS death is the provenance of poor places" due to the absence
of health systems. Governments, while generous about sinking funding
into medicines, have given health care systems short shrift, which
Clinton called "the next great frontier in health care for the poor."
Asked whether humanitarian and development visionary Paul Farmer would soon be joining the Obama administration in a high-level foreign aid post, Clinton averred that it was "not an announcement for me to make" and that "I don’t know yet" whether there will be an announcement. He spoke highly of Farmer, and called for broad-scale foreign aid reform. Only half of foreign aid money is actually spent in the target country, Clinton pointed out; the other half is spent on administrative overhead and US staff.
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When I asked what the Clinton Foundation does to promote women’s rights and reproductive rights as a cornerstone of global economic development, Clinton observed that the "practice that has worked uniformly across all cultures and religions" to depress the birth rate, the rate of unintended pregnancies, and of abortions, is "universal access to education and universal access to the labor market for women."
"Part of the world’s instability is rooted in inequality," Clinton observed.