There are signs in the Senate record of Sen. Hillary Clinton (D.-N.Y.) that she has never abandoned her dream of federalizing the U.S. health care system.
In the wake of the Sept. 11, 2001, terrorist attacks, Clinton has pushed an escalating series of proposals to make the federal government the funder and regulator of new health care programs for “first responders” and others who may suffer ailments as a result of the attacks.
Few conservatives would argue that such ailments should not be monitored by the government, or that there is no federal role in helping those afflicted. But many potential victims of 9/11-related ailments already have private health insurance, or are eligible for state Medicaid benefits, and it is questionable whether Clinton’s advocacy of an expanded federal role is either necessary or the optimal solution.
In 2001, Clinton allotted $12 million of 9/11 aid money to create the World Trade Center and Volunteer Medical Screening Program at Mount Sinai Hospital in New York. It was supposed to “track and monitor the health” of approximately 9,000 first responders.
It was described as “a comprehensive program of medical assessment, outreach and education, and diagnostic referrals for rescue recovery, volunteer and other workers exposed to health hazards at the WTC site.” All services under the program are free.
When estimates showed that more than 40,000 emergency workers toiled at Ground Zero, Clinton sought an “additional $90 million to expand federally supported health screenings for more than 30,000 additional workers and volunteers, and provide for health examinations and follow-up exams on regular intervals for up to 20 years, including for current and retired firefighters.”
In 2002, she pushed the Federal Emergency Management Agency to dedicate $20 million to create a “World Trade Center Health Registry” to track the health of 100,000 to 200,000 people exposed at or near Ground Zero. This included all those working, living, or cleaning up in the areas around the World Trade Center.
Five testing centers have since been designated in the New York/New Jersey area to perform free, comprehensive medical screening to assess the physical and mental health of each WTC worker or volunteer who helped with rescue or debris removal.
The program is open to illegal aliens.
Robert Herbert, co-director of the WTC Worker and Volunteer Medical Screening Program and the WTC Health Effects Treatment Program, told Congress in September, “This program is and always has been open to all WTC responders in need of treatment, including immigrant workers, and without respect to insurance status, with no out-of-pocket cost to responders.”
New York Mayor Michael Bloomberg told the Chicago Tribune that WTC clinics would give treatment starting in January 2007 to all uninsured and undocumented workers who suspected they have health problems related to the 9/11 attacks.
The program has demonstrated the efficiency most Americans expect from government health care. In June 2006, the waiting list for those seeking treatment was 16 weeks.
Although the program has received funding from private organizations such as the Red Cross, Herbert said, “We have always considered private funding to be a stopgap rather than a long-term solution to what is certain to be a long-term problem.”
Next, Clinton attempted to dramatically expand the program with the 9/11 Heroes Health Improvement Act of 2006, which has thus far stalled in the Republican-controlled Congress. It would spend $1.9 billion from 2007-2011 for “medical and mental health monitoring and treatment” facilities that treat first responders. The money would cover “firefighters, police officers, paramedics, workers, volunteers, residents and any other individual who worked at Ground Zero, Fresh Kills or the Pentagon or had lived or worked in the vicinity of such areas, whose health has deteriorated as a result of the [September 11] attacks.” Preference for the grants is awarded to individuals who are not covered by health insurance.
In a floor speech, Clinton said she based her $1.9-billion request on a rough estimate of $5,800 per individual per year. But, she warned, the $1.9 billion would only “begin the process of setting up the system and, over the next five years, implementing a system to take care of thousands of people who are getting sick and who are dying.”
These measures were largely based on studies conducted by the New York-based Mt. Sinai School of Medicine and funded by the Centers for Disease Control, the State of New York, the City of New York and labor organizations.
In 2003, Mt. Sinai released a preliminary study based on screening 1,000 workers who had removed and transported debris from Ground Zero. It found that 78% had lung ailments. The primary symptoms were a sore throat, coughing and wheezing. The study also said more than half suffered from “persistent psychological symptoms.”
In September, Mt. Sinai released a final report based on examinations of 9,500 first responders. Those tested were not eligible to participate in other federally funded programs. This report excluded firefighters whose health care was covered by the New York Fire Department.
Eighty-six percent of those screened were union members.
Clinton blames the ailments suffered by 9/11 first responders on the Bush Administration. On Sept. 13, 2001, then-EPA Director Christine Whitman said, “I am glad to reassure the people of New York … that the air is safe to breathe and their water is safe to drink.”
Clinton says this statement was misleading and charged in 2006 that “ the Environmental Protection Agency failed in its duty to protect New Yorkers from the dangerous cloud of toxic materials that was released September 11 [and] that the White House edited EPA’s statements to downplay the risks of contaminants in that cloud.”
The EPA did distribute masks and goggles for rescue workers at Ground Zero, and it also handed out 22,000 respirators and 32,000 respirator cartridges.
When the Hurricane Katrina emergency funding bill allocated $125 million to pay for long-term medical and mental-health monitoring and workers’ compensation benefits for first responders to that disaster, Clinton was not satisfied. She called it “just a down payment, a small down payment. We will not rest until we get the funds from our government to take care of all the people who are suffering.”
Most recently, Clinton and Rep. Peter King (R.-N.Y.), the chairman of the Homeland Security Committee, amended the Security and Accountability for Every Port Act to authorize the federal government to set up programs like the ones initiated in New York for first responders to any future disaster.
The amendment gives the President the ability to establish programs in partnerships with approved medical institutions for the “protection, assessment, monitoring and study of the health and safety of individuals.” The bill was signed by President Bush last week.
Additionally, Clinton asked Bush on October 13 to designate four counties around Buffalo, N. Y., as disaster areas because the region was hit by an unexpected October snowstorm. Buffalo averages 91 inches of snow per year.
“Of course, everyone wants to take care of the 9/11 responders and their unique situation,” said Dr. Wayne Brough, Ph.D., chief economist at FreedomWorks. “The concern here is that in just five years’ time, we’ve gone from a relatively limited, voluntary monitoring program to creating multiple open-ended, multi-million-dollar health tracking and treatment systems that include much of lower Manhattan. And the latest bill now opens the door for some of these programs to expand to potentially every responder to future emergencies nationwide.”
Other conservative experts on health care reform point out that New Yorkers are already well compensated by the state Medicaid program that spends more per person than any other state. On average, New York pays $9,842 per enrollee.
New York hospitals that administer emergency care are also well funded. In 2003, the National Center for Policy Analysis found that New York’s Medicaid program paid nearly $10 billion to hospitals for inpatient care and subsidies for graduate medical education and hospital-based clinics.
A recent NCPA study concluded that this spending could be reformed by giving the states block Medicaid spending grants based on the state’s poverty rate. Currently, 8% of the nation’s poor population lives in New York, but the state gets 12.9% of all federal Medicaid dollars. Texas has 10.3% of the nation’s poor, but receives only 6%.