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Elizabeth “Betsy” McCaughey (R-NY), a lawyer and future lieutenant governor of New York, writes a scathing analysis of the Clinton administration’s health care reform plan. The article, “No Exit,” is published in the New Republic, and sparks not only a detailed rebuttal from the Clinton administration, but numerous editorials and responses praising the article and joining in the attack. Echoing McCaughey’s arguments, Newsweek writes, “The plan would reduce the quantity and quality of health care and medical technologies by vastly expanding government’s coercive role.” McCaughey and Newsweek question the proposed creation of a seven-member “National Health Board” which will, she claims, “guess the nation’s health care needs and decree how much the nation may spend meeting them.” According to Newsweek: “Everyone would be locked into one system of low-budget health plans picked by the government. Fifteen presidential appointees, the National Quality Management Council, not you and your doctor, would define the ‘medically necessary’ and ‘appropriate’ care a doctor could give you. Escaping government control to choose your doctor or buy other care would be virtually impossible. Doctors could be paid only by the government-approved plans, at rates set by the government. It would be illegal for doctors to accept money directly from patients, and there would be 15-year jail terms for people driven to bribery for care they feel they need but the government does not deem ‘necessary.’ Government would define a minimum level of care and herd people in particular regions into dependence on the lowest-cost organization able to deliver that level. Doctors would be driven into organizations in which they would be punished financially for giving more treatment than the organizations’ budget targets permit. The primary care physician assigned to you would be, McCaughey notes, a gatekeeper with an incentive to limit your access to specialists and high-tech medicine. The premise of the Clintons’ plan is not just that government knows best, but that government knows everything relevant, including how many specialists there should be no more than 45 percent of all doctors [sic]. McCaughey says many medical students will be told that the specialties they prefer are closed, or closed to them because they are not the right race or ethnicity. Yes, the plan subordinates medical values to ‘diversity.’” Prescription drug prices would be controlled through the Department of Health and Human Services, and, McCaughey and Newsweek claim, would “certainly suppress research” that might benefit patients of incurable diseases and disorders. (Newsweek 2/7/1994)
Refuting McCaughey - The Clinton administration details the “numerous factual inaccuracies and misleading statements” contained in McCaughey’s article. The administration’s response says that doctors and patients, not “government bureaucrats” or a board of governors, will decide what treatments are “necessary and appropriate.” The government will not decide what treatments are, and are not, provided: “If anything, the ‘necessary and appropriate’ care provision in the bill delegates authority to the medical profession—rather than imposing further government bureaucracy between the patient and the doctor.” The plan will not block Americans from opting into private health care plans just as they do now, nor will it block doctors and hospitals from accepting payments from “non-approved” health care plans. Nor does the plan require doctors and hospitals “to report your visit to a national data bank containing the medical histories of all Americans,” as McCaughey writes. And the so-called “National Health Board” will not “decide how much the nation can spend on health care beginning in 1996,” as McCaughey claims. The plan will not seek to reduce quality of care in the interest of saving money, and it does not contain price controls. (White House 1/31/1994) A year later, author and columnist James Fallows will call the article “a triumph of misinformation,” and refutes McCaughey’s (and others’) claims point by point. (Fallows 1/1995)
Instrumental in Derailing Reform - The article will later be cited by House Speaker Newt Gingrich (R-GA) as “the first decisive breaking point” in the plan’s initial support; the plan will never be implemented. The article itself will spark tremendous controversy, winning the National Magazine Award while being attacked for being fundamentally inaccurate. (In 2006, the new editor of the New Republic, Franklin Foer, will apologize for his magazine having run the article.) In 2009 McCaughey will be a fellow at the conservative Manhattan Institute and will soon join the equally conservative Hudson Institute. Both are heavily funded by health care corporations. (Sarlin 5/15/2009)
Christopher Brown of the Hudson Institute writes that the Shanghai Cooperation Organization (SCO) is “perhaps the most dangerous organization that the American people have never heard of.” Brown asserts that the SCO’s publicly stated goals, including fighting terrorism, are a sham. He writes that the SCO is the most obvious but most ignored challenge to the US and warns that the potential future inclusion of Iran into the organization could lead to weapons proliferation. He reasons that “since one of the programs of the SCO is the linking of the road systems in the region,” the transportation of dangerous goods between Iran and China would increase dramatically. (Brown 5/30/2005)
Former White House official Lewis Libby, facing criminal charges of perjury and obstruction of justice for his involvement in the Valerie Plame Wilson identity leak (see October 28, 2005), joins the Hudson Institute, a conservative think tank that focuses on foreign policy and national security. Libby is a senior fellow whose focus will be issues related to terrorism and Asia, and will also advise the institute on strategic planning. Other prominent conservatives who are members of the Hudson Institute are former Reagan administration Solicitor General Robert Bork (see October 19-20, 1973 and July 1-October 23, 1987), and former National Security Agency Director William Odom (see September 16, 2004). Libby will be paid a salary commensurate with his White House remuneration of $160,000. (Kamen 1/6/2006)
Dick Cheney’s Office of the Vice President (OVP) is so cloaked in secrecy, journalist Robert Dreyfuss reports, that it routinely refuses to provide a directory of staff members or even the numbers of staff and employees. Dreyfus writes, “Like disciplined Bolsheviks slicing through a fractious opposition, Cheney’s team operates with a single-minded, ideological focus on the exercise of American military power, a belief in the untrammeled power of the presidency, and a fierce penchant for secrecy.” The list of current and former staffers includes, as of April 2006: former chief of staff Lewis Libby; his replacement, David Addington; top national security advisers Eric Edelman and Victoria Nuland; neoconservative and hardline Middle East specialists such as John Hannah, William Luti, and David Wurmser; anti-Chinese Asia specialists such as Stephen Yates and Samantha Ravich; a varying number of technocratic neoconservatives in other posts; and an array of communications specialists, including “Cheney’s Angels”: Mary Matalin, Juleanna Glover Weiss, Jennifer Millerwise, Jennifer Mayfield, Catherine Martin, and Lea Anne McBride. It is known that Cheney’s national security staff was assembled by Libby from various far-right think tanks such as the American Enterprise Institute, the Hudson Institute, and the Washington Institute for Near East Policy (WINEP), as well as carefully screened Cheney supporters from a variety of Washington law firms. (Dreyfuss 4/16/2006) Lawrence Wilkerson, the former chief of staff to former Secretary of State Colin Powell, will recall in early 2007: “A friend of mine counted noses [at the office] and came away with 88. That doesn’t count others seconded from other agencies.” (Rozen 1/7/2007)
'Cabal' of Zealots - Wilkerson calls Cheney’s inner group a “cabal” of arrogant, intensely zealous, highly focused loyalists. Recalling Cheney’s staff interacting in a variety of interagency meetings and committees, “The staff that the vice president sent out made sure that those [committees] didn’t key anything up that wasn’t what the vice president wanted,” says Wilkerson. “Their style was simply to sit and listen, and take notes. And if things looked like they were going to go speedily to a decision that they knew that the vice president wasn’t going to like, generally they would, at the end of the meeting, in great bureaucratic style, they’d say: ‘We totally disagree. Meeting’s over.’” The committee agendas were generally scuttled. And if something did get written up as a “decision memo” bound for the Oval Office, Cheney himself would ensure that it died before ever reaching fruition.”
Sidestepping the NSC - The National Security Council (NSC) is designated as the ultimate arbiter for foreign policy options and recommendations for the president. But, according to Wilkerson, Cheney’s office and the NSC were often at loggerheads, and Cheney’s “shadow NSC” had the upper bureaucratic hand. Cheney “set up a staff that knew what the statutory NSC was doing, but the NSC statutory staff didn’t know what his staff was doing,” says Wilkerson.
China Threat - Cheney’s Asia advisers, Yates and Ravich, were most often encountered by Wilkerson. They helped drive Cheney’s agenda for China, which was obsessive to the point of paranoia. China was a grave, if long-term, threat to the US, they believed. The US must begin strongly cultivating Taiwan as a counterbalance to China, whom they asserted was preparing for military action against the US. Former US ambassador to China Charles Freeman compares Yates to the Defense Department’s Paul Wolfowitz and Douglas Feith; all three believed, Freeman says, that China was “the solution to ‘enemy deprivation syndrome.’”
Iraq Policy - Cheney’s current and former staffers played an even larger role in shaping the administration’s Iraq policy than is generally known, and Cheney “seeded” staffers in other departments to promote his war agenda. Luti left the OVP in 2001 to join the Department of Defense, where he organized the Office of Special Plans (OSP). Wurmser, an AEI neoconservative, joined the Pentagon and created the forerunner of the OSP, the Counterterrorism Evaluation Group, which helped manufacture the evidence of connections between Hussein and al-Qaeda. Wurmser worked closely with Hannah, Libby, Luti, and another Pentagon official, Harold Rhode. Ravich worked with neoconservative Middle East analyst Zalmay Khalilzad to build up Ahmad Chalabi’s Iraqi National Congress, their designated supplanter of Hussein.
US or Israel Interests? - Many of Cheney’s most influential staffers are pro-Israeli to the point where many observers wonder where their ultimate loyalties lie. David Wurmser is a standout of this group. Wurmser worked at WINEP with Hannah, then joined the AEI, where he directed that group’s Middle East affairs, then joined Feith’s OSP before moving on to Bolton’s inner circle at the State Department, all before joining Cheney in the OVP. Most outsiders consider Wurmser’s ideas wildly unrealistic. A former ambassador says of Wurmser, “I’ve known him for years, and I consider him to be a naive simpleton.” (Dreyfuss 4/16/2006)
Vice-President Dick Cheney is reportedly considering asking Israel to launch limited missile strikes against the Iranian nuclear site at Natanz in order to provoke an Iranian counterattack. The Iranian retaliation would then give the US an excuse to launch its own air strikes against nuclear and military targets in Iran. Cheney’s Middle East adviser, well-known neoconservative and war proponent David Wurmser, tells a small group of unidentified officials that Cheney is considering such a request. Meyrav Wurmser, the wife of Cheney’s adviser and a member of the neoconservative Hudson Institute, later denies the story, which is reported in late September 2007 by Newsweek, from two unidentified sources. (Reuters 9/23/2007; Ha'aretz 9/23/2007; Ephron and Hosenball 10/1/2007)
Betsy McCaughey (R-NY), the former lieutenant governor of New York and a fellow at the conservative Hudson Institute, writes that health care provisions in the Obama administration’s economic stimulus plan will affect “every individual in the United States.” McCaughey writes: “Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and ‘guide’ your doctor’s decisions.” McCaughey says the provisions are similar to suggestions in the book Critical: What We Can Do About the Health Care Crisis, by former Senate Majority Leader Tom Daschle (D-SD), until recently Obama’s pick to head the Department of Health and Human Services. McCaughey writes that hospitals and doctors who do not use the system will be punished, by a federal oversight board to be called the Federal Coordinating Council for Comparative Effectiveness Research. Perhaps most worrisome is McCaughey’s claim that elderly Americans will be given reduced health care based on their age and expected productivity. “Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council,” she writes. “The Federal Council is modeled after a UK board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis. In 2006, a UK health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.… If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the US will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined.” (McCaughey 2/9/2009) McCaughey’s claims are very similar to the ones she made against the Clinton administration’s attempt to reform health care in 1994 (see Mid-January - February 4, 1994). They will be proven false (see July 23, 2009).
Health care opponent Betsy McCaughey either resigns, or is fired, from her post as a director of Cantel Medical Corporation. MSNBC’s Rachel Maddow announces that McCaughey is fired; other sources report that she resigned voluntarily. Many media observers believe that part of the reason behind her departure is her poor performance on a recent interview with The Daily Show’s Jon Stewart (see August 20, 2009). McCaughey retains her position as an adjunct fellow at the conservative Hudson Institute, where she has consistently lobbied against health care reform and promoted issues favorable to health care and health insurance firms. In a press statement, Cantel says that “on August 20, 2009 it received a letter of resignation from Ms. Elizabeth McCaughey as a director of the company. Ms. McCaughey, who had served as a director since 2005, stated that she was resigning to avoid any appearance of a conflict of interest during the national debate over health care reform.” (Yahoo! Finance 8/21/2009; Stock Market Today 8/22/2009)
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