Report From the States

Hillary Care --- Is It Coming To New York?

Karen Shore

Hillary Rodham Clinton held a Town Hall Meeting during the first hour of NBC's Today Show on May 11, 2000, 7:00-8:00 a.m., eastern standard time. For the other time zones, it was taped so that all zones saw it at the regular Today Show time (7:00-9:00 a.m. in each time zone; this was shown in the first hour in each). Katie Couric and Matt Lauer hosted it (they are the usual Today Show hosts). The Today Show invited sixty New Yorkers to be the audience. We were told to prepare two questions to ask Mrs Clinton. To my knowledge, questions were not censored.

It seemed to me that people were invited to be participants based on their activism in a variety of areas (i.e., education, child welfare, health care, business, human rights, international politics, etc.). My name was given to one of the producers by someone who knew me as an activist in health care reform and knows me as the President of the National Coalition of Mental Health Professionals and Consumers.

Some of those chosen from the audience to ask their questions seemed to have been chosen based on their catching the eye of Matt Lauer or Katie Couric. The producers were also communicating with Matt and Katie and directing them toward certain people.

Katie Couric introduced my question as follows: "Mrs. Clinton, I know you were a major proponent of health care reform, and we have a question that pertains to that."

I said: "Yes. I'm Karen Shore, a psychologist from Long Island and President of the National Coalition of Mental Health Professionals and Consumers. Mrs. Clinton, you and Mr. Clinton were strong supporters of managed care and managed competition. This system has denied citizens needed treatment, killing many people that we could have saved, and causing others unnecessary pain. It has frustrated and angered citizens by denying them choice and control over their own health care decisions. It has almost fully destroyed mental health care, and it has demoralized and depressed a nation of clinicians. We are now seeing some of the same intimidating techniques used by our single-payer system, Medicare. People need to make their own health care decisions, in private, with their own chosen clinicians. My two questions are: Are you willing to say that your support of the managed care system was a mistake? And two, what would you be willing to do to help us devise a better system without the heavy-handed control of either corporations or the government?"

Mrs. Clinton answered: "Well, you know, the system that was unsuccessful, that we proposed, had a lot of safeguards that you don't have in the current system. I think you've got to go back and set the goal, which I still believe in, of providing quality, affordable health care for everybody. And I just can't understand why our nation, which has so many smart people and so many resources, cannot figure out a way to do that. And that would be something I would work on with anybody willing to work with me on it. And the second part of your question is that I believe we should have mental health parity. I do not believe that we should continue to stigmatize mental health. And I meet so many people around the state who are struggling, as you very eloquently described, to find care for themselves or family members - and its not there. And managed care has begun to cut back on services that used to be under insurance policies and they no longer provide them. Now this is a very complicated issue, and I know that there are many people who have different points of view. I think we need to get people together again, include everybody, and make sure we take those steps that will move us toward a fair and affordable system of both mental health and full, physical health for everybody."

After the program, Mrs. Clinton talked with us. Another person spoke about managed care and she responded by talking about the need for strong Patients' Rights legislation. I then told her that no matter how much we regulate this system, it will not make it a fair or high-quality system because it is a system of control over people, and neither patients nor clinicians can be happy under such control. I asked her to consider that the whole concept of managed care is destructive to patients, to quality, and to professionals and that the whole concept has to be replaced, that a system of such strong control over people has no place in America. She said she would consider it, and I then stepped back to allow others to talk with her.

Ms. Shore is president of the National Coalition of Mental Health Professionals and Consumers. Her e-mail is

Originally published in the Medical Sentinel 2000;5(5);179-180. Copyright©2000 Association of American Physicians and Surgeons (AAPS)