“Our present system is outdated, ineffective and unsustainable,” Clinton said at George Washington University. “It is, simply put, broken. As president, I will make it my mission to fix it.”

“The money we save from the waste we eliminate and the way we change how we care for people should be used to help finance coverage for the 45 million Americans who have no insurance,” Clinton said.

Although Clinton singled out for criticism the two powerful healthcare industries — both long-time nemeses — she simultaneously reached out to other camps in the healthcare sector and to the rest of corporate America, which has become burdened with rising healthcare costs for their employees and retirees.

Clinton praised three large corporations — Safeway, Motorola and Pitney Bowes — for the healthcare programs they offer employees.

“The key is to develop the political will to make it happen through a coalition of those who are most directly affected,” Clinton said.

“We can’t advance reform without the participation and commitment of healthcare providers, employers, employees and other citizens who pay for, depend upon and actually deliver healthcare services,” Clinton said.

Acknowledging the failure of her efforts during the administration of President Bill Clinton to enact universal healthcare, the senator said her plans would generate a political backlash.

“I know very well that every one of these recommendations will run into considerable opposition from forces that do not want change in the system,” Clinton said.

During her husband’s presidency, the health insurance industry was credited with playing a decisive role in fending off the Clinton healthcare plan.

On Thursday, the senator laid blame for many of the problems in the healthcare system at the feet of insurers. Health insurance companies, she said, do not want to cover preventive services, and they work to exclude sicker and more expensive patients from their plans.

Clinton offered a harsh assessment of the business practices of health insurance companies and promised to enact new mandates and restrictions on the industry.

“In a system of universal coverage, insurance companies cannot as easily shift costs through cherry-picking and other means” of excluding older and sicker patients, Clinton said. “That’s how they profit: by avoiding insuring patients who will be expensive and then trying to avoid paying up once the insured patient actually needs treatment,” she said.

Clinton proposed that all health insurance companies that participate in government programs, such as Medicare and the Federal Employees Health Benefits Program, be required to cover preventive healthcare services. She further said she would implement limits on insurers denying coverage or raising premiums for sicker patients. Clinton also said she would seek reduced payments to health plans providing benefits through the Medicare Advantage program.

Taking aim at the pharmaceutical industry, Clinton said, “Let’s start getting drug costs under control.” Government-funded research has shown, she said, that expensive prescription drugs are not always better than cheaper alternatives.

“One of the things they’re finding is a lot of these so-called blockbuster drugs are no more effective, and sometimes less effective, than treating conditions with old standbys that have just been around for a long time and don’t have all the advertising with, you know, people running through fields of wildflowers,” Clinton said.

Specifically, Clinton advocated government negotiations of drug prices under Medicare, the importation of less expensive medicines and more use of generic drugs. Clinton also promoted her legislation to permit the sale of generic versions of costly and complex biotechnology drugs. “We need to break the monopoly that biotech pharmaceutical companies have over their products,” she said.