Sen. Clinton's Health Plan: A First Look
Sen. Hillary Clinton has offered an initial look at her plan for health care reform. It's not likely to change anyone's mind about her candidacy, or about health care reform, but at the overview level it's well-designed and thorough. Her plan is solidly in the center of Democratic proposals. It emphasizes mandated coverage, cost reduction measures, and the elimination of predatory insurance underwriting. At first review, it reinforces the sense that she and her staff are knowledgeable, highly competent, and incrementalist in their approach.
We'll look at the plan's details, and then quickly touch on the Republicans' (predictable) responses.
Sen. Clinton has abandoned the regional health alliances that were a hallmark of her 1994 proposal. That makes the Edwards plan, with its regionally-based Health Markets, more traditionally 'Clintonian' than Sen. Clinton's new proposal.
Here are the highlights of the Clinton plan, based on an initial review:
Like the Edwards plan and Mitt Romney's Massachusetts plan, mandates are the centerpiece of the Clinton program. Every American will be required to have health insurance. To offset this new requirement, the Clinton plan promises future cost savings to ensure affordability.
I'm not a fan of mandates, for reasons discussed here, although I understand the thought process behind them. There are fundamental issues of fairness that are easy to address in theory, using subsidies -- but most policymakers so far have failed handle premium and copayment structures in a way that does so effectively. I also suspect that Republicans will have a field day running against the mandate concept.
The Clinton plan -- like those of Edwards and Obama -- apparently offers a public insurance alternative, although details are sketchy at this point. The long-term impact of a public/private competitive model is potentially very significant: If private insurance companies can't compete on price and value, and if they're policed effectively enough to avoid their use of unfair underwriting advantages, they could potentially wither and die. That would leave the country with a de facto single-payer system -- one created by market forces. Yet there are many potential hurdles between a mixed system and a fair outcome.
Sen. Clinton's program is administered through the Federal Employee Health Benefit Program (FEHBP). She takes a page from John Kerry's playbook (and Ron Wyden's) by saying that this will provide "benefits at least as good as the typical plan offered to Members of Congress, which includes mental health parity and usually dental coverage." There will also apparently be also a public Medicare-like system, although details on that are sketchy at this point.
The problem is that, as Joe Paduda points out, many Americans can't afford the copayments and deductibles in the congressional health plan.
It will be difficult to light a fire under the political base with this plan, or for that matter with Edwards' or Obama's (although Edwards took the rhetorical lead today by promising to cancel coverage for the executive and legislative branches if health reform isn't enacted).
Sen. Clinton's plan appears to handle taxation issues in depth, and addresses the ongoing (and often neglected) issue of retiree health benefits. And Clinton has been ahead of the curve in addressing health IT issues.
Republican reaction was predictable:
"If you've seen the report this morning on the latest version of Hillarycare, you'll see that version 2.0 is not like to have any more success than 1.0," former Massachusetts Gov. Mitt Romney told reporters in New York. "Hillarycare continues to be bad medicine."
Yet, of all the candidates, Romney is the only one who has tried to enact health reform. As we've discussed before (here, here, here, and here), his record so far hasn't earned him any bragging rights. And Giuliani indulges in a typical attack of red-baiting, saying ""If you liked Michael Moore's Sicko, you're going to love HillaryCare 2.0. " That may not be a smart move, since a lot of people did like Sicko (a movie that condemned the "new Hillary").
As with any of the health proposals, the Clinton plan can't be fully assessed until more details are provided on knotty issues like premium calculations and benefit design. We'll be looking for more information, and will provide more details as we get them.
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The Sentinel Effect: Healthcare Blog
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RJ Eskow at the Huffington Post
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The fact that she did not follow up with her 1994 proposal shows that while she cares but enough. You look for a leader who will fight for the good of the people even under strong adversary, a leader who dare swim against the current for the good. It took a documentary film maker a lot of guts who is not afraid to fight for what is right against powerful rich giants to bring put this matter onto the table again. Now that the impetus for health care improvement is rolling again presidential hopefuls can cash in.
Not to say Clinton is not a good leader but the fact that she is the only one to have brought up the matter years ago and then gave up shows there is a pooor choice of candidates who truly cares.
Unless you get each candidate to sign a black and white agreement of all the promises they made in their campaign speeches otherwise there is no guaratee that they will not change their tune once elected. You cannot trust politcians,who knows the next candidate may even prolong the Iraq debacle or even start another war.
Let's say you are medicare eligible.
You have to wade through a myriad of medical information which many of our geriatric population are unable to do.
You have to be able to decide to stay in medicare or go with one of the HMO companies. They have to make a big profit so you get the old "bait and switch" until or if one day you realize you're getting screwed.
The HMO's cherry pick until you get old enough or sick enough and then they figure out how to get rid of you or don't pay for the kind of things you need at the end of your life. (The amount of money that is spent on you during the last six months of your life is equal to that spent on all your previous life). There's also a lot of companies to chose from to help the confusion.
Next, You have to get supplemental insurance to help pay for those things that medicare or the HMO won't pay. (A bunch more companies).
Next is medicare part D to cover some of your drug expenses. About 50 companies to choose from in my area. (A lot of b.s. so that the drug companies could charge medicare more and medicare isn't allowed to negotiate the price of the drugs by law). You don't want to know about the "donut hole" as to when drugs are covered and when they aren't.
You better be well educated , cynical and have a family member who is in a medical profession if you hope to wade through this system.
Surely, single payer medicine with no co-pays and no deductibles would be better than this.
You address the topic of Medicare. I would like to say some things about the future of Medicare.
When the Boomers hit the Medicare system we are looking at the Mother of All High Risk Pools. This will drive costs of Medicare through the roof.
In my opinion there is one way to address what is coming. That is enlarging the Medicare pool to include the young and healthy. That means Medicare for all. The administrative costs would be lower than what Clinton and some others have proposed. That is another advantage.
Clinton's estimate for the cost of her plan I believe are understated. Premiums for what she proposes will go through the roof for everyone when insurers are required to take all comers including those with pre-existing conditions.
(1) Let's say you are medicare eligible. You have to wade through a myriad of medical information which many of our geriatric population are unable to do.”
THAT IS NOT TRUE
And stop eing so rude. Older does NOT equal stupid or incompetent.
(2) You have to be able to decide to stay in medicare or go with one of the HMO companies.
NO. You are automatically enrolled in regular Medicare. If you want to look into an Medicare Advantange plan (HMO), you can. They cost more though.
(3) “The HMO's cherry pick until you get old enough or sick enough and then they figure out how to get rid of you or don't pay for the kind of things you need at the end of your life. There's also a lot of companies to chose from to help the confusion.”
NO THERE ARE NOT A “LOT OF COMPANIES.”
In my area there are no Medicare HMOs and only one (Humana – yuck!) offers an Advantage HMO/PPO type plan.
You switch to a PRIVATE insurer from regular Medicare and you get what you choose – profit driven insurance. If you are that stupid, that is your problem.
(4) Next, You have to get supplemental insurance to help pay for those things that medicare or the HMO won't pay
You may or may not choose to get a Medicare supplement. By the way, the AARP is way, way overpriced because that plan is done by United Health. For example, the AARP plans cost 4-5 times what my non-profit Blue Cross Medigap plans do,
(5) “Next is medicare part D to cover some of your drug expenses. You don't want to know about the "donut hole" as to when drugs are covered and when they aren't.
You don’t know only if you are to dim to read the description of the coverage and too stupid to look up your drugs on the plan formulary.
Republicans are criminal scum.
We have to deal with these irreconcilable mobsters, killers, and war criminals first.
America is at the fulcrum of revolution or slavery.
We're not going to be getting any new system at
all unless it comes with profits, until we
install America V2.0.
Take it or leave it, People.
Single-Payer payer will be less expensive for working Americans and for business, because we won’t have to pay for HMO-insurance company profits, big CEO salaries and bonuses, and administrative waste.
HRC is such a scammer. She waited this long to put out her Health plan only to lift everything from Senator Obama and Edwards? What is wrong with this woman?
She has not only stolen every idea, including the so-called let's do lunch to claiming to be an agent of change, HRC has revealed herself as a phony and unqualified to lead this country. Plus, SHE LOOKS JUST TOO OLD AND GLOOMY. America can do better. Obama is the future.
Totally agree and it's starting to tick me off. She basically waits till others put their plans out there, has the audacity to criticize them before she puts her own out and cherry-picks their ideas and basically repackages them. Then the media makes a big whooping deal, gives her headline billing when she finally announces something, as if it's original and earth-shattering. Gimme a freakin' break. We don't need another tabloid presidency!!
We need a national health care plan that does not include the insurance industry.
Hillary is in the pockets of the health insurance companies.
We should listen to Kucinich, those health insurance CEOs are ripping off the people now, imagine how much more they will after the government DEMANDS that we buy insurance from those companies.
Our car companies and other manufacturers in this country are at a disadvantage if the burden of health care is just on them. We Americans are fools, look at all the other industrial countries, they have good health coverage, despite what those people who want you to believe otherwise.
Ever notice, those who don't want everybody to have health coverage, already have it!
All of Europe also have 4-5 weeks paid vacations, by law!
Those European countries should hate American, because we are cheap labor compared to them, and we talk about those cheap illegal people undermining our country, not to mention that cheap labor in the third world countries where most of out good paying jobs are going.
Like I said Americans are fools!
They even elected Bill Clinton , who gave us those treaties that cost the middle class millions of good paying jobs and Cheney's speech-a-day pet monkey Twice,..... I rest my case!
Agreed. I can't believe more people aren't paying attention to Obama's healthcare plan. Is it perfect in my idealized liberal world? No! But I'm willing to pass the most comprehensive plan, with the most political support and have it benefit millions of Americans. American are in need now, and we can't have Hillary waiting to see what everyone else does before she comes up with a plan for everything! Poor leadership if you ask me...
http://www.barackobama.com/issues/healthcare/
Obama has sold out the Good of the Whole to the Welfare of the Few on healthcare too. He certainly is not proving to be the hero we all are all hoping for.
Promise the moon and deliver moldy bread. BLAH BLAH BLAH
Welfare for the insurance industry, nothing more. Same old, same old.
That's an excellent way to describe it.
Health care is simply a matter of priorities. Our priority is profit for the strongest and those with the biggest guns, etc. France, etc. have bullet trains for sensible transportation and free health care because the people don't allow their gov't to spend all their money on other things, like military, weapons, etc., and the french people seem to be way beyond our average joes in figuring this out. We have socialized education through high school, so why can't we have socialized education through college, and socialized medicine? Not really much of a leap, so all of you who fear socialism, remember that I help pay for your kid's education through high school and I don't have any kids and I don't mind a bit. Get a clue and vote for anybody who wants to socialize medicine, pharmaceuticals, and take the greed out of it. Hint-Guliani thinks it would be a "disaster"-and it would be for the insurance and drug companies as they now stand-so don't vote for that complacent, overconfident, arrogant friend of insurance companies.
So...if I drive and have no auto insurance I can go to jail. And if I have no health insurance and need hospitalization...will I get a ticket? What?...
This reminds me of the Bush presciption drug plan which essentially guarantees that the profits will continue to flow and the burden of the systems complexity and its expense will of course, be distributed to the consumer (you and me), without cutting out the middle man. Great.
While no fan of big government plans, could we at least take a stab at coming up with something simple for a change? If you're gonna hoodwink us already do you have to make it a headache too?
Well I am really happy to be reading the comments on this thread. While I am on the other side from most of you, I think it is great that we can sometimes find some type of common ground. Mabie for diffrent reasons, but its a start. Healthcare needs to be fixed, but what she wants is not the way on the right or left.
Haven't you been to a post office, the DMV, a Social Security office or even had your passport renewed lately? I can not understand why anyone would want the government handling their healthcare.
People complain about the incompetence surrounding Katrina, the running of the Iraq war, pork projects, governmental waste and mismanagement but still you want the government to do more. Remember the "big dig"? Social Security is going broke. Congress has a 20% approval rating and the president has a 30%.
Someone please tell me how this has any chance of working? I guess if it is free you cou could support it. But then again, you get what you paid for.
Seems we got a choice between a government-
run 'post-office'-type system that nobody
wants, and a 'money-grubbing' profit-based
insurance-industry-dominated system that
nobody wants.
There may be some variants, but logically
it looks like it's got to be one or the other.
Face it, whichever way we go, a whole lot of
people will be against it.
Is there not perhaps also a Libertarian approach,
which would do away with both? 'Health care
is for wimps!' after all.
Don't ask if you don't want the answer. Yes, I have been to a SS and Passport office lately - to replace a lost card and renew, respectively. Everything went without a hitch. Had the new SS card in two weeks, the passport in a month. The DMV? Well, no one's perfect. But my point is, the argument that gov. doesn't work is self-perpetuating and flimsy. I drink clean water every day thanks to government dictates, drive on safe roads maintained by gov-paid workers, send my kids to outstanding public schools, and visit vast parklands kept pristine by gov. agencies, with some private largesse that promotes environmental practices. Meanwhile, I've had to spend endless hours over the years battling private insurers to ENsure I received the coverage I was paying for when I was arbitrarily denied coverage. I always won, but no always without a fight. Private is NOT always better.
I love it when folks complain that the government does nothing well. It is revisionist history. Here are a few things the governemnt has done well. Earned Income Tax Credit, an incentive for poor folks to work. Head Start has helped more families than anyone ever imagined get a good start on the education of their children. FEMA prior to W was an effective source of government assistance to victims of disasters. The Clean Water Act has done just that, led to cleaner water. Medicare is more efficient than private insurance and has assisted a huge number of Americans.
Social Security may be forced to offer reduced benefits if the President and Congress continue to raid its surplus, but it will not go broke in the sense of running totally out of money. Those of us now working are paying the benefits of those who are retired, just as our kids will pay pur benefits. If the money paid in taxes for future benefits is not diverted to another purpose the system will hold.
The government does a number of things well, much better than the private sector. It is so sad to see these sorts of strawman arguments.
Spare us all this drivel aboout driver's license and other nonsense.
Honestly, are these people so dim as not to realize that Medicare is government insurance?
Medicare does NOT restrict one’s choice of physicians or hospitals.
Private insurers do that.
Medicare does NOT play the ‘get a 2nd opinion’ game.
Private insurers do that,
Medicare does NOT fiddle about with the ‘get pre-approval or it is not covered.”
Private insurers do that.
Bet ikegoodyeaaraz85338's over-65 relatives will tell him they adore Medicare and any politician who tries to eliminate it will have a huge rebellion on their hands.
As far as Romney and Guiliani ranting about ‘wait times’, they obviously haven’t tried to book an appointment in this country recently. My GP told me to see a dermatologist. I called all 9 dermatologists within 75 miles. Only 1 was accepting new patients at all and it would have been a 16-17 week (over 4 months) wait for an appointment. I have to book the appointments with my chronic pain specialist 6 weeks in advance.
does the word "sarcasm" ring a bell?
I don't much care for the idea of mandated insurance. I for one cannot afford to be forced to buy coverage. I have no insurance. I am 57 yrs old have worked most of my life and the only way I had insurance was through an employer. I am no longer with that employer, therefore no insurance. The premiums for me to buy insurance are ridiculous. No one can afford them. There is nothing wrong with socialized medicine. If we need tips on how to make it work we could ask our neighbors to the north or the Europeans. This so called system we have is absolutely barbaric and inhumane. And I am so grateful that Hillary is at least talking about it. I wish we could just dump the insurance companies all together. I agree with the poster who said pay 2% for medicare. We would all save money because we would not be paying these ridiculous insurance premiums. And don't tell me that medicare doesn't work because I know better. I took care of my ailing Mother for 7 years and dealt extensively with medicare. They are very efficient and knowledgeable. A lot more so than private insurance companies. They are a bunch of crooks.
Medicare isn't 2%.
If you don't have enough quartersof earnings to qualify for Medicare when you are 65, you have to buy into Part A. That is $410 a month.
Everyone has to pay Part B premiums - $93.50 a month
The basic Part D (prescription) premium in $32.
That, so far, is $535.50 or $125.50 if no charge for Part A.
Now, since Medicare has some very stiff deductibles (Part A $992 and Part B $131) and copays (Part A $248-496 a day for hospitalization; and Part B 20-50% of charges), that means a Medigap policy. For more than one that just covers Part B copays, that means $150 -300 a month.
Grand total? $685.5/835.5 -$275.5/425.5 a month.
For that to be 2%, would mean incomes of $411,300/501300 - $165,300/255,300.
givemycountryback - There may be another option for you (and I"m not assuming you haven't already checked into this): many state legislatures, frustrated by the lack of attention by the federal govt., are acting to provide subsidized health care to their citiziens. In most cases these are plans that address low income individuals, families and, of course, children. Usually, the requirement is that the "consumer" be living at 150-200% of poverty level, or earning below 30% of area median income. But those states that already have public health plans in place, and are operating at a surplus, may also be instituting other plans for somewhat higher income idividuals that uses medicare as a model. I don't know where you live, but it would be worth checking with your state's Dept. of Health Services. Or just call your state rep or state senator's office, explain your predicament and ask "what can you do for me???" It's important to put them on the spot.
I'm not too far from your situation, though I'm younger and have savings. But I'm so many years from being able to sign up for medicare...
Good luck to you.
Oregon is one such state. We're aiming to have universal coverage by 2009. I just wanted to put that up in case you'd like to check with our state and see how we're going about it.
My brother, who is now retired and on Medicare, says it's MUCH BETTER than any HMO, PPO, Etc.
If European nations can afford universal healthcare, so can America. We pay much more with private ins because we're paying insurance company profits, but government universal healthcare is cheaper because there is no profit. It's so simple to figure out...
It was also cheaper at the Post Office when the gov. ran it. Now we pay MUCH MORE for postage and get MUCH LESS(shabby service) because we are paying this "PRIVATIZED" company PROFIT in addition to the mailing costs. Same situation.
Don't Americans have memories or the ability to think things through and come up with correct answers instead of constantly being bamboozeled by politicians and corporations?
How can you be happy Clinton is talking about forced health nsurance and she calls it health care. What a joke. Dennis Kucinich is the only one with the courage to stand up to the insurance lobby. Kucinich has a real health care plan with no insurance. It works for medicare already.
Why is it incumbent on employers to provide health plans for employees, other than to perpetuate a system in which profit-reaping insurance corporations get to bill every other type of corporation for inflated premiums? How do you legislate a requirement by which every single person MUST purchase an industry's product (this is already an unabashed, government-mandated shakedown and sop to the insurance industry when it comes to car insurance)? Her plan would seem to merely codify the gruesome corporate owned health beauracracy we already have in place. What a sellout she is.
The best solution to the healthcare mess is for the government to provide universal (that means everybody physically in the US) health coverage without copays. The only reason anything else is ever discussed is due to the lobbying efforts of the pharmaceutical and insurance industries. The pharmaceuticals are misguided in their protests, since universal coverage immediately expands their market by a large percentage. The insurers will just have to find other types of insurance to peddle, but they really have only themselves to blame for the current mess.
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