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.
A Night Light
The Sentinel Effect: Healthcare Blog
Future-While-U-Wait
RJ Eskow at the Huffington Post
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So this is Hillary’s big plan to change healthcare in this country.
Instead of a universal, one-payer, nonprofit healthcare system, we are going be required to PURCHASE insurance from the very same companies who are making massive profits at the people’s expense.
…and if we can’t afford it, the “government” will pick up the tab, effectively subsidizing these sale same companies.
Considering that Hillary’s biggest supporters include PFIZER INC., AMERICA'S HEALTH INSURANCE PLANS PAC, THE BLUE CROSS BLUE SHIELD ASSOCIATION POLITICAL ACTION COMMITTEE, and the AFLAC INCORPORATED POLITICAL ACTION COMMITTEE,
it should come as no surprise that Ms. Clinton is proposing a system that will immensely enhance the profits of the self-same corporations that are the root and cause of our health insurance problems;
That Democrats consider this woman a populist is what truly amazes.
Right on, lastams. And if you take a quick look at who controls those biggest supporters at GreatRedDragon.com then you'll not only see you're right, but who's at the root of the rest of our problems. Using medical insurance as the "cattle prod" we're being herded into a corner like never before. I do not want my grandchildren born into slavery, and I suspect few others do either.
Thanks for the link. That's one funny bunch of histrionics. If I were you, I'd grab a pike and man the barricades. Of I forget, you're being prodded and corralled! Steak anyone?!
It would probably be best if corporate America
would just require politicians to wear their
sponsors' logos whenever they're out in public,
like NASCAR drivers or tennis players.
President Cal Coolidge said, in 1925, 'The business of
America is business.' Truer words were never spoken.
http://usinfo.state.gov/usa/infousa/facts/factover/ch5.htm
Unfortunately Coolidge didn't live in an age of globalized multi-national corperations where what is good for GM may NOT be good for America.
At some point the good of the people, of the health of the country, has to come first.
At some point our leaders have to speak for US, the people who elected them, instead of spending half of their time on the telephone collecting "donations" for the next election cycle.
There are bills in Congress to accomplish these very goals, and progressive far sighted individuals who believe in service to their country.
It may take the establishment of a third party to give them a voice ... but to expect real change to evolve from THIS environment is naive.
To expect someone like Ms. Clinton, a corporate invention, to discard her economic base and fight for the right of middle class Americans is equally naive.
We can do better than this; but we need to change the rules and expect more from our elected officials.
Touche!
Dennis Kucinich has the best plan for providing universal health care. It cuts out the "for profit" HMO's and insurance companies and the so called "managed care" approach to medical coverage which imposes limitations if not outright denial of coverage. His plan is basically an extention of Medicare. It can be paid for by a 2% increase in the payroll tax for employees and employers, thus eliminating the payment of insurance premiums, co-payments and deductibles which in the aggregate would cost more. People will have their choice of doctors and hospitals (who will be paid by Medicare). It's not socialize medicine. It's not like the VA medical care system where the doctors are employees of the government and the hospitals are owned and operated by the government. The only problem is that the HMO's and insurance companies will strongly oppose Kucinich's plan along with the Republicans, including some Democrats who have received political contributions from lobbysists representing the insurance industry.
I like the Kucinich health care plan and love his ideas on Impeachment. It seems now that the greedy corporate industries (HMO's, Big Pharma, Big Oil, Tele-Coms etc.) have been given so much by this administration and just steam roll over individuals. You notice there are very few Republicans that support campaign reform.
I also resent that the second tier candidates are just largely ignored by the media. I am far from making a decision- I'd like to hear the ideas of ALL the candidates.
Any plan that doesn't include the Insurance Companies has to be the best. The exclusion of the Insurance Companies would also take away any temptation of our esteem Congress to think about we the people instead of lining their own pockets. No Insurance Companies would also aid in the education of more Doctors, which we definitely will need and great health care facilities for all the people. Even as I write this, I'm aware that my next request for an appointment with my Doctor will be 3 to 4 weeks longer than previously. I find myself now competing with the Illegals that have invaded this country. Perhaps if we ALL sent our requests to Congress, they may take the hint.
'Canadian physicians who wish to make millions a year
leave Canada to practice in the US.'
Once you get past doing what the 'insurance
industry' (HIAA) demands that you do (as a politician),
you must then do what the 'medical profession'
(AMA) wants.
There are many rea$on$ why Canadian doctors
(& Indian, Arabian, Swedish, Fijian doctors)
want to practice in the US. It's a lot like
a 'gold rush', these days, apparently.
These are the guys who don't need no 'stinking
socialized medicine', thank you very much.
So presumably the Clinton plan takes this in
to account also. She does NOT need, cannot
afford, to piss off either the HIAA *or* the AMA.
Sen. Clinton defends taking money from Washington lobbyist.
I dont know how you take money from the insurance companies and say you would do what is best for the people.
I think it is all talk, and it might just fall through like her proposal while in the White House. She would do what is right by them and not us.
Does some one make a profit providing insurance coverage with Hillary's plan? (I'm not talking about medical providers being paid for services)
If someone gets to make a profit, then its a moronic and unethical plan.
I'm highly skeptical of the government managing *anything*, but the current for-profit structure is killing people.
Spot on, wise one.
Sad to say, this country runs on profits.
Looks like HRC has come to understand this.
The government would be the exception that
proves the rule. Whatever else happens,
the healthcare solution will still be profit-based.
Maybe if we get to USA V2.0, things will be different.
Profits are great for businesses that actually provide real goods and services, but allowing a totally unnecessary middleman to divert billions of our healthcare dollars before they have been used to accomplish anything worthwhile is diluting profits for healthcare consumers and providers alike. Providers don't like low reimbursements from Medicare and Medicaid, but that problem could be easily resolved if we weren't allowing 31% of what we're spending to be wasted on unnecessary bureacratic overhead created by the health insurance industry. Care providers need to understand that if they are going to be paid more money (if they think they deserve it), they will have to get it from the leeches (insurance part of the equation) because the turnips (people) have been bled. Now the insurance industry makes sure sick patients must live in fear that care providers will bankrupt them, and tries its best to keep care providers living in fear that patients will sue. If all Americans were united into one protective pool, eliminating unnecessary (and extremely greedy, amoral) middlemen, with all necesary healthcare paid out of that collective & protective pool, no one would have to sue or bankrupt anyone over medical bills. Patients and providers could become friends again.
i think eskow is confused when he writes that Sen. Clinton's public alternative is based on offering all Americans an option to join the Federal Employee Health Benefit Program (FEHBP). the public option is based on medicare. FEHBP plans are all private insurance plans
http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx
'The Same Choice of Health Plan Options that Members of Congress Receive: Americans can keep their existing coverage or access the same menu of quality private insurance options that their Members of Congress receive through a new Health Choices Menu, established without any new bureaucracy as part of the Federal Employee Health Benefit Program (FEHBP). In addition to the broad array of private options that Americans can choose from, they will be offered the choice of a public plan option similar to Medicare.'
Nothing short of arriving at a single payer system is worthwhile. Why pay 30% of our healthcare buck to insurance companies? Even mandated insurance like Massachusetts has will not get rid of those bloodsuckers.
We recently traveled in Ontario and asked anyone that would listen about their medical care system, everyone from employees in convenience stores to professional folk in the Toronto area. Uniformly, they seem satisfied. Canadian physicians who wish to make millions a year leave Canada to practice in the US. Those physicians who are content to make a very good living stay in Canada, practice their profession, deliver great medicine, all in a timely, medically acceptable way. There are no long waits, EVERY body is covered. There are great preventative medical programs.
It is true that the citizens of Ontario pay higher taxes for their coverage, but I pay huge premiums to cover the uninsured (along with myself), as do most folks who have health insurance. I would rather drop the extortionate premiums and pay a higher tax, knowing I am covered, and that my hard working neighbor and his kids have coverage too.
Is there a candidate who has the cajones to push for single payer coverage? Maybe they can just start expanding medicare....I have my dreams!
I agree with you. Universal health care seems like the best practical option.
We know it'll be cheaper for everybody if we have universal healthcare. We know it's govt funding that supports medical research, not private practice. We know pharmaceuticals will raise the price of their AIDS medicine 400% when used in combo with other AIDS meds so that you'll be force to either pay the increase or use their combo meds. so why are so many people against universal healthcare? Do you know?
Is anyone who knows or doesn't like universal healthcare please explain the problem to me?
Yeah, they think they are untouchable. They will never get sick, nor will their families or loved ones. Give them time.
Well, Dennis Kucinich seems to be the only candidate with any cajones at all. His plan is the way to go. Problem is nobody would vote for him to be President because they are jealous of his beautiful young wife. Or at least that's what I'm told.
Earthlings Unite!
"Is there a candidate who has the cajones to push for single payer coverage?"
I believe there is. From the Kucinich web site:
Dennis Kucinich is the only candidate for President with a plan for a Universal, Single-Payer, Not-for-Profit health care system.
LET'S HEAR IT FOR KUCINICH.
The CONS might be better off if they actually based their criticisms on the plan rather than reflexively yelling "socialized medicine" and "higher taxes"
Requiring people to purchase anything is unconstitutional.
In her speech, she compared mandatory health insurance to mandatory auto insurance. The problem is, you don't have to get auto insurance if you chose not to drive, but health insurance will apparently be mandatory for all of us.
The government mandates how you spend your money...How is this anything other than taxation? And quite regressive at that.
She said the insurance will be "affordable", I guarantee you that what is affordable to HRC is nowhere near affordable to me.
What a great racket, buddy up to the insurance/pharm industry, take some "donations" from them, and then get your new friends guaranteed wealth. Dick Cheney and his friends over at Haliburton would be proud.
Now, if someone wanted to actually address the healthcare crisis in this country, by removing the grossly inflated profits "earned" by the insurance companies, well that would be a plan.
The problem with Hillary's health care program is the same problem she has with many of the ideas she proposes. It's not well thought out and she does not have the skills to work across the aisle or with other stakeholders to get things accomplished.
Hillary has spent her whole political life locked in some sort of battle with the 'vast right wing conspiracy'. She herself has said she's been fighting the right for twenty years.
Things this country needs like healthcare are not going to be accomplished by the right fighting the left.
Things like healthcare will get accomplished by a person who's vision and skills will be successful at uniting this nation.
I see that person as Barack Obama.
All vision, otherwise an empty suit. VP, at best.
Obama hasn't had 'plan' for anything,
He did a cut n' paste from the Mass. system for his so-called healthcare proposal(and skipped large parts of it.).
His "ideas" ahve more holes than swiss cheese and he spouts nothing but hot air and vague generalities..
Obviously you've never read Obama's Healthcare plan. His is the only one that won't criminalize those who do not have healthcare. Or did you miss that part of "mandatory" in the health care plans and that this was the biggest obstacle for universal health care over Republicans? Thus, Obama's plan is the most passable in a Congress that isn't 100% Democrat.
Obama has also passed the most comprehensive ethics reform in Washington in decades., and has very detailed education and environmental policies.
It's too bad you don't bother to look anything up or read, you could save yourself from looking foolish.
"His "ideas" ahve more holes than swiss cheese and he spouts nothing but hot air and vague generalities.."
That's interesting because through the first 6 months of this year, more than 258,000 donors who gave to Obama disagreed with you.
And, if Obama is about nothing but "vague generalities" and hot air, how come he has been endorsed by an increasing number of Iowa legislators: http://www.desmoinesregister.com/apps/pbcs.dll/article?AID=/20070915/NEWS09/709150328/1001/NEWS
We can go on and on of course.
First I thought you might have "paralysis", because like others in the HUFFPO community who level those charges against Obama, it seems odd that you would pass on an opportunity to go to barackobama.com and click on ISSUES.
"paralysis" might now refer to your hands, but rather to you inability to see beyond your uninformed opinions of him.
Barak Obama could be a real hero if he wanted to be. The problem is in order to do that he would have to use real courage. I have read healthcare legislation he co-sponsored, and his proposed (lack of) healthcare "solution", and he is just as full of smoke and mirrors as are the other politicians who have sold out the Good of the Whole for the Welafare of the Few. If he were different I would be singing his praises to high heaven, but he's not. He's pretending to be.
RJ Eskow,
"That would leave the country with a de facto single-payer system -- one created by market forces."
Great analysis.
US cannot go to a single payer system overnight. The insurance companies would assassinate any candidate advocating it.
What Senator Clinton is proposing is a gradual process. It is doable. It might be the only way to get to single payer.
How long, oh Lord, how long? And someone up the thread is talking about taking baby steps. How did other countries get to the single payer system? The insurance companies will ALWAYS assassinate any candidate advocating it. The trouble with this country is it's not only Congress who lack spines--the whole country is that way. Don't forget now: think small!
Yep and she practically copied the plan Edwards proposed months ago.
Plagarism is SOOOOO tacky.
Hillary Clinton has accepted more money from pharmaceutical companies and doctor's special interest groups than ANY OTHER candidate, Republican or Democrat.
Clearly, it shows. Her "plan" involves letting the insurance companies have carte blanche over the American public. There must be no "middleman", as Michael Moore pointed out. Health care is not like anything else in the economy. It's not like buying a television set. "Supply and Demand" don't really apply here, at least not if you have even a shred of compassion. Humans will always need health care. To make it a negotiation, or left up to the whims of the marketplace, is simply barbaric, and to think that profit-motivated compainies have any place in the discussion belies a very unfeeling person. Shame on her. She does not have my vote.
If the Dems determine policy based on what Michael Moore advises, the White House will remain the home of the GOP.
Why don't so many people like Michael Moore?
This is such a sad comment on the state of our nation that I can't bring myself to believe that it's true even though it sounds true. Why should this be? Sanity and reason can never win out over idiots with guns?
The right has controlled the agenda so well over the past forty years that Moore's "position" on health care looks like a loony left-wing conspiracy to anyone slightly right of center. Whatever happened to actual moderates in the middle who could listen and understand a reasonable proposal, then make a decision?
Earthlings Unite!
Where does it say that? I thought Bush had her by at least 15 lengths.
"Medicare for All". . .We need a Free, Universal, not-for-profit, single-payer, health care system, as proposed by Dennis Kucinich. What Hillary's corporate sponsors want is forced insurance. Government money paid to the insurance and pharmiceutical industries. . Don't get fooled again.
It will be interesting to see what Harry & Louise (from
the Health Insurance Association) have to say about
the Clinton plan, this time around.
http://www.bmj.com/cgi/content/full/308/6933/924/a
The devil is in the details. She ran into much
trouble from anxious & disrespected elements
of the super-powerful insurance industry last
time around. Seems like this time she's getting
ahead of them: they *like* mandated insurance,
after all: really, really like it.
Without knowing the details, it would seem that
the Clinton plan isn't too much different from the
'mandatory' Romney plan in Massachusetts. The
question, of course, will be how, what do 'they'
do to make it mandatory? There has to be a penalty.
Tell us about it, why don't you?
So we continue to live in an increasingly
corporatized America. That in itself seems
a major disappointment, no?
mittens thinks OOPS - says "people who don't have insurance don't pay taxes anyway"
There are various flaws in the Massachusetts
plan. The 'penalty' (alluded to above) is
elimination of the personal exemption on state
income taxes & is said to be useless for the
reason stated. Small business was supposed to
be charged a fee for not participating - that's
not happening. Age-based premiums are *very*
high for older people, not exactly 'affordable' for
anyone else who's uninsured. Benefits are meager.
It would seem to be a plan in need of *much*
tweaking, *maybe* a dubious model for others,
and probably 'not much of a success' for Mitt
or for Massachusetts (yet). We are ever hopeful.
I will vote for a republican before I vote for HRC. Please don't nominate this wicked witch, the country deserves better. John Edwards is the only viable democrat unless, god willing Gore runs for a second term.
I practiced law in North Carolina for 10 years and frequently referred business to John Edwards, plus I had the privilege of watching him before a jury. He is a fine man. That said, he can't even win North Carolina. Put more simply, he has no chance in a general election.
Wicked witch ahe may be but if we have no other choices she is a step in the right direction. Even though she's only an inch or so to the left of your average conservative that's the way we need to move... baby steps, ya know?
And if you think you'll get any kind of affordable health plan out of any repub, think again... that ain't gonna happen.
We were promised "future cost savings" that would be passed on to the consumer when we foolishly accepted that all drivers in California have mandatory car insurance. Hillary's health insurance plan is the very same boondoggle. It's the insurance companies, stupid!
Earthlings Unite!
Exactly. As long as health insurance is in private hands, we will be the victims of insurance company abuse. Mandatory coverage only gives the insurance companies more leverage. If I am to face a monopooly, i'd much rather it be a government one because private monopolies spell financial disaster for the little guy.
Insurance companies as gate-keeper of healthcare means more of the same : restricting coverage of expensive tests prescribed by physicians, restricting expensive treatments, expensive medications and delays and more delays by requiring patients to call numerous times to get approval, not to mention exclusion of coverage due to pre-existing conditions which under Hilary's plan is disallowed. They also will continue to restrict re-imbursements to physicians, hospitals and care facilities and try to make as much profit as possible for the insurance companies. At least, this is what has been going on all these years. A drastic reform is in order if the insurance companies are the main players, but so far, there has been no such proposal.
Hillary's entire career and her tenure in the Senate is well-thought-through! She attempted to rehaul Health Care when the right wing controlled Congress! She made it an issue well before anyone else in the race (on both sides of the aisle)had even thought about it!
Her campaign, her messages and her Presidency are/will be based on solid facts and considerations. It will not be empty rhetoric and fluff with populist themes that have become hallmarks of virtually all her opponents!
As an afterthought and observing the usual Hillary bashing by the right and left wing nuts here; they are the same crowd who scream the loudest but never get anything done
For, if a matter was actually resolved, they would have to stop screaming. The same left wing nuts who screwed Al Gore in 2000 have now become his most ardent supporters! It is this political fringe that laps up the fluff and rhetoric I mentioned above!
How very Rove of you to lable anyone who doesn't support this corporate shill to be a "right or left wing nut".
Instead of a universal, one-payer, nonprofit healthcare system, we are going be required to PURCHASE insurance from the same companies who are the root and cause of our healthcare problem.
…and if we can’t afford it, the “government” will pick up the tab, effectively subsidizing these self-same companies.
We already have a universal healthcare bill in Congress ... It's called HR 676.
We can do better than a plan to enhance insurance companies at government expense, and we can damn sure do better than Hillary Clinton for president.
Hillary has actually NEVER created a hallmark piece of legislation. She has begged borrowed and stolen her way onto a number of bills but never created any of much worth.
Her first Idea for "fixing" American health care was as first lady. It was to SOCIALIZE (destroy) the entire US health care system. The DEMOCRATS were in control of congress and they killed her bill on birth. It's not that it was just too big or too complicated, it was also too STUPID.
So now we are supposed to believe Hillary no longer wants big time socialism and has come up with an "american" plan?
Lets stop letting single politicians dictate Health care and demand all our congress people in both parties sit down and work this out for a year or two and come up with the best, the most modern, the most american, the most likely to succeed plan in the world and dump this "I have a plan" crap.
And while we are at it, how about if we demand Democrats give us a balanced budget, a fix for social security, and a fix for medicare. The Repulican failed....that's past history. Now it's the democrats who are failing. That's the present. Isn't it time we demand the stop failing and fix our broken social programs and balance our budgets? No way Bush would veto a social security fix, a medicare fix, a balanced budget plan.
The Republicans are already screaming about the “effective tax hike” that will be created by the Democrats if they do not extend the massive budget busting give-aways put in place by the Last Congress.
So much for let’s all get together and balance the budget, eh?
"The Republican failed....that's past history."
It's not past history. It was last year. After 12 years of pretty much a lock on Congress and a pseudo-republican president in Clinton signing all legislation the crossed his desk.
Want to balance the budget and fix our social program and infrastructure?
Get out of Iraq and cut the defense budget in half next year, as a start.
Modernize the military to fight alongside other free nations in defense of global issues but spend most of their time defending the country and responding to natural disasters.
Attach meaningful regulation to ALL government contracts and make sure the contractors perform or go away, after giving back the money they stole.
Quit subsidizing failing industries with tax payer dollars. If we're going to spend money hand over fist on private concerns, lets just go ahead and give that money back to the people in the form of health care and education and mass transit and bridges that don't collapse under the weight of our high-fructose corn syrup asses.
Republicans are HORRIBLE at government because they see government as simply another way to make more money at the expense of future generations. The republican party has become a bunch of vampires, sucking every last drop that they can out of our world before handing it over to their kids to do the same thing.
Unless we find a way to put the GOP out of our misery, things are unlikely to change. Unless we find a way to be both global and local simultaneously, the American public will never truly change.
Why? Because our "leaders" have been paid to avoid change at all costs. That's why we are screwed silly each and every year, no matter who is in charge.
For the VAST majority of this country, the American Dream died a long time ago replaced by two or three jobs, credit card debt and a dwindling supply of self respect, let alone optimism.
Yeah, defacto Republican rule since Reagan has really helped this country achieve its destiny.
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