Hillary Learned the Wrong Lesson from 1994 Health Care Fiasco

The pundits might have it right on this one. Hillary Clinton did learn a lesson from her 1994 fiasco on healthcare reform. Unfortunately for most of us who don't have an Inc. after our name or a private jet to cart us around, it was the wrong lesson.

In the days leading up to the announcement of her latest, much anticipated health plan, Sen. Clinton threw around the word "consensus" a lot. In this case, the consensus she was seeking was with the same industry that so savaged her prior experience with healthcare.

This time, she apparently wants to soften them up in advance with a proposal that will generate hundreds of millions of dollars in additional profits for the insurance giants. It's probably not a coincidence that she is also the top recipient of healthcare sector contributions to her presidential campaign.

Looking past the bells and whistles -- which do at least include some good sound bites on retiree health and giving regular Americans the same health plan options as members of Congress -- the Clinton plan seems to rest on three shaky legs:

1. Forcing all Americans, who do not have current coverage and do not qualify for public assistance, to buy and maintain insurance;

2. Mandating large employers to either provide health benefits or contribute to the cost of coverage

3. Tax credits for just about everyone

If the central elements here sound familiar, they should. The plan is a smorgasbord of the worst elements of what we've seen and heard from some other presidential candidates and the plans floating around several state Capitols.

Ironically, given the overheated reaction from Republican candidates, Clinton's plan most closely resembles the approach of two Republicans -- the Mitt Romney-crafted law in Massachusetts and the proposal by California Gov. Arnold Schwarzenegger.

That's hardly a badge of honor. The Massachusetts model is working best for those with public subsidies, and Schwarzenegger's plan is now buried in the minutia of a special legislative session while public support for it has been plummeting in the polls.

The biggest failing of this plan, like the Romney and Schwarzenegger schemes before it and like most of the other Democratic candidates' proposals, is the abject failure to challenge healthcare industry price gouging and runaway costs.

Insurance premiums have climbed 87 percent the past decade, and though they have slowed a bit in the past year, the increase is still double the average increase in wages. That does not include, of course, the rising cost of deductibles, co-pays, prescription drug prices, hospital charges, and, the latest fad, annual doctor fees, like what many people are charged for the privilege of having a credit card or checking account.

This is only the biggest healthcare story of the year. One recent example. Consumer Reports last month reported that more than half of the "underinsured" postponed needed medical care due to cost and a third had to dig deep into their savings to pay for medical expenses. Another third of those over 50 said decisions about their retirement were adversely affected by healthcare costs, one quarter had outstanding medical debt, 38% postponed home or car maintenance repairs due to medical bills, and only 37% said they were prepared to financially handle unexpected major medical costs in the next year.

Throwing more Americans under the wheels of the insurance industry will not solve this problem any more than criminalizing the uninsured is humane or sound health policy.

Clinton's solution is a combination of tax credits, unspecified encouragement to drug companies to "offer fair prices," and promoting "consumer price consciousness in choosing health plans."

But tax credits mostly benefit higher income Americans. And families grappling with skyrocketing prices, and no controls on costs, will likely choose the cheapest, high deductible plans that provide the worst coverage. The sad outcome may be seen in a report earlier this year by the American Academy of Pediatrics that families with high deductible health plans are far more likely to put off needed care, including immunizations and recommended treatment, due to the cost.

Sen. Clinton might have drawn an entirely different idea from her prior unpleasant history with the healthcare industry. She might have decided to cut them out of the business of profiting off pain, suffering and medical debt, and proposed a very different solution, such as expanding Medicare, Medicaid, or the State Children's Health Program to cover everyone.

Accommodating the insurance behemoths, and effectively offering them massive public subsidies -- using the considerable power of government to force everyone to become paying customers of the private insurers -- is not the kind of leadership on healthcare we need.

Rose Ann DeMoro is executive director of the California Nurses Association/National Nurses Organizing Committee and a national vice president of the AFL-CIO

Comments

[Tom Gerosolina]

The Government should provide, Protection, Education and health care.
Our health is our most important asset; therefore it will benefit the government to make sure that every citizen is healthy. Healthy citizens pay more taxes than sick ones. Too much mental time is being consumed by our citizens’ worrying about health care. They shuld be think about other things like geting ride of congress.
Our health professional have to accept it is not all about money. It is about the health of our nation. If they can’t accept that then they need to pursue another profession.

[TankerRat]

This blog has been fascinating to read with lot's of vague opinions, shakey judgements, and outright SWAG's as well as more than a few good ideas.

A perhaps puzzling question for all of you though. Can anyone tell me exactly where it is mandated that any type of "health care" or "insurance be provided for the entire country?

Now don't get me wrong. I know that peope need these things.

As to Medicare being so efficient. Well, my wife works processing­/adjusting Medicare claims. It would be extremely foolish to tell this fiesty little carrot-top the things a lot of you have stated. I'm afraid she'd get a bit red in the face and tell you to stick that idea where the sun doesn't shine.

BTW. She doesn't make the same as old Bill McQuire of United Healthcare who took home $1.4 BILLION last year.

[Spoons]

President Bush recently said, "It is the duty of the government to protect the lives of its people". Using your analogy and to remain logically consistent, we would have to not offer any public services not specifically mandated in the constitution. That would mean we should disband our public school systems, libraries, parks, mail delivery, child protection, fire protection, highways and infrastructure systems, and healthcare for the disabled and over 65 crowd. If your wife worked for a profit-driven health insurer, I bet she would have even more interesting tales to tell. Honest Medicine's website has some very interesting articles written by a whistle blowing insurance agent. I hope you and your wife see through the Trojan Elephants that have been injected to destroy the 40-year history of 2-3% efficiency, quality and cost-effectiveness of our Medicare system. Part D was purposefully designed to be overly expensive and inexplicably complicated, and Medicare (Dis) Advantage plans are proving to provide outrageously expensive and all-too-often totally unreliable coverage.

[Mark Bernadiner]

I am surprised when somebody use the world “healthcare system” with regards to America. What America has is called “money extortion system”. The fundamental principle of the American healthcare is very simple: make people permanently thick, but, not let them die, because patients are “cash cows”. What happens to America, if police will star profitable from arresting people? All American population will be in jail. What happens to America, if fire departments will profit from fiare fighting? Entire country will be in fire. That is exactly what we have now with so called “health care”.

[Kendo Nagasaki]

The insurance companies must be dancing with joy at this latest Hillary boondoggle..

A big thank you from Bill Frist and Friends.

Rudy Ghouliani couldn't have come up with anything more Machiavellian.

[wrabbitt]

we have had the wool pulled over our eyes once to often. the corruption is too much. i will only vote for someone who has never taken money for a favorable vote sadly another vote for Mickey Mouse.

[Janelynne]

Do you really think that the insurance companies and the pharmaceutical companies will just roll over if Hillary suggests they roll back profits? These behemouths are nervous now, that Hillary is coming back with reform. They do not want reform at all, and that is how we have been locked for these years. Sure, we progressives can hardly live like this for one more minute, but if Hillary rushes in like a bull in a china shop, the insurance and pharmaceutical industries, along with the other contenders and the right wing media, will knock her out. With the reform she is suggesting, they are all very edgy. If people have a choice, they might start demanding more choices! When will progressives, liberals,and Democrats become sophistocated enough to use strategy and finesse? When will we stop attacking our own because we aren't getting instant gratification? How 'bout Bush's plan; do you like that? IT's called "yoyo" (you're on your own.) Instead of Hillary bashing, invision 4 more years of what we have now. It could come to that if we don't unite. If you think Hillary can just change mindsets by pushing a button, you are way too naive to have a blog with a byline. Sorry. And I am on your side! You should hear how I talk to the GOP!

[Spoons]

That would be all fine and good if innocent lives were not at stake here. The longer we wait, the more real (not make-believe) Americans die, and the more money and morality are lost. If Hillary can work this hard to convince people that the problem is the solution, she would stand an even better chance at convincing people of the truth if she chose to do so. I think more of us would "get it" if someone like her wanted to at least attempt to help us along. One appearance by Obama speaking the truth to justice on this issue with Oprah (rather than Michael Moore, no offense) could be the catalyst we need as well, if Barak only had the real courage required to choose to do so as well. The problem is in order to be real heroes, they have to have real courage. The American voting public isn't as stupid as they think. These candidates are smart enough to figure out how to communicate what is right and good for our country as a whole..if they choose to do so.

[Bytesmiths]

I am so glad I moved to Canada!

[IllinoisHillbilly]

"Sen. Clinton might have drawn an entirely different idea from her prior unpleasant history with the healthcare industry. She might have decided to cut them out of the business of profiting off pain, suffering and medical debt, and proposed a very different solution, such as expanding Medicare, Medicaid, or the State Children's Health Program to cover everyone." You mean LIKE Kucinich's plan???? Which was totally ignored??!!!

Health care in the US is too expensive and leaves 46 million Americans without insurance and millions more underinsured. Dennis Kucinich is the only candidate for President with a plan for a Universal, Single-Payer, Not-for-Profit health care system.

http://www.dennis4president.com/go/issues/a-healthy-nation/

[CharliePfromHB]

It seems to me that any health care solution, including the single payer plan results in high taxes ultimately paid for by the tax payer, ie. dominantly the working class. Canada, England,and France testify to that. Michael Moore's documentary admits to that, but points out that coverage is universal and mobile. Given that large monopolistic institutions, including governments, translate dominance to arrogance and ultimately greed and corruption, who is offering the true balance of power necessary for any hope at effective medicine (incl. drugs and organic / preventive healthcare) at reasonable cost? Although "Sicko" is effective and mostly right, where is "Sicko II"... You Can Get it Right! Everyone complains and use "video bites" in order to make their points. But what candidate is offering "reality bites", that suggest how the public and private sectors can make this work and also encourage health care, drug, and organic medicine innovation. Yes to mobility, cutting out the insurance companies, and universal coverage! Maybe the real issue is to challenge the candidates to reform the use of lobbying money...perhaps the real villian in all the issues of the day and the future. Then we could perhaps have rational discussions on health care, energy, terrorism, and more. All this noise is an "assault on reason", perhaps a "thought bite" indicating who might stand a chance at leading us to the "promise land"...a land where promises are followed up with effective results.

[Kendo Nagasaki]

If HillaryCare ever gets enacted, insurance premiums will soar skyward. Fasten your seat belts
or opt out altogether if SHE will let you.

[fisharefreinds]

So what are we to do? We can't seem to rid ourselves of the Insurance Industry--Berkshire Hathaway, Warren Buffet, Cigna, Kaiser.... Is Hillary's plan good? No, but what do you have to put in it's place? Get rid of ridiculous compensation for health care industry as a whole is a start, but Dr. Gupta will never allow it. The congress will rip her plan (and personaly attack her) to shreds if she is elected; we all know this. Nothing will happen except maybe the one on forcing insurance companies to insure everyone no matter what. Follow the money.

[Nancyann]

The reason that insurance companies are in her plan is because she gets more money from them than any other politician. Just ask Michael Moore as he said in "Sicko". She is cagey and duplicitious. She gets to keep their money and have the insurance companies beholden to her. No one said she was stupid but dishonest yes.

[tandem33]

The insurance companies are always complaining about government interference. It is quite funny when one finds out that one payer government programs that are managed correctly in modern countries are much less expensive and more efficient than our three tiered insurance plans involving, insurance companies, health providers, and the government.

[JusticiaParaTodos]

Great commentary Ms. DeMoro! Basically Ms. Clinton has been bought off, lock, stock and barrel by the Healthcare monopolies that are the root of the crisis in our healthcare system!

What is so tragic is that there are some in oorganized labor that actually have the naivete tto believe that Clinton deserves their vote and money!

If the leadership of labor can't figure it out, what chance does the rest of the working class have??

Kucinich is looking better everyday!

[Spoons]

#1. Some in labor don't see beyond "I want my employer to pay for it" without understanding that the employer is paying too much and getting too little in return already for this benefit. We could all save a bundle if only we would be willing to unite together with all of our fellow Americans to form one big health coverage "United Protection Pool" (aka Single payer), administered locally. It's not just small businesses that are priced out of the health insurance market whenever one among them falls ill, but big ones too, amd not-for-profits. Working in government is about the only safe place, unless you are wealthier than Christopher Reeves before his accident (who was cut off by the insurance company his grandfather started). Also consider that members of the same household can be covered under two or more "apples and oranges" plans, small business owners often have to send a spouse out to work for a large employer or the government, others who could retire otherwise can't because of health insurance coverage. If united together for our collective healthcare protection, job creation would BOOM. Financial security would BOOM. Now our current system makes individuals unable to compete in job markets, small businesses unable to compete with larger ones, and large businesses unable to compete globally. #2. Some labor bosses saw the gravy train and are now gorging themselves on the profits from the health insurance middleman trough (as is AARP).

[Kendo Nagasaki]

I opted out of paying insurance premiums for health care many years ago after Blue Cross would only pay its miserly "customary amount" on my actual hospital expenses for a fractured femur.

So far I am ahead of the game by about $100,000 by paying my own medical bills. In any event I can fly to Europe and receive free treatment if I wish. So could you, but don't tell anyone.