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

[seatech1]

You said it. I already emailed Hillary and basically said the same thing. What we need is universal, guaranteed health care; not mandatory insurance. Her plan is so wrong. It not only does not address the problems; it makes a few more.

[artistgirl]

I agree, and couldn't say it any clearer. This is such a disappointment.

I think Dennis and Michael have the right idea. We have the resources to insure every US citizen (including our visitors). We just need to get rid of the greed.

[CriminallySane]

It bears repeating: Mandatory individual purchase of "health care coverage" is a massive welfare program for the insurance industry.

[SamanthaJaneSalem]

I was looking forward to reading Paul Krugman's analysis of Hillary Clinton's plan, seeing how he is something of an expert on the health care industry, but what I read above laid it out very clearly for me already.

I'm afraid Hillary's "consensus" (with her health care donors) is exactly the kind of thing that will put her in the White House. Which wouldn't be the worst thing in the world. But today I read Nedra Pickler of AP pick apart Obama once again, and that's the trick: don't come across to Big Media as too extreme or they will crush you (remember Howard Dean).

So it's back to horse race politics for me. And I'm hoping someone can tell me who they think would be a good replacement for Hillary in New York's Senate seat if she becomes President. That's a very important seat, it seems to me, and the Democratic choice would be fascinating.

[runswithscissors]

"My solution is to force even more people to pay the corrupt companies that helped create the whole mess in the first place" is essentially her message. So she's pretty much worthless on this issue as well.

[Clare822]

I agreed with you until I took a closer look at her plan. It's a lot like John Edwards' plan in that we would all have a choice between our private plans or a gov't plan (read: non-profit). I like Hillary's plan better than Edwards', tho, because there is no new bureaucracy; the plan is administered by the current dept. that administers Congress's plan. This is essentially a voluntary single-payer system that can negotiate drug and provider prices and, since it is non-profit, will have premiums that have to be vastly lower than for-profit insurance companies'. Over time, that should force the insurance companies to either lower their prices to be competitive with the gov't. plan or go out of business. Hurray!!! I think this idea is a step in the right direction.

[altohone]

Thanks Rose-Ann!

Forced participation into plans we can't afford to use solves nothing.

Markets fixed so providers can't lose isn't capitalism... it's government sanctioned extortion.

[Neaguy]

You are so correct.

[Merlin7]

Altohone is correct about forced participation. What will they do if we refuse to sign up -- deport us to Mexico? And in all likelihood any health care scheme, no matter how modest, will die in Congress or will be greatly watered down.

The deeper lesson is that our election process offers little to America's underclass. No meaningful improvement in health care will be forthcoming regardless of who is elected. That's very sad.

[Spoons]

You can add middleclass to the statement "our election process offers little to America's underclass"...(or middleclass either). People keeo forgetting that one third of ouruninsured earn over hte median income, as well as over 90% of our newly-uninsured 2.2 million. That doesn't mean they can afford profit-driven health insurance under the current rules at their currrent prices. BTW, when you hear a health insurer complain about "over-regulation"... we do have bazillions of laws regarding health insurance on the books. I have read many of them, and so far the health insurance industry wrote them all.

[Mannycongo]

More grist for the mill Michael Moore proposes: Get rid of the insurance companies in favor of a single-payer plan run by the government. The Republicans won't like it, but at this point... Fuck 'em!!!

[linkunlovr]

Obviously the only candidate with a real universal health care plan is Dennis Kucincih.
But only the people want it not the corporations. Its unbelieveable the hold the lobbyists have over the candidates - except for Dennis Kucincih. We need him for a CHANGE!

[lawyeredup]

Wrong Rose-Ann! there is a saying that "in the absent of desirable, available becomes desired" I believed thats the syndrome or better yet, the dilemma we have been force to accept when it comes to our healthcare system in this country. And, as far as I am concern, Hillary is the only one; in the last three decades that have propose anything remotely acceptable. Let me get this straight, we will not pay our teachers more money nor will we pay our police officers or our military men & women more; should I even mention the plight of our elderly and the most vulnerable one among us -- our children. Our school is at it lowest level, our infrastructures are collasping, we claims the cost of healthcare to cover every Americans is too high but, our president keep telling us to fund the war we have no business fighting.
We are still the richest country in the world right?, notwithstanding if that wealth is concenstrated in the hands of just 3% of the population; notwithstanding if 42 million of our fellow citizens do not have health insurance coverage and, notwithstanding if our senior citizens have to choose between their medications or groceries (afterall its a jungle outthere and, we are not our brothers keeper) We are a heck of a nation! hippie.