What Hillary Clinton won’t discuss
You need to know how much more coercive “health reform” could be if Hillary Clinton were to be elected president.
A new ABC News/Washington Post poll shows that 61 percent of Democratic voters support Clinton for president in 2016, which is far more support than other possible contenders have. Obamacare’s future is uncertain, with the Supreme Court revisiting the law and Republicans now in control of Congress. That, too, could change in 2016. If Hillary were to make it to the White House, what could we expect on health reform?
Clinton ducks that question. Her proposal in 1993 as first lady would have been more coercive than Obamacare. She would have put price controls on doctors, a hard-and-fast limit on how much health care the nation could consume annually and limits on how much health care you could buy for your own family, even if you paid for it yourself. That was 21 years ago. But it’s an important window into her thinking.
Before Americans choose their candidates for 2016, they need to ask how much power government should have over their health care and whether Clinton stands by what she proposed the last time she occupied the White House.
The Obama administration is using ads and street fairs to persuade people to get covered. Millions are still saying no. Obamacare penalizes the uninsured, but it also offers many exemptions, including just pleading “hardship.” The Congressional Budget Office estimates that 90 percent of the uninsured will not be penalized.
Clinton wouldn’t take “no” for an answer. In her plan as first lady, if you failed to enroll in one of the approved plans or if the plan you chose was oversubscribed, government would have assigned you to one. As for people simply not paying their premiums, the first lady told a House hearing that the money would have been “deducted from their wages or obtained through tax deductions in some other
If you walked into a doctor’s office, you’d have had to prove you were enrolled or get enrolled on the spot. The doctor could only have been paid by the plan, not by you. Government officials would have put price controls on what doctors and hospitals could charge, and they would have been barred from charging more or accepting payments directly from patients. The White House asked why anyone would want to pay a doctor directly. Privacy, for one thing. Also, access.
Access would have been a problem under the Clinton plan. It would have put strict limits on what every American would have been allowed to pay for health insurance. That would have limited how much money would be in the pot to take care of you during a sickness. It would have made insurance companies rationers. Princeton professor Paul Starr — Clinton’s Jonathan Gruber — explained that it was designed to force doctors and hospitals “to manage under constraint.” Government would have limited premium hikes based on the consumer price index. And no one would have been allowed to buy a plan that cost more than 20 percent above the average plan’s cost.
In contrast, Obamacare doesn’t outlaw generous plans. Its Cadillac tax, scheduled for 2018, would discourage them, but union opposition makes that tax an uncertainty.
Under Obamacare, people who can afford it pay doctors extra to get care without waiting. But these concierge practices would have been outlawed under Clinton’s scheme, which effectively would have barred you from going outside the system to get better or faster care, even after you paid the mandatory premium.
The biggest difference between Obamacare and Clinton’s approach is in their methods of reining in the nation’s health spending. Obamacare tries payment innovations, such as accountable care organizations, with little progress so far. Federal actuaries predict that health spending will increase rapidly, hitting a staggering 19.3 percent of gross domestic product by 2023. Clinton wouldn’t have put up with that.
Her plan would have been coercive because its goal was to strictly limit how much health care every person could consume. Clinton said at the time, “We all must learn to live within a budget.” The government would have imposed a dollar limit on what the nation could spend. If spending neared its limit, insurers and government payers would have been legally required to cut payments to doctors, nurses and hospitals to avoid going over the budget. Such central planning — even in the face of unforeseen problems such as the flu or EV-68 — would risk the lives of patients and the livelihoods of doctors and nurses. Is this what Americans want?
Betsy McCaughey, Ph.D., is chairwoman of the Committee to Reduce Infection Deaths and a senior fellow at the London Center for Policy Research.