Corinne Ramey

Where Do the Candidates Stand on Health Care? Hillary Clinton

At first glance, Hillary Clinton and John Edwards are a policy world apart. On some of the issues -- like how long to keep troops in Iraq, for example -- Clinton and Edwards are marching to beats of different drummers. But when it comes to health care policy, Clinton and Edwards have surprisingly similar platforms. Both candidates have released comprehensive plans that would create mandated universal health care. As Paul Krugman writes,

"It’s [Clinton's plan] as strong as the Edwards plan — because unless you get deep into the fine print, the Clinton plan basically is the Edwards plan. That’s not a criticism; it’s much more important that a politician get health care right than that he or she score points for originality. Senator Clinton may be politically cautious, but she does understand health care economics and she knows a good thing when she sees it."

Clinton's plan, which she calls "America's Health Choices Plan," not only has plenty of pictures of healthy people and smiling doctors, but lays out a fairly comprehensive plan for universal health care. Under Clinton's plan, Americans would be given the choice to keep their current plan, enroll in a plan similar to the Federal Employee Health Benefit Program (FEHBP, the plan currently offered to members of Congress) or choose a public plan, similar to the Medicaid system that exists today. The government will regulate the insurance industry to prevent discrimination against elderly people or people with previous health conditions. Her plan reads, "By creating a level-playing field of insurance rules across states and markets, the plan ensures that no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums."

Clinton's plan will create a Health Choices Menu, which will include both private plans currently offered in the FEHBP and public plans. This "Menu" will give employers, businesses and the uninsured the option of buying of high quality group health insurance. "The Health Choices Menu will have the purchasing power of millions of
Americans in securing high-quality and affordable insurance," writes Clinton, which will help to lower costs. She says that available plans will include mental health parity, dental coverage, and focus on preventative services "that experts agree are proven and effective."

The most interesting part of the Health Choices Menu is what Clinton has to say about public plans. Her health care plan reads,

"In addition to the array of private insurance choices offered, the Health Choices Menu will also provide Americans with a choice of a public plan option, which could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options in the Health Choices Menu without creating a new bureaucracy. The alternative will compete on a level playing field with traditional private insurance plans. It will provide a more affordable option, in part through greater administrative savings. It will not be funded through the Medicare trust fund."

If the public and private plans would cover the same benefits, but the public one is "more affordable," why would anyone not choose the cheaper plan? This may be Clinton's sly way of doing what Edwards' plan honestly admits to -- allowing the private and public insurance systems to compete with each other, in the hopes that the private sector will be unable to compete with the government. Eventually, the system could hypothetically become single-payer care. As Edwards' plan reads:

"Health Care Markets will offer a choice between private insurers and a public insurance plan modeled after Medicare, but separate and apart from it. Families and individuals will choose the plan that works best for them. This American solution will reward the sector that offers the best care at the best price. Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan."

Given her previous health care baggage, and desire to appear less "populist" than Edwards, Clinton probably doesn't want to even mention anything that sounds remotely like "socialized medicine." But, she sneakily suggests, if that's where the market goes she wouldn't complain.

Clinton's policy, like both Obama's and Edwards', contains a grab bag of new policies and federal agencies. One, a Best Practices Institute, would research medical treatments and work to disseminate research information to insurers and consumers. Other policies include programs to better care for the chronically ill, financial incentives for medical providers to adopt information technology, and incentives to expand preventative care. Clinton even includes policies to fight HIV/AIDS (both in the U.S. and abroad), cancer, and autism.

The one issue where Clinton's and Edwards' plans diverge from Obama's is that of mandates. As I wrote here, Clinton's plan would require that every American have some kind of health insurance, whereas Obama's plan only mandates that children have a health insurance plan. Obama's plan, charges Clinton, would leave "as many as 15 million Americans" uninsured. Obama has claimed that the main barrier to health care coverage is cost, so after health care becomes affordable more people will choose to buy insurance.

A fairly appetizing menu, if you ask me. But where does all the money come from? Clinton spells it out fairly clearly in her plan. Like Obama, Clinton plans to scale back the taxes on Americans making over $250,000 a year -- Edwards sets that bar at $200,000 -- which she estimates will save about $52 billion a year. The rest of the $112 billion plan will come from reforms such as modernizing the health system through information technology, phasing out "excessive Medicare overpayments to HMOs," better managing chronic care, and government purchasing of bulk, generic prescription drugs.

Overall, Clinton offers a solid proposal that would certainly improve the current system. Although some questions remain -- such as how the mandate would be enforced, for example -- her plan would be a welcome change for not only America's 47 million uninsured, but for the middle class at large.

Corinne Ramey: Author Bio | Other Posts
Posted at 6:26 AM, Jan 07, 2008 in The Candidates on Health Care
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