Hillary Clinton has just released her health care plan (more detailed pdf version is here), which joins plans she has already released on controlling health care costs and improving quality. Reviews of her plan are coming in, and they’re pretty good.
Here’s the thumbnail: Clinton’s plan is of the “individual mandate” variety, in which universal coverage is achieved by mandating that every American purchase health care. In order to ensure that that’s both possible and affordable, the Clinton plan creates a few new coverage options, reform the insurance industry, limits coverage costs to a percentage of income, and washes your car. Okay, it doesn’t wash your car….
So the policy is very, very sound.
Jonathan Cohn (TNR):
Would she be vague, figuring she had the least to prove on the matter and that details could only come back to haunt her? Would she settle on something less than universal coverage, figuring the political support for it was too weak? Would she kowtow to the insurance and pharmaceutical lobbies, which had started donating to her campaigns?
The answer seems to be no, no, and no…. Broadly speaking, the Clinton plan is as ambitious as any plan touted by a major presidential candidate right now.
I’ll have to wait and see what more expertish people have to say about this proposal, but it certainly has the look and feel of a decently ambitious proposal (indeed, probably too ambitious to be enacted, but we’ll have to see how the Senate looks after the election) in a way that really undercuts some of the main arguments that have been made (including by me) against her.
And here’s Yglesias on the politics of it all:
I feel like Clinton is drawing close to checkmating her opponents.
Well well.
…the Clinton plan creates a few new coverage options, reform the insurance industry, limits coverage costs to a percentage of income…
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suggests that she is proposing something more in line with the German health care financing model that I have described. Provided, of course, that there are at least some minimum requirements for the “coverage based on income.”
plan with it's individual mandates, but it differs in key ways, like allowing people to buy into a public plan or a government administered plan. I'm reading reviews from progressives like Ezra Klien to conservatives like David Brooks praising the plan so I think she hit the political sweet spot with this.
How it works in Germany, if you could opt into a medicare-type plan. I don't think it's a bad idea and, if it's as good as Klein seems to suggest, maybe Hillary will deserve to win. The fact that she's a war hawk and annoys me to no end on her glbt stances will still prevent me from voting for her, though.
I will vote for her over Mitt Romney in a heart beat.
…but with that disclaimer, this makes me uncomfortable: “the Clinton plan creates a few new coverage options“.
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Is that like Massachusetts where the more you can afford, the better plan you can get? Screw that. I don’t want options, I want to have equality in coverage.
not from a pragmatic, but from a philosophical point of view.
The MA plan requires me to enter into a contract with a private company. What business is it of my government to require me to enter contracts with third parties? Before you mention auto insurance — I don't own a car. I choose not to. I live in a region within a state that has public transportation and high density, and that's no accident on my part.
I think that a government requiring a private contract is just plain wrong [and btw, it's corporatistic nature was also seen in Mussolini's fascist Italy].
So, I've only read about HClinton's plan on major news sites and therefore don't know much about it. How does it differ from the MA plan?
I haven't looked at the proposal directly yet, but from what I've read, there are two major things different: One is the creation of a government plan that you can buy into, which will be in direct competition with the private plans. Kind of like Stafford loans, if you think about it. That's good, IMO. Two is some serious cost-control measures, like a Best Practices Institute (yeah, that's actually a big deal), negotiate with drug cos, etc.
When faced with the situation where individual failure to do what is responsible could result in his death and others, Massachusetts, in the 19th century, required its residents, by law, to receive a smallpox vaccination: they were required to contract with a private party (a physician) to receive a vaccination.
How is requiring a smallpox vaccination significantly different from the current law that requires health insurnace? Would you hold such a libertarian principal if say, there was a vaccination for HIV?
Massachusetts, in the 19th century, required its residents, by law, to receive a smallpox vaccination
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Do you know what “Gesellschaft” means? Of course you don’t. It means community. If you want to be part of a community, you have to allow the community to protect itself against your depredations, including those regarding public health. Hence the requirement for vaccinations to be able to participate as part of the community.
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When faced with the situation where individual failure to do what is responsible could result in his death and others…
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How is requiring a smallpox vaccination significantly different from the current law that requires health insurnace?
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The problem that you have is that the Gesellschaft–the community–will pay for your failure to provide for your health insurance. In many ways. Example: if you are whisked to the hospital after an accident or falling ill, the hospital will care for you–at some level of care–and charge either the government or those who are financially responsible and have insurance to care for you.
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Example: if you have the good graces of dying as the result of an accident or your infection because of your failure to get a vaccination, your Hintergebliebenen–those that you left behind–will probably become public (welfare) charges, at least in part.
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The point being that, if you want to be part of a community, sometimes you have to allow the community to protect itself against you, and require you to do things that you might not want to do otherwise.
I think you just spent 7 paragraphs agreeing with me.
Mitt Romney called the proposal “a solid step in the direction of socialized medicine and I will oppose that step and similar socialized steps on the way to the White House”
Isnt the Clinton proposal basically Romneycare? Isn't he essentially attacking himself? And wasnt Romneycare going to be the big thing leading him to victory? Very interesting how in the big race to the bottom to be the most socially backward er conservative candidate on the issues Romney ends up forgetting his own few accomplishments as governor. Is the man even running on his record anymore?
Also as to the Hillarycare 2.0 it is actually very similar to Hillary care 1.0 and Romneycare. While I appreciate the two tier model with a government plan competing with private plans and anyone can buy into either, and also that her plan is more honest and succinct than the Edwards plan, I am a little bit worried about the individual mandate. The experts seem to love this and I know others have expressed reservations about it but I should be allowed to choose not to buy insurance and the government shouldnt mandate that I do. Also it does little to end employer based insurance which is the really stupid aspect of the American system. The Obama plan ends employer based insurance and the HMO system altogether but does so in a smart and incremental way. That said I like parts of her plan better than his plan and hopefully the eventual nominee takes the good elements from all the healthcare plans being touted to make the best one going forward into November.
And to bring it back to Romney and the other Republicans, it looks like any of our nominees would have a monopoly on healthcare policy going into the general since none of those guys have any plans.
That’s really not true, according to people who know much more about both plans than I do — and, I’m wagering, than you do.
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Klein:
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Cohn:
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But should I take it that my comparison with Romneycare was still apt? I mean essentially the big difference between the two is the creation of a new public option i.e a public HMO that ideally would be subsidized, have lower rates, and thus be more competitive with the private HMOs and ideally most people would voluntarily sign up for the government plan. I find that all in good, but I strongly oppose mandating that anyone sign up for a plan, especially those people out there that are bound to be unqualified for a subsidized plan but still do not want to purchase/pay high premiums on private insurance. I also dislike that it does not outright eliminate employer based health insurance like the other Democratic proposals. The mandate will hurt small businesses extensively in addition to the individual purchaser who might be opted out of the government plan.
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The way I would reform Hillarycare 2.0 to make it more suitable to my own standards would be to have the government plan open to everyone, individuals can purchase private or government plans (ideally run through the states but funded federally so that even Mississippi spends its fair share on its own people), end employer based insurance, and provide essentially universal government sponsored health coverage since if the government plan is cheaper and more comprehensive than any of its competing private plans than most people will choose that plan, and thus this also makes private plans more affordable and comprehensive improving the system for all.