Hillary Clinton frequently says that, as president, she will “build on the successes of the Affordable Care Act.” If you are among the 54 percent of Obamacare enrollees who hate their coverage, or belong to the majority of Americans who want the law repealed, or are merely one of the millions whose out-of-pocket health care costs have skyrocketed, you might wonder, “What successes?” In the unlikely event that any voter or journalist gained access to Clinton and asked that question, she would merely recite the usual fictions about the uninsured rate and a few anecdotes about people with pre-existing conditions.
But the reality is that Obamacare is broken beyond repair. Neither Hillary nor anyone else can make this unworkable admixture of mandates, taxes, and bureaucratic avarice into a success. It has cost twice the money its authors estimated and insured half the people to whom they promised coverage. It has reversed a decade-long downward trend in health care inflation while costing insurers so much money that they have been forced to abandon its exchanges. Even the law’s infamous individual mandate has failed. Millions would rather pay a fine than buy the lousy insurance offered through Obamacare’s “marketplaces.”
So, why does Mrs. Clinton insist on “defending” Obamacare? Because, for her, the law has nothing to do with health care. She couldn’t care less if it is successful in accomplishing its ostensible goals. For Hillary, Obamacare is about the only two things she has ever cared about—money and power. She believes she can use promises to build on the law’s supposed successes as a way of garnering the votes of gullible voters. She hopes that, by promising to double down on Obamacare’s dumbest provisions and exhuming bad ideas that didn’t make the cut in 2010, she can buy enough votes to become president. It’s really that simple.
That is why she has dusted off the public option. This is one of those bad ideas that the left refuses to abandon despite its essential unworkability. Here’s the magical thinking behind this hare-brained scheme, as explained by one of its longtime proponents: “The public option would be a large plan with the bargaining power to restrain prices… it would create more competition in the system… it would reassure consumers that they didn’t have to rely solely on private insurers.” Like so many policy proposals put forth by progressives, the public option sounds great. The problem is reality. It has been tried and it failed miserably.
When was it tried? The latest attempt involved one of Obamacare’s most spectacular failures. When the Democrat-controlled Congress that concocted Obamacare rejected the public option, they added a fall back provision that would ostensibly accomplish the same goals—state-run, nonprofit insurance co-ops. And more than one member of the Obama administration assured the public that these entities would perform the same function as the public option, including the President. As Sally Pipes reports at Investor’s Business Daily, “President Obama said to Time magazine that the co-ops could serve the same purpose as a public option.”
So, how did that turn out? All but seven of Obamacare’s 23 nonprofit co-ops have gone belly up. And the others will probably go before the end of the year. Has that served as a wake-up call for Hillary? Nope. She is, as Pipes puts it, “now calling for a new public option to replace the co-ops—which, of course, were supposed to work just like a public option.” If this sounds crazy, remember that the goal for Clinton has nothing to do with the potential success or failure of a program. It’s about buying votes. That the public option has no chance of succeeding, or getting through Congress for that matter, is a matter of indifference to Her Majesty.
This same indifference to the actual results of her policies also underlies her “solution” to the high out-of-pocket costs that Obamacare has imposed on millions of Americans. Her health plan “would prevent insurance companies from imposing excessive, double-digit rate increases without a clear justification.” In other words, she would use the power of the federal government to impose price controls. The obvious effect of these price controls will be to drive out the few remaining insurers willing to sell policies though Obamacare’s “marketplaces.” This will further reduce consumer choice and accelerate the implosion of the exchanges.
Clinton would further meddle in the free market by interfering with the consolidation plans of insurers and providers. Her website tells us that she wants Beltway bureaucrats to tighten their already vice-like grip on these entities: “Hillary Clinton will appoint regulators and ensure full funding so that America’s antitrust authorities have the resources and vigor to monitor the changing industry landscape and to move quickly to investigate mergers.” The excruciating irony here is that government regulation of the health care industry has increased the cost of doing business such that consolidation is the only way providers and insurers can survive.
In the case of the hospital industry, the imposition of government price controls has made it impossible for small community facilities to keep their doors open without partnering with larger systems. If they are further molested by Hillary’s “antitrust authorities,” a lot of small communities will lose their hospitals. Rural facilities are already closing at a rate of one per month. And this has real consequences for real people. Small community hospitals have long provided life-saving access for patients who don’t live near large trauma centers. When they close, it means people die. But, of course, rural voters usually vote Republican.
And, in the end, this is all Hillary cares about. Let’s face it, if Clinton’s backstage doctors can’t get her latest coughing fit under control, they’ll put her on a helicopter that will take her to the nearest Level I trauma center. If you start hacking, on the other hand, you had better hope it’s nothing more serious than a “Trump allergy.” Because, when she finishes fixing Obamacare, your access to coverage and care will make today’s mess look like the good old days.