Despite its obvious deficiencies, the Donald’s plan is far less scary than Hillary’s.
As I have frequently written in this space, Donald Trump’s Obamacare replacement plan is profoundly underwhelming. It contains several exceptionally bad ideas and desperately needs fleshing out by a serious health care policy team. Despite these deficiencies, it is vastly superior to the regulatory blitzkrieg Hillary Clinton has planned for a medical delivery system already badly damaged by the “Affordable Care Act.” While Trump at least promises to repeal the justly reviled law and introduce market competition into the system, Clinton vows to expand Obamacare and demolish the few remaining vestiges of free market health care it has left intact.
As Hillary herself phrased it during a Democrat debate, “I would certainly build on the successes of the Affordable Care Act… we don’t have enough oversight of what the insurance companies are charging everybody right now.” The “successes” of Obamacare exist exclusively in the imaginations of the Democrats and their soul mates in the media, but the kind of government oversight that Clinton wants to expand is all too real. Obamacare already dictates what kind of health plans can be sold and to whom insurers must sell them. The inevitable result of such meddling with the market has, of course, been soaring premiums and skyrocketing deductibles.
Clinton’s “solution” to the spikes in the out-of-pocket costs patients have endured under Obamacare is more government meddling in the health insurance market. Specifically, she wants to introduce that old Democrat standard — government price controls. “Hillary Clinton’s plan would create a fallback process for states that do not have the authority to modify or block health insurance premium rate increases. This would help prevent insurance companies from imposing excessive, double-digit rate increases without a clear justification.” It goes without saying, of course, that unelected and unaccountable government bureaucrats would define “excessive.”
And Hillary’s affinity for government price controls doesn’t stop with health insurance. Clinton has proposed a $250 per month cap on drug spending for individuals with chronic diseases. She also wants to meddle with Medicare’s prescription drug plan, the only government health care program that permits market forces to work and has — not coincidentally — saved taxpayers hundreds of billions. Clinton wants Medicare to “negotiate” directly with drug companies. But, in practice, Medicare’s dominance of the market will permit it to dictate prices. This terrible idea, if implemented, will kill innovation while ignoring the actual drivers of high drug prices.
The worst effect of Clinton’s price controls will be obvious to anyone who has taken a basic economics course — reduced access and fewer choices for patients. Just as the price controls that Medicare and Medicaid impose on doctors have dramatically reduced access to primary care for seniors and low income patients, caps on premiums and deductibles will reduce the number of insurers willing or able to sell health plans to the public. United Healthcare is the harbinger of that future. Likewise, the price fixing that will inevitably result from Medicare’s direct “negotiations” with drug companies will reduce the availability of critical medications to seniors.
And it gets worse. Hillary is currently in a bidding war with Bernie Sanders to see which can make the most irresponsible promises. The latest manifestation of this is that, in addition to extending the reach of Obamacare, she now says she’ll expand Medicare to Americans 50 and older. Last week, Bloomberg reported, “At a campaign stop Monday in Northern Virginia, Hillary Clinton reiterated her support for a [public option] possibly by letting Americans buy into Medicare, to stem the rise of health-care costs.” The claim that this would slow health care inflation is based on the myth that Medicare has lower overhead costs than private insurance.
As Avik Roy explains at Forbes, the people who claim Medicare has lower overhead deliberately ignore that the program is partially run by a variety of other federal agencies like the IRS, the Social Security Administration, and the Department of Health and Human Services. In reality, despite Medicare’s ability to hide costs by failing to include those absorbed by other agencies, its administrative cost per patient is still higher than that of private insurers. And there is that minor issue of Medicare’s $38 trillion unfunded liability. This is more money than can be paid by taxing every American at 100 percent. In other words, Hillary’s Medicare idea is nuts.
As much damage as all this meddling with the health care market would do, it by no means exhausts all of the bad ideas Clinton wants to foist on our medical delivery system. The bottom line is that Hillary Clinton, if the voters are crazy enough to elect her President, will remake Obamacare into her own oppressive image. And here’s one more item to consider: If you have forgotten the humiliating defeat that Mrs. Clinton endured when Hillarycare was rejected in 1993, you can bet she hasn’t. I’m no fan of Donald Trump’s health care plan. It contains plenty of bad ideas as well. But it is nowhere near as scary as Hillary’s revenge — HillaryObamaCare.