You need to know how much more coercive “health reform” could be if Hillary Clinton is elected president.
A new ABC/Washington Post poll shows 61 percent of Democratic voters support Mrs. Clinton for president in 2016, far more than other possible contenders. 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 makes it to the White House, what can we expect on health reform?
Mrs. Clinton ducks that question. Her proposal in 1993 as First Lady was more coercive than Obamacare. She put price controls on doctors, a hard and fast limit on how much healthcare the nation could consume annually, and limits on how much healthcare you could buy for your own family, even if you paid for it yourself. That was twenty plus 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 healthcare and whether Mrs. Clinton stands by what she proposed the last time she occupied the White House.
The Obama administration is using ads and street fairs to convince 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.
Mrs. Clinton wouldn’t take “no” for an answer. If you failed to enroll in one of the approved plans, or the plan you chose was oversubscribed, government would assign you to one (pp. 144, 146 of the Health Security Act, the official name of her plan). As for people simply not paying their premiums, the First Lady told a House hearing that it would “either be deducted from their wages or obtained through tax deductions in some other way.”
If you walked into a doctor’s office, you’d have to prove you’re enrolled or get enrolled on the spot. The doctor could only be paid by the plan, not by you. Government officials will put price controls on what doctors and hospitals can charge, and they are 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 put strict limits on what every American is allowed to pay for health insurance. That limits how much money is in the pot to take care of you when you’re sick. It makes insurance companies into rationers. Princeton Professor Paul Starr — Mrs. Clinton’s Jonathan Gruber — explained that it was designed to force doctors and hospitals “to manage under constraint.” Government would limit premium hikes based on the consumer price index. And no one would be 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 be outlawed under Mrs. Clinton’s scheme, which effectively 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 Mrs. 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 GDP by 2023. Mrs. Clinton wouldn’t have put up with that.
Her plan was coercive because its goal was to strictly limit how much healthcare every person could consume. Mrs. Clinton said at the time “we all must learn to live within a budget.” The government would impose a dollar limit on what the nation could spend. If spending neared its limit, insurers and government payers would be legally required to cut payments to doctors, nurses, and hospitals to avoid going over budget (p. 137). 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?
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