Clinton Redux

Senator Hillary Clinton’s release of her universal health coverage plan dominated the news this week, with journalists and policy experts dissecting the 10-page outline of policy ideas she offered. Our articles section below has several links, including a piece I wrote for USA Today in response.

Bottom line: The plan is carefully focus-group tested, without the hubris of 14 years ago when the White House dropped 1342 pages of legislation on the desks of members of Congress. The language now stresses choice, allowing people to keep the private plans they are in, and promising no new government bureaucracy.

The lightening rod in the proposal is the federal mandate that everyone would be required to have health insurance and that employers would, for the first time, be required to pay. Government unavoidably would get into the business of defining what an acceptable policy would be, determining how much people and companies would have to pay for this government-defined coverage, and setting enforcement provisions for those who don’t comply. There is every indication that the insurance required would be the Cadillac coverage that members of Congress have.

Drug companies would be required to offer “fair prices” (read, price controls), insurers would play by a much more stringent set of rules, and competition in the Medicare program would be a thing of the past.

So she offers an individual mandate and a defacto employer mandate, plus expansion of existing government programs such as Medicaid and SCHIP, creation of a new Medicare-like program, steps toward price controls, new federal subsidies, and much more stringent regulation of one-sixth of the economy. And all of this would be accomplished without new government bureaucracies.

There are several ideas in the plan that the free-market policy community supports, including refundable tax credits for lower-income people to help them buy coverage, the beginnings of a cap on the exclusion that exempts job-based health insurance from income taxes for employees, and an insurance buying pool that looks like the Federal Employees Health Benefits Program. There’s something for everyone.

We should be very glad that the voters have more than a year to decide what they think about the plan.

Health Policy Matters is a weekly newsletter containing summaries of timely and informative studies and articles on free-market health reform. It features research and writings by participants in the Health Policy Consensus Group, articles of interest from the health policy world, and announcements of coming events. Health Policy Matters is published by the Galen Institute, a not-for-profit public policy organization specializing in information and education on health policy. For more information about the newsletter and our organization, please visit our website at www.galen.org.