DES MOINES — Democratic front-runner Sen. Hillary Clinton offered a plan Monday to provide health insurance to all Americans positioning all of the party's major candidates as advocates for ambitious programs of either universal or near-universal health care.
Thirteen years after presiding as first lady over a failed attempt at a national health-care plan. Clinton presented an estimated $110 billion plan that avoided some of the political pitfalls that contributed to the demise of the Clinton administration's health plan in 1994. Unlike her previous effort she would allow Americans satisfied with their current health-insurance plans to continue their coverage and avoid a large new federal bureaucracy.
The groundwork is now laid for a general-election contest that will provide a clear choice between the two parties on health care.
Republican candidates offer tax credits to lower the cost of health insurance with private markets relatively undisturbed while Democratic candidates urge a greater government role in guaranteeing availability of health insurance for all. The Democratic candidates would pay for their programs by eliminating Bush administration tax cuts for high-income earners and through projected savings from new efficiencies they say their plans would create in the health-care system.
Clinton would offer federal subsidies to businesses and individuals to reduce health-care costs particularly for lower-income families while imposing a new federal requirement that every American purchase health insurance.
Her approach echoes state-based plans proposed by Republican Gov. Arnold Schwarzenegger of California and then-Gov. Mitt Romney of Massachusetts that require individuals to buy health insurance much as many states require drivers to buy auto insurance.
Her Democratic rivals also borrow heavily from the GOP governors' approach though unlike Clinton and John Edwards. Sen. Barack Obama (D-Ill.) would mandate coverage only for children not adults. As with the California and Massachusetts plans the major Democratic candidates would rely on individuals to obtain coverage by buying it or through their employers provide subsidies for coverage and allow the public access to government-based insurance programs.
"All of the Democratic candidates have now come out with big plans," said Drew Altman president of the Kaiser Family Foundation a non-partisan health-care policy foundation. "Those plans in the end are going to look more similar than different to Democratic voters in the primaries and despite differences are more similar than different."
Clinton unveiled her plan at a publicly funded health center in Des Moines contending the nation faces a moral imperative to address the health needs of 47 million uninsured Americans.
"We can no longer tolerate the injustice of a system that shuts out nearly 1 in 6 Americans," Clinton said. "Ultimately this is about who we are as a people and what we stand for."
In contrast to the complexity and forced movement of consumers into government-managed health plans that contributed to the unpopularity of her prior health proposal. Clinton and her aides portrayed her new plan as stressing simplicity cost control and especially consumer choice. The campaign titled the plan the "American Health Choices Plan," and she repeatedly used the word "choice" in her speech.
The linchpin of the plan is to require all Americans to obtain insurance so that relatively healthy people who are less expensive to insure balance out the cost of covering older and sicker people. Aides said she had not come up with a way to enforce the mandate though one possibility was denying some tax deductions to the uninsured.
She said most insured Americans would likely see reductions in their premiums even if they continued their current coverage. Her plan also would offer businesses workers and the uninsured the option of buying coverage through the federal employee health-benefit plan that provides insurance to members of Congress.
The proposal would not allow insurance companies to deny coverage to people who apply and pay their premium regardless of pre-existing conditions. Insurers also would have to standardize premiums so they couldn't charge more based on age sex or occupation.
Large employers would be required to offer health insurance or help pay coverage costs. The proposal also would offer tax assistance for small businesses to provide coverage and give tax credits to lower-income people to purchase insurance.
The Clinton campaign estimated the annual cost of her program at $110 billion which she said would be made up through savings modernizing technology limiting prescription drug costs and discontinuing President Bush's tax breaks for households making more than $250,000 annually and employer tax breaks for health benefits for families earning more than $250,000.
Democratic rivals said they would be better equipped to win passage of a health-care plan noting that Clinton's last attempt failed.
"The real key in passing universal health care is the ability to bring people together in a process that's open and transparent," Obama said speaking to a union conference in Washington. "I've got a track record of doing that."
In his address to a different union group meeting in Chicago. Edwards stressed that Clinton's political miscalculations on health care in the White House have had significant human consequences.
"The cost of that failure.. is not just somebody's political fortune or their scars," he said. "It's the millions of Americans who have now gone for almost 15 years without health care."
Romney running for the GOP presidential nomination denounced Clinton's health plan as "bad medicine," despite similarities to the plan he initiated as governor of Massachusetts.
Former New York Mayor Rudolph Giuliani's presidential campaign criticized the plan as Clinton's "latest health scheme" that "includes more government mandates expensive federal subsidies and more big bureaucracy."
I can't believe people are falling for this universal health care push. I currently work every day and pay taxes to have the "freedom" to choose where and when I want and need to visit a doctor. With the government regulating healthcare you will be told where and when you can receive healthcare and medications. More government regulation over every apsect of our lives is NOT the answer.
I currently work every day and pay taxes to have the "freedom" to choose where and when I want and need to visit a doctor. Posted by: Dave | September 18. 2007 8:05 AM
Thats good Dave. That doesn't however mean there isn't a "real" problem with health care. So you have a job with bennies thats great what about the people that don't? Do you have any idea what health insurance costs the self employed? How many jobs don't give bennies? Just because your "doing fine" doesn't mean there isn't a need for some kind of change. What's wrong with getting some ideas going? There has to be a middle ground it's halfway between you and me.
The plans offered by Senators Clinton. Edwards and Obama and those currently in effect in Massachusetts. Singapore the Netherlands. Germany and scores of other places do NOT tell patients what doctors to see when you can receive health care and what medications you can take. Their main feature is to provide a subsidy based on income for the private purchase of medical insurance by people who don't receive medical benefits through their employer. My challenge to Dave and to other readers of this article is to actually study the plans and then explain in what way they affect their freedom of choice.
Dave... Probably works for an insurance company. I choose where and when I want and need to visit a doctor. I am told nothing by the government. I receive a statement stating how much I will pay as a co-paymnt and how much the government will allow the provider. The government allows much less than that payed by the uninsured. For thirteen years my co-payment have been less than half of the cost of gap insurance. Medicare a government program has been great for me.
"Her approach echoes state-based plans proposed by Republican Gov. Arnold Schwarzenegger of California and then-Gov. Mitt Romney of Massachusetts that require individuals to buy health insurance much as many states require drivers to buy auto insurance."
Yet right wing hate radio has been calling her a "communist" a "socialist" and a plethora of other insulting names even though her plan matches what some Republicans have previously proposed.
When will a Republican have the backbone to admit that they hate Hillary because she's a woman and Republicans want to continue the status quo of "good 'ol boy" network?
Several states have tried to provide health care for those who do not have access to it through their jobs. This being health care that goes beyond Medicare and Medicaid. Tennessee being a good example was looking at being bankrupt due to the increasing health care cost. Medicare is routinely pictured as being a system that will run out of money in the foreseeable future. I wonder where the magic is going to come from that will reduce the cost of health care or come up with the dollars to fund it. An English scholar whose name I do not remember stated that there is a life expectancy for a democratic government because when the public finds out it can vote its self anything it wants it will bankrupt the system. Health care may be that issue for the US.
Universal health care is a must. The insurance industry works best for the insured when it is a break-even scenario that is when the claims distributed equal the premiums collected. That is a function best served either by a subsidized not-for-profit government corporation or the federal government itself.
Personally the only problem I have with universal health care is that people who willfully choose to be unhealthy (the obese and smokers) should not be eligible or should have to pay increased premiums. Much like welfare should not be a bailout for people who simply choose not to work health insurance should not be a bailout for those who don't make an effort to be heathly.
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