Monday, September 17, 2007

Gosh, Thanks Senator Clinton

"Individual mandates". It's the new way for politicians to say that insurance companies count more than their constituents do.

Senator Hillary Clinton has just announced her (yawn) health plan:

"I believe everyone — every man, woman and child — should have quality, affordable health care in America," the New York senator told an audience in Iowa. She vowed to accomplish the goal in her first term.

Clinton unveils health care plan

Uh huh. So, you know what's coming next, right? Grab your wallet:

The centerpiece of Clinton's "American Health Choices Plan" is the so-called "individual mandate," requiring everyone to have health insurance — just as most states require drivers to purchase auto insurance. Rival John Edwards has also offered a plan that includes an individual mandate, while the proposal outlined by Barack Obama does not.

Clinton unveils health care plan

"Individual mandates", as far as I'm concerned, mean that health insurance providers still get to determine who gets health care, and they get to set the price. The insurance companies have a history of intimidating people who try to collect the money they are owed. And as Jane Hamsher pointed out not too long ago based on her own experiences, they aren't in the least bit shy about doing it to people who are sick. In fact, as PBS's Now showed not too long ago, that's become their policy in home insurance, and profits have soared. The government doesn't interfere, because political candidates love all that money they receive from insurance companies. That's one thing that no fault auto insurance should have taught us. And here's another fun thing - if your credit rating is low, like as in you're poor, insurance companies are allowed to charge you more. Don't believe me? Read the fine print on your next insurance bill.

So far, I'm not impressed by any of these plans. As NOW observed recently:

"Universal health care" has become the grand Democratic mantra, found on every campaign web site and repeated in every stump speech and debate. But the phrase itself is misleading—most often, it actually means "universal health insurance." While the plans do outline some modest and not altogether meaningless reforms, especially when it comes to care for children, most are designed to preserve—and even benefit—the twin scourges of the U.S. health care system: the insurance companies and the pharmaceutical industry. With the exception of the acknowledged mavericks Dennis Kucinich (D-Ohio) and Mike Gravel, no one has suggested anything resembling a single-payer national health care system (that is, one that is managed and administered by the federal government), which would boot out the rapacious middlemen of the insurance industry and reign in Big Pharma—the primary obstacles to quality, affordable health care in this country.

Health Care and the Horse Race

As Taylor Marsh has observed, Clinton's plan is rich in details. Yet, you can provide details out the wazoo and still be spectacularly and utterly wrong if you start with wrong assumptions. That's what Clinton and John Edwards have both done. Obama's plan hasn't really been fleshed out yet, but I suspect it will have similar flaws, minus "individual mandates".

They need to do better.

UPDATE: One difference I'm seeing between Clinton's health plan and John Edwards' (PDF) is that the latter clearly states that individual mandates don't start until the rest of the plan has kicked in and lowered health costs:

Finally: Individual Responsibility. Once insurance is affordable, everyone will be expected to take responsibility for themselves and their families by obtaining health coverage. Some Americans will obtain coverage from public programs like Medicare, Medicaid, and SCHIP and others will get coverage through their jobs. Other families can buy insurance through the regional Health Care Markets. Special exemptions will be available in cases of extreme financial hardship or religious beliefs.

Universal Health Care Through Shared Responsibility

I find this an optimistic feature, but at least it moves the burden to where it should be - after costs have been reduced.

UPDATE 2 (Sept. 18): Since a giveaway to the insurance industry seemed to be daft enough, I didn't even touch on other issues. One is Clinton's proposed tax break for medical expenses. Not only is there already such a tax break, this is obviously, to anyone who's been in this situation, almost no help at all. Suppose you're earning $30K a year and have $100K in medical expenses that your insurance doesn't cover. This situation isn't at all unusual. How much good is the $8K a year (maximum) that you'd see from this tax break? I suppose after you've sold your house and all your other assets, you can use that $8K to put an addition on your refrigerator box.

No comments: