Hillary and Health Care

by: Mike Lux

Wed Sep 19, 2007 at 16:27


Since I was still in Iowa on Monday morning, I went to Hillary's speech on health care. It was a bit of a flashback feeling for me, as I heard her give about a thousand speeches on health care when I served as part of the health care team in the Clinton White House in 1993-94. (You can read my analysis of what went wrong here.)

There is nothing I want to do more than get health care reform passed. It's very personal for me: I have had two very close friends die because they had no health insurance, and being a diabetic I know how capricious the system is when people have "pre-existing conditions." But you can't live in this country and not know how our screwed-up system hurts just about everybody in it except insurance and drug companies.

But there's one other reason the issue haunts me and drives me. Being part of that health care fight in 1993-94 was an experience that I can never forget. I don't like losing, especially when the stakes are this high, and unlike elections where you have another chance to win just two years down the road, a chance at getting something this big and complicated done comes along only once a generation. So we better get it right this time.

I think Hillary's new proposal is pretty damn good. I still think, have always thought, a Canadian-style single-payer system is the best way to go policy-wise, but that ain't happening absent a miracle, and Hilary's proposal is pretty sound policy-wise in terms of doing the things a health reform policy should do: it covers everybody, cuts costs and improves quality. And there's no one in the country who knows more about health policy than Clinton- she is pretty amazing in that regard.

The big question is the political decisions one has to make to actually pass a bill, because as not only the Clintons, but also LBJ, Truman, FDR and even Nixon learned, passing a bill to achieve universal coverage is a hell of a lot tougher than proposing one. Clinton has made three major political decisions about this proposal:

1. Emphasize the "do no harm" element. The first thing in her proposal is to announce, emphasize, repeat and hammer home the idea that if you like your current health plan, you are free to stick with it. Emphasizing this up front, and over and over again, is a clear way of saying she is not going to be "Harry and Louised" again, allowing opponents to distort small details of a big piece of legislation to make it seem like everything they do like about their current health care coverage is going to be taken away.

2. Keep it simple. The "health alliances" (regional health cooperatives) we proposed in 1993-94 were hideously complicated contraptions, virtually impossible to explain to average folks who get most of their information about politics in small sound bites and 30-second ads. The new plan doesn't create new agencies or cooperatives, thusly, it is a whole lot easier to explain.

3. Buy off small business. One of the major reasons we lost the fight in 1993-94 was the white heat of opposition from the small business community that freaked out about an employer mandate. Hillary has decided to wave the white flag on this one, buying small business off with big tax-credit subsidies, and not asking anything of them by imposing a mandate to cover their employees.

From a policy point of view, like I said, my first choice would be single-payer. My second choice would be a mandate that every business had to contribute something toward covering their employees, even if you have to give them a subsidy to do it. But taking some of the intensity off small business opposition (nothing will take it away completely because the National Federation of Independent Business and the Chamber of Commerce are run by right-wing ideologues) does make political sense.

There is plenty to pick at in this plan, as there is in any health reform proposal. But no one knows this issue like Hillary does, and no other politician I have ever met has the fire in the belly to take this on and make it such a high priority. The lessons she learned form the 1993-94 debacle are good ones, I think, and are reflected in the political decisions she made in this plan. I had been afraid, frankly, that the lessons she had learned would be that she should be hyper-cautious and not be ambitious in taking on this issue, but having seen the plan, I no longer worry about that. It's not everything I would want, but it's an ambitious plan that achieves the big goals in a politically savvy way.
Mike Lux :: Hillary and Health Care

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Hillary and Health Care | 45 comments
Can someone outline (0.00 / 0)
the major differences between the plan's offered by Hillary, Obama, and Edwards and do so without being biased towards your candidate? Thanks.
EDWARDS PLAN (0.00 / 0)
Their is not much differences between Edwards and Hillary's plans.

Remember Edwards came out much earlier than Clinton  the health plan. by about 7 months.

Obama 's plan doesnot have a mandate that every individual must buy health insurance like the other two plans. His plan came out in May.

[ Parent ]
My guess-- time table (0.00 / 0)
Clinton has said it will be her "top priority." But this means she doesn't plan to fully implement her entire idea until by the end of ther second term. We would have to elected her twice to get the full deal, and wouldn't really know whether its a good idea or not until after she's gone.

Edwards- I am not sure what his time table is. but that would be a good question for someone with any pull to ask.

[ Parent ]
In the SEIU Nevada healthcare forum... (4.00 / 1)
....clinton said 8 years and Edwards said 4. Obama has also said 4.

However, the way my local news reported it, it sounds like clinton has changed her tune and wants to get it going and done within her first term. I would think she changed because she caught a lot of flak for that. I mean...what if we don't want her for 8 years? Do we not get healthcare?

[ Parent ]
If that is the case then the peo over at Ezra Klein (0.00 / 0)
don't understand that. When I mentioned the issue they kept acting like her saying healthcare is a top priority was answering the concern over her saying it will take 8 years for  her to implement it. That there wasn't an inherit problem in her saying that beyond the wonkish - why should it take you 8 years to implement you legislation? I thought the Klein site covered healthcare closely- however, I am guessing maybe not if you are right.  The idea that a candidate would say that would have in ordirary elections been a reason to question a candidate's seriousness but because the A blogs seem to be running in fear (only thing I can think to explain why they ignore) of her campaign or not being in on it if she wins (again the only thing that makes sense) they do not.
[ Parent ]
Much too little (4.00 / 3)
To me, the Clinton proposal fails to address points that I think are absolutely must-haves for a truly useful health-care reform. Maybe Mike or somebody can explain why these points are misguided or actually addressed:

1. It fails to sever the tie between employment and health care. Thus employers retain unwarranted power over the lives of their employees, and hiring will continue to be tilted away from applicants who present a potential insurance risk or bureaucratic problem. This despite the fact that many large corporations are begging to be bailed out of their insurance obligations. And small business is not going to be all that happy with some bureaucratic combo of mandates and subsidies. They'd rather have the health monkey off their backs.

2. It does nothing to address the incredible inefficiency of the current system. The insurance companies, who are responsible for our having the most expensive and least effective system in the developed world, will simply get bigger troughs.

3. It does nothing about privacy. Employers, insurance co. and government bureaucrats, and gods know who else will continue to freely snoop into everyone's health record. There is no good reason for anyone but the patient and their doctor to have access to such records.

4. It sets up a multi-tiered system where the privileged have one set of options and the not-privileged and the sick still have to prove to public or private bureaucrats that they deserve coverage/subsidies. Given Bill's shameful welfare "reform" I can see it being a small step to "work or die".

5. It isn't simple. It offers a mishmash of public and private, mandated and subsidized. It looks like the ill-begotten prescription drug law writ horrifically larger. The workforce is changing, but as far as I can tell, this plan does nothing to accommodate the growing number of Americans who leave regular employment to try their hand at starting a business, freelancing, or similar alternatives. It also doesn't seem to offer much to those who are staying in oppressive jobs because they can't afford to risk their health insurance.

My overall problem with it is that it fails to present health care as a human right instead of a handout. It's already obvious that it will not be run with the rights, worth, and dignity of its users as its top priority.

I don't believe that this is anywhere near the best plan that has any chance at political success. The health-care crisis is now bringing down major corporations and alienating all but the most privileged Americans. Sorry Mike, but the '94 proposal went down because it was unintelligible and promoted with breathtaking ineptitude. By all appearances, nobody at the Clinton White House ever imagined that there would be resistance they'd have to deal with. Since Bill is not politically inept, I've never really believed that the effort was anything more than an excuse for him to say "I tried".

If we really believe that we'll elect a Dem White House and more Dem Congress next year, it seems to me that "hyper-cautious" does exactly describe this plan. If this is the initial demand, it's hard to believe that the ultimate compromise position will be worth bothering about. Once again a major Dem politician starts out appeasing instead of going for the home run. The plan reinforces my suspicion that Hillary's experience of failure has not taught her how to do it better this time around.

Unfortunately, the proposals from Obama and Edwards appear to be about the same as Hillary's. Even Bush has not managed to inspire the Dem "leadership" to think beyond tweaking a dying and broken system. We could do so much better -- but that would take political skill and creative imagination.

Single payer. (4.00 / 1)
The only plan that I can think of that gets at everything you are talking about is single-payer, which absent a $100 million dollar communications and organizing campaign is pretty much a political non-starter.
In terms of the specific points you raised:

1. It doesn't entirely sever the tie between coverage and employment, but goes further than you think because it makes health insurance completely portable, and makes insurance discrimination and cherry picking very difficult.

2. Because it doesn't allow insurance companies to discriminate or cherry pick on the basis of health, it takes a lot of insurance co. bureaucracy away. Plus the getting med records on computer will help with inefficiences a lot.

3. I think you may be right re privacy being addressed in this plan, but I've talked with Hillary in the past about that issue and know she is into dealing with it, so I'm guessing she would be very supportive to adding something.

4. The privileged almost always have different options than the rest of us, but I don't agree with your point re the rest of us. You don't have to prove anything to any bureaucrat to buy insurance, and to get subsidies you just have to show in your tax return that you qualify for them.

5. It's not simple compared to single-payer, but it's not as complicated as the current system. You can keep the plan you're on now, or switch to a medicare style plan, and the insurer doesn't have the right to deny you coverage.

The '94 plan went down because we made it too complicated, because Clinton was still too new to the Presidency to have the experience to negotiate such a tough issue, because Gingrich figured out if the Repubs did everything in their power to block it they could beat us in the '94 elections, and because the opposition spent several hundred million to beat us. It was not for lack of effort. 

[ Parent ]
The devilish details (0.00 / 0)
I don't see any details on her site as to how, exactly, it would be portable. If my employer uses Blue Cross, for example, would blue cross have to keep my policy going when I became unemployed/self-employed, etc? At what cost?

I still don't see the point in subsidizing employers instead of subsidizing individuals directly. There is no logical connection between employment and health care rights, and employers no longer see a benefit in shouldering the burden.

I had missed the part about having a Medicare-style option, which does mitigate the flaws to some degree. But since Medicare is already administered by private entities, why not make that the sole plan? Why bother with mandates and the rest? It still wouldn't be government dictating your health care -- it would be government paying for the plan you choose, like Medicare does now.

I'm not a Canadian-plan deadender. I can see other options, especially now that Bush has shown us just how deeply corrupt, oppressive, and incompetent our political/government system can be. But the killer for me in Hillary's proposal is the use of tax credits, which should have no place in anything Democrats ever do -- they are designed to benefit those who pay enough taxes for credits to matter.

Here's a plan that would work at least as well as the Canadian system, to my mind: give every American healthcare purchasing power sufficient to buy good insurance (worth $300-400 a month when all risk categories are levelled and averaged?). Force every insurance/health plan provider that wants to do business to offer plans that meet standards set by the law that cost no more than that amount. Allow very limited extras like dental or glasses for extra fees. Make approval of doctor-ordered procedures/medicines the default -- if companies wanted to contest them the burden of proof would be on them, not the patient or doctor.

Simple, universal, fair, minimally bureaucratic, no involvement from the tax system. All it would take would be for Dems to quit cowering before the money of the insurance, pharma, and hospital interests.

[ Parent ]
Corrections (0.00 / 0)
Yes, you keep your insurance when you change or lose a job.  When you later renew you can't be discriminated based on medical conditions.

Individuals are subsidized if they pay for the heath coverage and employers are subsidized if they pay for the health coverage. It's fair because the payer, whoever it is, is subsidized.

You can choose the Medicare or the federal employee plan or keep what you already have and you have an individual mandate. Some people just want to keep what they already have.

The privacy aspect is already covered by HIPAA, a federal law.

The tax credits are REFUNDABLE. That means that even if you don't pay any taxes you still get money if you file a tax return. Take your refund and buy an insurance plan.  EVERYONE, including poor people will benefit from the refundable tax credit.

I you want health care, work hard. If you want universal health care, vote for liberals.

[ Parent ]
I really, really, really don't care that... (4.00 / 2)
...you think single-payer is a non-starter. Here's the problem in a nutshell.

As a small business 'owner', gotta laugh at that one as I own not much more than my house and part of my truck, I cannot deal with more mandates. Just can't do it.

No time.

No money.

Wake up and smell the gotdamn coffee! If progressives are going to work for something let's work for something that will help everyone.

Not-for-profit single-payer is the only way. And using the Clinton plan to 'transition' to single-payer will not work. The inertia, not to mention the insurance industry will bog any 'transition' down.

We need to stop fucking around and do what everybody knows has to be done.

Not this kludge of Clinton 'plan' that give life to the major problem.

Health-care for profit!

Peace, Health and Prosperity for Everyone.

[ Parent ]
Single Payer (4.00 / 1)
We need to elect a candidate first, but demand all the candidates just open a debate once elected with a single payer plan as an option. 

I am currently a small business owner from KC who is currently living in Melbourne, Australia.  And you know what, I do not have to pay a cent, and every employee I have here is covered 100% by a single payer system, including myself and my wife.

Do you know how much that means to 1-25 employee company owners?

Do you realize how this allows small firms to thrive, employ more employees without fear of getting socked with unreasonable costs from insurers?

Wake up folks, we are way behind in the US, with the exception of major corporates.  Yet it is the small business people who make our economy really work.

All of the candidates at the top tier have different, yet similar plans.  Whichever dem gets the nod, I will vote for them.  But then we need to have a debate, and give Medicare for all...

Wake up while we still have a country to save, please!

[ Parent ]
Single-payer. (4.00 / 1)
If the political climate changes by 2009 and single-payer is viable, I'd be all for pushing it through. But people are dying, and their lives are being utterly ruined, right now, and I'm not willing to wait for the perfect if we can get major improvements- universal coverage, no cherry picking or pre-existing conditions by insurance companies, cost controls, etc- passed now.
[ Parent ]
I think you're wrong. (0.00 / 0)
You're cowering before the moneyed might of the narrow special interests. Competent politics can overcome that. The '94 loss is not an example of competent poltics. Americans are overwhelmingly in favor of universal health care, according to all the polls. How about we work with them instead of pandering to the enemy?
[ Parent ]
competent politics (0.00 / 0)
the ol Im smarter then everyone else critique...how unique
[ Parent ]
just being angry and sure (0.00 / 0)
doesnt make the other side give in.

Naderesque rage is impotent and juvenile.

[ Parent ]
Right on, DaveW - (0.00 / 0)
To start a political negotiation with a proposal like Hillary's is a mistake.  It can only get weaker.  This appears to be a "centrist" position suited for the primaries and for continued insurance lobby money.

The few relevant polls are not specific enough to this issue to state the majority viewpoint on a "single-payer" plan vs. this type of approach at this point.  But I will point out two items that appear to me to be relevant: 1) we never know how an issue will turn until that issue has been brought into the national debate in a serious manner; and 2) Social Security is both well-regarded and jealously-guarded by an overwhelming majority of citizens.

Mike - a side note: I've been voting Democratic Party for 40 years.  In the early 90s, even I was sick of the congressional Democrats.  It wasn't just the health plan fiasco (which was one of the few places that I could still heartily support the party).  You could not talk to any of them; they were so entitled.  Bush and crew show only a little more hubris and arrogance than the Democratic Bozos of that era.

By the way - did I mention that I'm running for president?

[ Parent ]
Bonddad said it best. (4.00 / 1)
If you haven't read Bonddad's diary, Single Payer Health: Cheaper and Better, you should.  He says it all and makes the argument for health care and not the insurance industry.

Finally there is the issue of competitiveness.  I'll let General Motors of Canada make the argument for me.

"The Canadian plan has been a significant advantage for investing in Canada," says GM Canada spokesman David Patterson, noting that in the United States, GM spends $1,400 per car on health benefits. Indeed, with the provinces sharing 75 percent of the cost of Canadian healthcare, it's no surprise that GM, Ford and Chrysler have all been shifting car production across the border at such a rate that the name "Motor City" should belong to Windsor, not Detroit.

Just two years ago, GM Canada's CEO Michael Grimaldi sent a letter co-signed by Canadian Autoworkers Union president Buzz Hargrave to a Crown Commission considering reforms of Canada's 35-year-old national health program that said, "The public healthcare system significantly reduces total labour costs for automobile manufacturing firms, compared to their cost of equivalent private insurance services purchased by U.S.-based automakers." That letter also said it was "vitally important that the publicly funded healthcare system be preserved and renewed, on the existing principles of universality, accessibility, portability, comprehensiveness and public administration," and went on to call not just for preservation but for an "updated range of services." CEOs of the Canadian units of Ford and DaimlerChrysler wrote similar encomiums endorsing the national health system.

Health care costs are killing American business.  Our international competitors don't have to deal with these costs.  As a result, private health care is making US business less competitive. 

So, public health eliminates a conflict of interest that compromises individual health, is cheaper and makes the US more competitive.  And we don't have a public health system because?

And this from ManfromMiddletown. 


UAW Chooses GM as Strike Target

I'd like to close with this.  Even if you don't give a damn about the UAW or organized labor, this matters.  Because the creation of a new union run insurance system would introduce a significant new player into the national debate on healthcare.  And I have no doubt that the possibility of a UAW VEBA and the influence of David Bonior are what lead the Edwards campaign to propose the healthcare plan that they did.  The idea being to use the power of union VEBAs to fuel the creation of a government run healthcare plan that will bring a single payer plan through the power of the market.  And the thing is that there's a strong possibility that it would actually work.

I'm sorry, but the Clintons truly suck.

They're asking for another four years -- in a just world, they'd get 10 to 20. ~~ Dennis Kucinich  

[ Parent ]
If she is elected I believe we... (4.00 / 1)
...face economic and social disaster. This 'plan' of hers too allow the health insurance industry to continue to drain the life's blood of our nation is a perfect example of why.....

She is wrong for America!


Peace, Health and Prosperity for Everyone.

[ Parent ]
jd-in-nyc said it best (4.00 / 1)
jd-in-nyc pwns Bonddad in Multipayer Universal Healthcare: Why It Works.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
It can get stronger. (0.00 / 0)
If 2008 is a Democratic year and we pick up seats on the House and have 55 or more in the Senate, I think we could end up with something better than what Hillary, or whoever is the President, proposes.
[ Parent ]
I don't like the plan (4.00 / 2)
I think it's a violation of spirit, if not the letter of the Constitution to force people to buy health insurance. And comparing it auto insurance doesn't cut it. You pay for mandatory auto insurance for the privilege to DRIVE; there should be no corresponding privilege to LIVE--it is a right. I hate it, as I struggle with money enough as it is as a single mother. I don't need the government twisting my arm and forcing me to give a sizable portion of my limited income to crooks like those who work in the insurance industry.

Besides, I don't WANT health insurance, I want an affordable health care delivery system. I don't want any compromise with Rethugs or conservatives, and I'm willing to wait for a proposal that doesn't include a a sharp instrument being inserted where the sun don't shine. Hillary's plan is similar to Romney's Mass. plan, and I think it's a VERY bad idea, regardless of whether or not people are dying for lack of insurance. I'm sorry you lost friends, but we will ALL be effected by this plan. Hillary lost my vote, a vote I had been waiting more than a decade to cast, when she made this proposal.

Looks like Obama will do the least harm. Goodbye Hillary.

yeah ... (4.00 / 2)
it's a tax on the healthy.

There are so many ways that the American "system" disproportionately taxes young people. Blue-collar work is culturally unacceptable, so everybody has to go to college to become a banker, doctor, or lawyer. Can't pay? No problem--here are "cheap" loans that you can pay over 30 years of your life, so you can have a ridiculously overrated credential!

Hillary is an insurance subsidiary this time around. So of course she's going to do what they want.

The tax break for corporate health insurance, which is what conjoined healthcare with employment in the first place, needs to be eliminated. Not only does the gummint get lots of money, but workers gain some leverage back from employers.

This just ensures that every citizen is coerced into the current bureaucratic nightmare bullshit insurance "market." Not only does it do virtually nothing to solve the underlying problems of the current system, but it reinforces the source of it all -- the uncertainty that large companies and insurers must deal with in restructuring the system from a corporate to an individual basis.

[ Parent ]
You are wrong (4.00 / 1)
Driving is a RIGHT that comes with a RESPONSIBILITY because you may harm someone when driving. Therefore we have a license to dive.  Choice in health care is a RIGHT that comes with a RESPONSIBILITY to be insured so that others don't pay for you when you are sick.

You won't pay an excessive amount of your income for health insurance because of the refundable tax credit in the Clinton plan.

I you want health care, work hard. If you want universal health care, vote for liberals.

[ Parent ]
What utter bullshit... (4.00 / 1)
Funny how we are the only industrialised democracy which let's giant corporations make obscene profits off the citizens getting sick.

But with folks like you around it's a real 'no-brainer'.

Sickening for sure.

Peace, Health and Prosperity for Everyone.

[ Parent ]
And (4.00 / 1)
All the more reason for Hillary Clinton's health care reforms which will lower the cost of health care and bring it to everyone.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
Please put down that big mug of... (0.00 / 0)
...Kool-Aid you're drinking from. The Hill's 'plan' will do nothing but further enrich the insurance companies.

At our expense.

Do you honestly think the insurance companies are gonna cover me, someone with a pre-existing condition?

Maybe for a nice big, fat surcharge.... which will, under The Hill's plan, be mandatory.

Oh goody!

And if I'm denied who will intercede for me?

Ghoulianni's Dept. of Health, Education and Welfare?

Don't make me laugh.

This is, like all of The Hill's plans for us little people, MORE OF THE FUCKING SAME!

Tell ya what...I'll take the same health-care plan SHE HAS RIGHT NOW!

Nothing less, no compromises.

How would that be? Seems pretty fair to me.

THE SAME HEALTHCARE PLAN SHE AND EVERY OTHER FAT-ASSED SENATOR HAS RIGHT THIS SECOND!

Peace, Health and Prosperity for Everyone.

[ Parent ]
That's actually what she's proposing. (4.00 / 2)
That everyone will have the same choices on health coverage as members of Congress do, with subsidies for those who can't afford it.
[ Parent ]
dud, you need a prescription for a (0.00 / 0)
chill pill

Take two ...and then stop pretending that you know better then everyone.

[ Parent ]
The kool-aid is like a fine wine (0.00 / 0)
The Clinton plan outlaws discrimination based on preexisting conditions. It allows people people to buy the same insurance as Congress which is the federal employee insurance plan. It provides subsidies to small businesses through tax credits. It provides subsidies to individuals through refundable tax credits.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
point to that section of the Constitution (0.00 / 0)

[ Parent ]
Exactly (0.00 / 0)
I have to say that libertarians often have a firmer grasp on common/civil law. Liberals tend to appreciate the fact that the government can be do good in a very equitable and efficient manner. Personally I usually examine things from the liberal and conservative perspective to come to a conclusion. However, I am a liberal because of the polices that I support.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
just dont like the free loose use of terms (0.00 / 0)
dumbs down understanding.
[ Parent ]
Thanks for the analysis (4.00 / 1)
Your expertise on this issue is really helpful. Health care is my #1 issue for many of the same reasons you cite.

I really appreciate your analysis of the plans. This is important stuff, and way to wonky for the average blogger to address sufficiently.

I always look forward to reading your posts about health care.

How does it differ from Edwards and Obama? (0.00 / 0)
I know that was asked, not fully answered.
Policy expertise. (4.00 / 1)
I'm not enough of a policy expert to do a really good detailed analysis, but folks like Bondad and Ezra Klein have done a lot of good writing on the comparitive aspects of the candidates' plans.
[ Parent ]
I'm curious to know... (0.00 / 0)
your perspective on how high a priority this really is for Hillary?

She played it safe by letting others release their plans first, then integrated their best elements.

She has said several times that she promises health care reform by the end of her second term, which tells me this isn't a priority for her.  How do you reconcile that with the idea that she has made this "such a high priority"?

I realize that first isn't always best, but I'm not convinced that she is willing to risk her political capital early in her term to tackle this.  In my opinion we need someone willing to take this on early - planned and communicated the right way, it's a winning issue.

This and the environment are my voting issues as frankly I don't trust any of them on Iraq.  For those 2 issues, Edwards seems the strongest, though I acknowledge he hasn't lived through hc reform once which can help, or potentially hurt, the process.

Our lives begin to end the day we become silent about things that matter. -- Martin Luther King, Jr

I've been asking that question (0.00 / 0)
And getting no answer. When I asked that over at Ezra Klein - someone who is supposed to be a wonk about healthcare- he spouted by the retort by the campaign "It will be a top priority for her." When I kept in three different post by him about what he thought of the plan itself asking- but "what policy reasons to spread her efforts over 8 years?" Still no answer- several posters said my question was answered by her saying it was a top priority.

Here's the thing. You capture the heart of the matter. Arguing over plans is nice, but if this is just a plan that will never be implemented then it's a lot of wasted words. Thats why it's important to know what she means by implemented by the end of her second term- which would require us to electe her twice and would mean we wouldn't start to know the effects of her ideas until the next President after her.

Now, this is a question that needs to be asked of all the candidates. I am not sure it has been- but its definitely one that needs to be asked rather than ignored to guage their seriousness on this issue.

[ Parent ]
Priorities. (0.00 / 0)
I think her waiting for others was more political strategy than a reflection of her priority, and my sense is that the 8 year thing was more about how long it would take to fully phase in than when she would propose it to Congress.

Based on my experience with her, I think she will rate this as a very high priority, probably her top domestic priority. I have my problems with Hillary's position on the war, and on trade issues. I do not doubt her commitment to this issue.

[ Parent ]
Based on my experience with her (0.00 / 0)
That line by you sums up the discussion. But I am going to call it what it is- personality. We aren't supposed to listen to what candidates say anymore- but trust because they are on our team. How about this. How about someone actually asked her what she meant by what she said. How about she gives a clear unambigous answer.
[ Parent ]
It's an important question (0.00 / 0)
I think you raise an important question. Although Clinton shouldn't completely telegraph her legislative strategy, she needs to reassure the people that the most important parts of her health care plan will be implemented in a reasonable timetable. Now that her full plan has been released this is the time to ask the tough questions.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
asking for why her time table (0.00 / 0)
is signicantly different from others isn't telegraping what she will do.
[ Parent ]
You are not completely understanding me (0.00 / 0)
There are three parts to Clinton's plan. The third part was just announced. All three together may take two terms to implement but she hasn't said when she plans on finishing the implementation of the most important part which makes health care universal. So the timetable is not clear. Therefore we have to ask her to clarify the timetable.

I you want health care, work hard. If you want universal health care, vote for liberals.
[ Parent ]
Too Expensive (4.00 / 1)
Thanks for the good analysis.

I'm glad that the plan is as good as it is. But to me, Hillary's plan -- just like the 93-94 version -- is vulnerable to attack by saying "it will cost too much".

Single-payer has the political disadvantage that it directly challenges the medical insurance industy and would throw a lot of people out of work. But it has the political advantage that it costs less than our current system, so it frees up lots of money to pay off people who lose their jobs. And it is simple to understand (Medicare for everyone).

Now that virtually everyone is being screwed by our current horrible, expensive system, I think it will be a lot easier to push through a new healthcare system. But plans that are complicated and cost more than the current system will have the same political problems that the 93-94 plan did.

I wish one of the major candidates was pushing for single-payer so the arguments for single-payer could finally get a hearing.

I agree. (0.00 / 0)
It would be great if one of the major candidates would really go out and campaign on single-payer, so that it would get a fair hearing. I fear the fact that no one is, though, is more evidence that no one thinks it has a chance. 
[ Parent ]
Cost and Quality (0.00 / 0)
All of the discussion this week concerns the mechanics of implementing universal coverage without reference to cost containment and improving care delivery. All three candidates have spoken to this -- in Hillary's case, the specifics were rolled out in the first two parts.

My view is that w/o cost containment/improved quality in delivery, none of these multipayer UHC plans will work as advertised. These elements are as important and more to the point, necessary prerequisites to implementation of universal multipayer.

My gut tells me the prerequisite aspects of 'reform,' as discussed by the candidates, will not be completed in less than four years. For this reason I was not particularly alarmed when Hillary spoke of complete implementation by second term (I happen to think this is the more realistic scenario). So, if future discussion continues to revolve around 'first term' vs 'second term' arguments, I hope it's not limited to this idea that passing UHC legislation is the be all and end all.

Hillary and Health Care | 45 comments
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