Hillary Clinton Criticizes Barack Obama's Health Care Plan Saying It Would Not Cover Everyone--Is She Right?
This is a repost of an original that addresses Hillary Clinton's claim, repeated in this week's Texas debate, that only her health plan accomplishes universal coverage because it has a individual mandate and Barak Obama's does not. Senator Clinton goes so far as to say she would garnish wages to enforce her mandate that everyone buy health insurance.
Hillary Clinton has gone on the attack in recent days criticizing Barack Obama's health care plan. She charges that his plan would not cover everyone and hers would.
Is she right?
Senator Clinton has an individual mandate in her plan. That means that everyone would be required to purchase coverage or suffer a penalty she hasn't defined. Senator Obama does not have an individual mandate in his plan although he would require all children to be covered. Both candidates would require employers to cover their employees.
She points to studies that show without a mandate there would still be 15 million people uninsured.
In the sense that the Clinton plan requires everyone to be covered, one could argue that she covers more people. But I will suggest it is not that simple.
The new Massachusetts health plan is really the outline upon which both the Obama and Clinton plans are based. Mass has an individual mandate. But the problem is people still can't afford to buy insurance. Mass is doing a great job getting people covered with incomes so low that they have their health insurance fully paid for. But, for those families who make too much for a subsidy that pays less than the full cost--or none of the cost--the Mass program is faltering. Only a few thousand uninsured Mass residents whose incomes are above the lowest levels have signed up for the mandated coverage.
For example, a family of three making $50,000 gets no subsidy and the cost of a $2,000 deductible plan is in the $7,000 to $9,000 range. Mass has a law that says they must purchase coverage but how, with such high costs, can they really be expected to?
So, there is a mandate and you can say we are covering everyone because they have to be covered but in fact the mandate is a hollow provision if people can't afford it.
So, when the day is done, I don't see much real difference here.
The real issue is how each of the candidates would make premium affordable in the first place.
When I look at Senator Obama's 12 page health care plan, I see a number of proposals to reduce cost including investment in health information technology, improving prevention and management of chronic conditions, providing reinsurance for big costs, making care universal to reduce uncompensated care, simplifying paperwork, making insurance portable, improving quality of care through disease management, integrated care, and better transparency about costs.
When I look at Senator Clinton's 12 page plan, I see virtually the same things not only on cost containment but everything else.
Senator Clinton would limit premium payments to a percentage of income, "This guarantee will be be achieved through a premium affordability tax credit that ensures that health premiums will never rise above a certain percentage of family income."
But Obama says that, "Individuals and families who do not qualify for Medicaid and SCHIP but still need assistance will receive income-related federal subsidies to keep health insurance premiums affordable."
Both candidates seem to be offering the same cost containment strategies.
Both candidates are offering a vague guarantee that everyone will have access to "affordable" health insurance premiums.
I don't see a difference between them here.
When the day is done, as Massachusetts is showing us, a mandate does nothing if people don't have affordable premiums.
They both claim they are going to give us affordable premiums and would go about it in a very similar way.
I worry that both of them have cost containment strategies that would do little more then dent the continued escalation in health care costs and undermine both of their guarantees for affordable coverage. You can learn more about that by reading my posts on their respective health plans that can be found in the index to the right.
See my earlier posts:
When it Comes To Health Care Policy It Really Doesn't Matter Which Democrat Or Which Republican Wins Their Nomination
Massachusetts Expected to Further Backpedal on its Individual Mandate
California Health Care Reform—An Individual Mandate is Nowhere Near as Important as Affordable Health Insurance
5 comments:
Have you seen Mike Bloomberg's healthcare comments for the next president on rl.tv? He sounds presidential in his own right?
http://www.rl.tv/Community/Decision2008/tabid/791/Default.aspx
Neither plan can reduce costs and impact premiums to the degree that is required to make health insurance affordable and close the gap.
The really big savings are in single-payer.
Short of that, the only way to make the health insurance premium affordable to families and individuals is with tax-financed subsidies.
Increasing access to primary care, incentives for lifestyles, and more appropriate use of medical technology (devices, drugs, diagnostic equipment, etc.) are necessary to slow the rate of increase in healthcare costs and make the system both more efficient and effective.
But while the cost containment features of the plans are a necessary condition for affordability, they are not sufficient.
Bob -- Obama made a statement in the Texas debate this week that all Americans should have as good of coverage as Congress. I don't know what that plan is, but I'll venture a guess it is a rich PPO plan. There is NO WAY that type of coverage is AFFORDABLE under the present COST structure.
Why don't we cut to the chase and actually get something done. The fastest way to universal health care is to mandate CATASTROPHIC coverage only. A $10,000 individual deductible plan will be affordable TODAY.
Then we can all focus on the REAL issue, which is finding SOLUTIONS to the rising COST of care in the present delivery system.
The question I'm posing that nobody is answering is,
Are Obama and Clinton overstating the problem of the uninsured, given that some 14 million uninsured are really self-insured and another 15 to 20 million of the so called uninsured are illegal immigrants with no rights to government-paid programs of any kind in this country. Then look at the various Census Bureau reports on the uninsured and you'll see that the 47 million figure is vastly over stated because of inflated reports by the states. Other reports have indicated there are about 36 million uninsured. Subtracting the self-insured and illegals gives you less than 10 million truly uninsured American citizens.
Is the problem big enough to justify the Obama/Clinton plans? I don't think so. There are better, market-oriented solutions, but the Dems will never go for them, and they're in power.
In the 3 major policy areas of tackling home foreclosures, foreign policy and healthcare, Hillary scores over Obama. Here’s my analysis.
Home mortgage crisis: Obama’s plan does not call for a moratorim on home foreclosures and an interest-rate freeze. His much more tepid plan of tax credit for home-owners stems from the deregulation free-market policicies of his economic advisers who have strong connections to Wall street. He claims that Hillary’s plan (moratorium on home foreclosures) would cause mortgage rate increases for existing home buyers/owners. While that could be true the economic disadvantages of that are nothing compared to the tsunami of economic woes that are assailing the nation and the huge collateral damage that are and will be affecting ALL, including those who are currently affording their homes, if the home foreclosure issue is not handled strictly and immediately. Anything else will be too little, too late.
Foreign policy: Obama made an anti-Iraq war speech in 2002 before he joined the Senate. That is not the same as voting against the war while holding political office. A speech’s true sincerity emerges when it is made INSPITE of its risk to one’s political office. With this standard very few, with the exception of Kucinich perhaps, can stand up to scrutiny. He wants to take troops out of Iraq but is just as quick to add that he will redeploy them in the region. If his haste at unilateralism (attacking Pakistan) is any indication, retraction notwithstanding, it gives one the impression of impulsiveness and naivete which are a dangerous combination in foreign policy.
Healthcare: Both Obama’s and Hillary’s are basically very alike with the exception that Obama’s does not call for mandatory universal coverage. There can be no true and equitable and in my opinion, even affordable healthcare without mandatory coverage. If given the option to join, too many just making ends meet, will opt out but end up in the emergency room during catastrophes, resulting in the buck being passed on in a totally unplanned way to the system which will inevitably ratchet up the costs in unforeseen and incalculable ways.
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