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Pluto
Joined: 19 Dec 2006
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 Posted: Thu Feb 07, 2008 12:52 pm Post subject: HillaryCare II |
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Hillary Clinton and Barack Obama agree on most policy issues, but that makes their rare differences all the more revealing. To wit, their running scrap over Mrs. Clinton's "individual mandate" for health care, which Mr. Obama has now had the nerve to expose for itsinevitable government coercion.
Mrs. Clinton's proposal requires everyone to buy health insurance,along with more insurance regulation, a government insurance option for everyone and tax hikes.Mr. Obama likes all that but his mandate would only apply to children. He argues that the reason many people aren't insured is because it's too expensive, not because they don't want it. Mrs. Clinton counters that coverage can't be "universal" without a mandate.
But then Mr. Obama had the impudence to defend his views. His campaign distributed a mailer in key primary states that claimed the Clinton plan "forces everyone to buy insurance, even if you can't afford it." It also featured an image of an anxious couple at a kitchen table. The Clinton apparat went apoplectic, claiming the flyer evokes the famous "Harry and Louise" commercials. A common article of liberal faith is that this "smear campaign" doomed HillaryCare in 1994 -- as opposed to, say, its huge cost and complexities. But never mind.
Yet if Mrs. Clinton's plan is better because it has a mandate, how does it work in the real world, where some people still won't be able to afford insurance, or would decline to acquire it? At a recent debate, the Illinois Senator drove the point home, asking Mrs. Clinton, "You can mandate it but there will still be people who can't afford it. And if they can't afford it, what are you going to fine them? Are you going to garnish their wages?" And in an interview with ABC's George Stephanopoulos on Sunday,Mrs. Clinton conceded that "we will have an enforcement mechanism" that might include "you know, going after people's wages."
Well, well. In other words, HillaryCare II isn't all about "choice," but would require financial penalties for people to pay attention, including garnishing wages. To put it more accurately, the individual mandate is really a government mandate that requires brute force plus huge subsidies to get anywhere near its goal of universal coverage.
Mitt Romney's mandate program in Massachusetts is already expected to reach $1.35 billion in annual costs by 2011, up from $158 million today. And that's with only half of the previously uninsured currently enrolled; no less than 20% didn't qualify for subsidies and were granted exemptions because the costs were too much of a hardship.
Most experts calculate that a national mandate with subsidies like Mrs. Clinton's would enroll about half to two-thirds of the uninsured, less for a voluntary plan and subsidies alone. But such guesswork is pointless without the basic enforcement assumptions, which Mrs. Clinton refuses to provide. She's more interested in wielding what she calls "a core Democratic principle" against Mr. Obama. "My opponent will not commit to universal health care," she said Saturday.
The logic of Mr. Obama's approach is that policy makers should target those who are priced out of coverage. The Census Bureau says 38% of the uninsured earned more than $50,000 in 2006, 19% above $75,000. They aren't a major public policy problem --xcept that a big reason they lack coverage is because it is more expensive than it needs to be thanks togovernment market interference. And 29% earn under $25,000, which means they probably qualify for existing subsidy programs like Medicaid or Schip but haven't enrolled.
The news here is that all of this is being exposed now, and by a fellow Democrat. Many Americans are uncomfortable with thecoercion of the mandate-- and not all of them are Republicans. The California health-care overhaul was recently done in by liberals concerned about its consequences for the working poor.
The political lesson that Mrs. Clinton learned in 1994 wasn't about compromise or market forces. It was that a government health-care takeover can only be achieved gradually and by stealth. Her individual mandate is an attempt to force everyone to buy into a highly regulated and price-controlled system where government redistributes income and dictates coverage. We assume the McCain campaign is paying attention. |
From the Wall Street Journal
Hillary's plan would only make things worse; that means more regulation, more gov't interference, more expensive health care, less quality and higher taxes.
HillaryCare II is not the answer. The market must be clear of government interference. That means less taxes, less regulation, freer health care markets and more tort reform. This will ensure better quality and lower prices. Indeed, the way towards more 'universal' coverage is to just the opposite of what Hillary is advocating. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Thu Feb 07, 2008 1:33 pm Post subject: Re: HillaryCare II |
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| Pluto wrote: |
Hillary's plan would only make things worse; that means more regulation, more gov't interference, more expensive health care, less quality and higher taxes.
HillaryCare II is not the answer. The market must be clear of government interference. That means less taxes, less regulation, freer health care markets and more tort reform. This will ensure better quality and lower prices. Indeed, the way towards more 'universal' coverage is to just the opposite of what Hillary is advocating. |
Right now the American gov't is already spending over 5% of its GDP on public health care. But Medicare and Medicaid serve only those who cannot pay. Its necessary to cover all to collect the taxes that would support the current public health care system.
The following is the biggest myth concerning American health care around the world: America has a private health care system. This is emphatically not the case. We have a slapdash, segregated public-private health scheme. It is inefficient. It is cost-ineffective. It is fiscally abhorrant.
There is the pragmatic case for universal health care. The idealistic case is much easier:
Health Care is a fundamental human right. |
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bucheon bum
Joined: 16 Jan 2003
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| Posted: Thu Feb 07, 2008 1:50 pm Post subject: Re: HillaryCare II |
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| Kuros wrote: |
Right now the American gov't is already spending over 5% of its GDP on public health care. But Medicare and Medicaid serve only those who cannot pay. Its necessary to cover all to collect the taxes that would support the current public health care system.
The following is the biggest myth concerning American health care around the world: America has a private health care system. This is emphatically not the case. We have a slapdash, segregated public-private health scheme. It is inefficient. It is cost-ineffective. It is fiscally abhorrant.
There is the pragmatic case for universal health care. The idealistic case is much easier:
Health Care is a fundamental human right. |
so
1. How does Hillary's plan fix any of these problems? Seems to me it just blends the private and public sectors even more, thereby worsening the situation.
2. Why not support McCain, who favors deregulating the health care system and allowing for more competition in the sector? That would push it to being closer to a private health-care system. |
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Pluto
Joined: 19 Dec 2006
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| Posted: Thu Feb 07, 2008 2:02 pm Post subject: Re: HillaryCare II |
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| Kuros wrote: |
Health Care is a fundamental human right. |
Indeed it could very well be argued that it is a fundamental right. So, the question becomes how do we achieve, or realize, that right. I've done a few case studies of the health care industry and I have got to admit that I still don't know much about it; it's so complicated thanks in no part to gov't interference. The gov't has made industry exit impossible for any hospital. -- What kind of service can you expect from a hospital that can't pay its employees, keep services running when it simply doesn't have the capital to do so.?
I'm convinced that the best way is to completely privatize the industry, make it harder for opportunistic ambulance chasers to get their (un)fair share and just support the health care business by keeping gov't out of theirs. In short, I believe less gov't interference and a freer market will ensure more universal health care. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Thu Feb 07, 2008 2:11 pm Post subject: Re: HillaryCare II |
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| bucheon bum wrote: |
1. How does Hillary's plan fix any of these problems? Seems to me it just blends the private and public sectors even more, thereby worsening the situation. |
Hillary knows from experience that universal health care is impossible. Too many Americans fear having to change their employer-provided plans, which was one of the reason she lost the fight over ten years ago. She's accomodating that reality.
Hillary's plan will allow for more taxes to be raised. Right now a lot of healthy American youth are not paying into either the public or private system. These Americans do not need much medical attention now, but the system needs their money now to pay for their treatment as they age.
| Quote: |
| 2. Why not support McCain, who favors deregulating the health care system and allowing for more competition in the sector? That would push it to being closer to a private health-care system. |
Because a private health-care system is a segregated health-care system.
Our law school had a speaker on Health Care equity on Tuesday. Its not uncommon for poorer Americans to forego preventative health simply to pay the mortgage. I'm no bleeding heart, but I can recognize that we pay for that lack of investment when they end up having elderly afflictions in their 30s and 40s, and Medicare finances that treatment.
McCain's system would not fix Medicare.
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In 2006, health care providers nationally and industry-wide increased their profits by 6%. They also increased their health-care rates by 6%. Free-market principles have not worked in health insurance. |
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Gopher
Joined: 04 Jun 2005
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| Posted: Thu Feb 07, 2008 2:31 pm Post subject: |
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| bucheon bum wrote: |
1. How does Hillary's plan fix any of these problems? Seems to me it just blends the private and public sectors even more, thereby worsening the situation.
2. Why not support McCain, who favors deregulating the health care system and allowing for more competition in the sector? That would push it to being closer to a private health-care system. |
These are excellent questions.
I think Clinton has learned much, has matured, and has developed an increasingly realistic approach to this. She seems to understand that she needs to go slowly and surely and develop consensus on a broad front. I get this from listening to her talk about it.
Some approach matters pertaining to regulation and deregulation formulaicly. And it becomes a difficult discussion. Personally, at this point I have no passionate feelings for or against either of these approaches -- unless we are going to bring in Michael Moore's hyperbolic nonsense, and then I will express my passionate feelings on it -- and very much look forward to their potentially going after each other aggressively in debate, and getting the specifics out on the table for discussion, etc. |
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bucheon bum
Joined: 16 Jan 2003
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| Posted: Thu Feb 07, 2008 3:32 pm Post subject: Re: HillaryCare II |
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| Kuros wrote: |
McCain's system would not fix Medicare.
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In 2006, health care providers nationally and industry-wide increased their profits by 6%. They also increased their health-care rates by 6%. Free-market principles have not worked in health insurance. |
#1- you are right. No argument here- his system would not fix medicare. Congress hasn't helped matters over the years either. the prescription drugs "benefit" that passed a couple years ago was disgusting (not the principle of it, but the form of the bill itself). Throw in the fact that Congress has "dipped" into the Medicare system in years past, and you have a disaster on your hands.
Which brings up question #3: How does Hillary's plan ensure that those raised taxes aren't used on BS expenditures unrelated to health care?
#2- Free-market principles really have not been applied to health insurance. |
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wannago
Joined: 16 Apr 2004
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| Posted: Thu Feb 07, 2008 9:00 pm Post subject: Re: HillaryCare II |
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| Kuros wrote: |
Our law school had a speaker on Health Care equity on Tuesday...
In 2006, health care providers nationally and industry-wide increased their profits by 6%. They also increased their health-care rates by 6%. Free-market principles have not worked in health insurance. |
You should also recognize that, because of what you and your law school buddies, and obviously the ones before you, have done, with frivolous law suit after frivolous law suit (yes, even in medical malpractice), health care prices in the U.S. have increased simply to protect the providers from blood-sucking attorneys. I have a friend who is an OB/GYN and his premiums to have insurance against medical malpractice is STAGGERING.
Leave it to a lawyer, even a budding one, to solely blame the evil health care providers for rising prices and not the ones who are truly getting wealthy...the lawyers. |
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Gopher
Joined: 04 Jun 2005
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| Posted: Thu Feb 07, 2008 9:22 pm Post subject: |
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| There are all kinds of lawyers. I know insurance-defense attys who despise frivolous lawsuits and the so-called ambulance chasers, for example. This does not derive from their clients' interests, either. They choose to represent such clients in the first place. |
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wannago
Joined: 16 Apr 2004
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| Posted: Thu Feb 07, 2008 11:44 pm Post subject: |
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| Gopher wrote: |
| There are all kinds of lawyers. I know insurance-defense attys who despise frivolous lawsuits and the so-called ambulance chasers, for example. This does not derive from their clients' interests, either. They choose to represent such clients in the first place. |
I know there are all kinds of lawyers...there may even be an honest one or two out there. 
I am commenting mainly on the lawyer mindset that its the "evil" medical providers who are solely responsible for driving up medical costs when I would say that its the legal profession that bears most of the blame. |
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thepeel
Joined: 08 Aug 2004
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| Posted: Fri Feb 08, 2008 1:00 am Post subject: |
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While I am a nutty libertarian, I do have my weaknesses. One of these is that I support national, and mandatory, medical insurance. While I do not believe the Canadian/North Korean/Cuban model of every brick involved in health care be property of the government (sorry, "the people") I do see some critical and devastating flaws in private insurance. The main problem is that people who do not likely require medical care will likely not purchase it, and those who will require it will purchase it. This creates a system in which risk can't be evenly spread among all individuals and the outcome being much more expensive insurance for those who do buy it.
Also, the American economy is no longer a 'lifetime employment' economy, and many people have their insurance tied up in their jobs.
Another big flaw is that American firms are put at a competitive disadvantage against European and other firms because of their massive health care liabilities (General Motors, for example). It is better that the state just take care of insurance and private industry facilitate the care. Publicly funded, privately delivered.
Better, that the state provide a reasonable level of insurance for all (paid for by evil taxes) and those who can afford it can buy additional coverage. |
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Pluto
Joined: 19 Dec 2006
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| Posted: Fri Feb 08, 2008 8:26 am Post subject: |
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I personally believe that a free market in any industry, including health care, can bring about the best quality service. The argument has been made that younger people don't seek health care as much as older people so this causes a type of imbalance. I disagree. Forcing young people to pay will not clear the market and therefore it will only cause more imbalance.
I feel that more tort reform and less regulation is needed in the industry. This will go a long way to getting rid of any inefficiencies in the health care markets. One worry I find will a gov't sponsored initiative is a gov't run monopoly. I wish to see that the customer has choice and thta the gov't doesn't have monopoly power over the industry. You could also have puplic insurance and private industry running the show. That would seem to lead to more regulation and more inefficiencies. Anyways, at the end of the day, the issue is more about cost than it is about insuring or taking care of people. First things that need to be done are more tort reforms and easing up the gov't interference in the health care markets. This will go a long way towards driving down cost.
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| and very much look forward to their potentially going after each other aggressively in debate, and getting the specifics out on the table for discussion, etc. |
Yes, there different proposals will come under much more scrutny as the general election season nears. |
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Kuros
Joined: 27 Apr 2004
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| Posted: Fri Feb 08, 2008 9:27 am Post subject: Re: HillaryCare II |
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| wannago wrote: |
| Kuros wrote: |
Our law school had a speaker on Health Care equity on Tuesday...
In 2006, health care providers nationally and industry-wide increased their profits by 6%. They also increased their health-care rates by 6%. Free-market principles have not worked in health insurance. |
You should also recognize that, because of what you and your law school buddies, and obviously the ones before you, have done, with frivolous law suit after frivolous law suit (yes, even in medical malpractice), health care prices in the U.S. have increased simply to protect the providers from blood-sucking attorneys. I have a friend who is an OB/GYN and his premiums to have insurance against medical malpractice is STAGGERING.
Leave it to a lawyer, even a budding one, to solely blame the evil health care providers for rising prices and not the ones who are truly getting wealthy...the lawyers. |
So its largely lawyers' fault? Does anyone at all agree with this?
Studies have shown that most of the malpractice lawsuits are not frivolous, and that many malpractice claims are not pursued.
If you'd like to talk about malpractice law, I'd be happy to do so. But if you're going to broadly attack lawyers I don't believe I'll be able to be of any use to you. |
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Ya-ta Boy
Joined: 16 Jan 2003
Location: Established in 1994
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| Posted: Fri Feb 08, 2008 2:08 pm Post subject: |
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Since we long ago decided socialized subsidies for drug companies in the form of extremely high costs is a good idea, I see no reason to be hypocritical and say socialized medicine for the public in some form is a bad idea.
I hope whatever plan we adopt includes addressing $8 aspirin in a hospital--even if it means putting in roll away beds for family members like the Koreans do. |
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