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Hillary Aims To Please This Time: Ms. Clinton's New Health Care Plan Promises Coverage for All Texan

Oct 12, 2007
So she finally did it. She finally told us what was on her mind. This Monday, Hillary Rodham Clinton revealed the bare bones of her proposed healthcare plan, "The American Health Choices Plan," in Iowa. In her speech, she clearly attempted to avoid the flaws of the 1993-1994 Clinton administration's healthcare proposal, and aimed to please more of the lobbyists that thwarted it last time.

And for good cause. While the Clintons' former plan was full of good intentions, it also attempted to reorganize one-seventh of the American economy, created vast new bureaucracies, and wound up alienating numerous businesses -- including the private health insurance industry and individuals who saw better options in the private insurance sector. While few argue that there are definite flaws within the current healthcare system that desperately need addressing, many believed the Clintons' early-90's plan would have done little short of embarking on an unrealistically complicated dismantling and restructuring process.

Hillary's new plan, in contrast, elects to build on the existing, employer-based system, present new options for purchasing private and public health insurance plans, and offer subsidies and tax credits to small businesses and individuals who would otherwise not be able to afford it. She would also require, much like Massachusetts did, that all Americans obtain health insurance in some form.

Texans would do well to pay attention to what's going on here. Twenty-five percent of the state, including twenty-seven percent of its young adults, are currently living without health insurance -- the worst rate in the nation. The expansion of the State Children's Health Insurance Program (SCHIP), which would provide insurance to millions more children, is still under debate, even though more than 1.2 million Texas children under 300% of the Federal Poverty Level (FPL) alone are left without coverage. According to a report released by the Kaiser Family Foundation, the "Kaiser Commission on Medicaid and the Uninsured," twenty-seven percent of children in Texas under that 300% FPL are living without health insurance.

This, combined with Texas' higher-than-average rate of obesity, high incidences of diabetes, and new studies conducted on children in Dallas, Houston, and Austin revealing trends that may increase that number, would suggest that Texas potentially has more to gain -- or lose -- from changes to the current system than any other state.

Hillary's $10 billion plan would be funded by rolling back tax cuts for Americans earning over $250,000 a year, which were instituted by the current Bush administration. She would also garner funding by savings within the healthcare system itself.

The fears are that, like the early-90s Clinton plan, this proposal would require individuals and employers to join organizations like "regional alliances" to get covered, and that the healthcare system itself would be run by a national agency with widespread authority to regulate the system. Those satisfied with their current insurance, or who see better options in the private health insurance industry, worry that their benefits and choices will be dictated by a large, bureaucratic health maintenance organization.

These are fears that Senator Clinton is clearly trying to abate. Under the "The American Health Choices Plan," employers would not be required to provide coverage, but -- particularly the small businesses -- would be given tax incentives to help with the cost of doing so. "This is not government-run," said Ms. Clinton. "there will be no new bureaucracy. You can keep the doctors you know and trust. You keep the insurance you have, if you like that. But this plan expands personal choice and keeps cost down." Among those choices would be subsidies to obtain private coverage.

Stuart Altman, health economist at Brandeis University and policy advisor since the Nixon administration said the plan "is much less radical [than the first]. It's not fair at all to say it's a redo of the old plan." Sixty-one percent of Democratic primary voters would seem to agree, revealing in a CBSNews poll conducted Monday night that they had confidence in Ms. Clinton's ability to make the right decisions on healthcare.

Still, not everyone is in support. Mitt Romney, the governor of Massachusetts who signed legislation requiring all residents of his state to obtain coverage, believes Senator Clinton's approach is un-American. She "takes her inspiration from European bureaucracies" and "fundamentally does not believe in markets and in the states," he said. Romney would prefer to rely more on the market, state and tax credits. It's a debate worth having; clearly, his plan has been at least somewhat successful. By May of this year, 100,000 residents of Massachusetts who were formerly living without health insurance had gained coverage.

In the end, the political circus accompanying any election, but particularly the presidential election, will reveal how the proposal plays out in the eyes of the American public. The last Clinton plan started with great promise too, after all. Obviously, something has to be done. Fifty million people in the United States are currently living without health coverage -- in states like Texas, it's up to one-quarter of the population. And, according to many reports, including one released by the Commonwealth Fund, such individuals are also living with less access to healthcare because of it. That's inexcusable. Hillary's plan may aim to please, but we'll have to wait and see how many it actually does.
About the Author
Pat Carpenter writes for Precedent Insurance Company. Precedent puts a new spin on health insurance. Learn more at Precedent.com
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