Mandating Health Insurance: The Poor Have Too Much Money

I commend Hillary for the effort she has made with her new health care proposal. And I must give it to her that I have not had the opportunity to study it in great detail. I want to be able to read the original. But the fundamental premise of it is at some level offensive.

Mandating health insurance, how much sense does it make? The suggestion seems to be that the poor masses are sitting on piles of money, but instead of buying health insurance, they go ahead and spend it on beer and cigarettes. So the way to change that bad behavior would be make it illegal for them to not buy health insurance.

Granted she has talked of helping people with the money. What if you are given tax breaks? What if the government steps in and helps you out a little. Those good sounding suggestions sound like the voucher schemes the Republicans have for the schools in poor neighborhoods designed to pit the poor against the poor, and like Edwards' voucher scheme to help a few to vacate poor neighborhoods entirely. His cure for urban poverty is to help a few escape the neighborhood. See no evil is the cure to evil.

I get the impression Hillary has learned entirely the wrong lesson from her health care debacle in the early 1990s. She is reluctant to confront big pharma and the big dogs of the insurance industry.

Hillary's solution to the health care crisis seems to be give even more private and public money to the insurance companies. Make it the law of the land that the insurance companies must get richer.

She still does not understand that it is not particularl policy per se but the political style, the political methods used that will make positive change possible. Her proposal exhibits her lapse of judgment.

Edwards errs in the other direction. He makes it sound like he is going to nuke the insurance companies to get to universal insurance.

Barack has middle, sensible ground. With Hillary, the insurance companies get most of the chairs around the table. With Edwards, they get kicked out of the room. With Obama, the insurance companies get one of many chairs in the room.

That is one big reason Obama's health care plan is not too specific. It is evolving. He has a few basic benchmarks. But other than that he is open to listening to all parties concerned. He will take the stand, he will pick fights if he has to, but ultimately for him it is less about posturing or cowering, and more about actually getting the stuff done. He is serious about getting a solution.

Granted there are other positive details to what Hillary has put forth. But the central premise overclouds those good details. Go back to the drawing board, Hillary. Instead of surprising the people with a plan, she should make transparent the very process and the discussions that lead to her plan. She has repeated her 1993 mistake of doing seemingly big work in opaque ways.

The process is central to the possibility of a positive outcome. Hillary doesn't get it.

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In The News

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Clinton unveils health insurance plan Los Angeles Times a plan that would require every American to have health insurance, offer generous subsidies to help pay for the policies and gingerly seek to tamp down rapidly rising medical costs. ...... she had learned the lessons of her earlier failure, pledging to do less mandating and more negotiating. ..... left key elements open to bargaining..... would require sweeping changes to, among other things, the nation's drug and insurance industries ..... Half of the $110 billion-a-year cost of Clinton's "American Health Choices Plan" would come from savings that she says she can squeeze from the current health- care system. ........ Clinton's savings from modernizing the system and improving clinical practices are highly uncertain but little different than those cited by other candidates .... all Americans would face an "individual mandate," a requirement that they have health coverage, just as most drivers are now required to have auto insurance. ...... Because of her history with the issue and her status as a former first lady, Clinton dominated news coverage Monday with her release of the plan. ....... a candidate who has spent much of the presidential campaign seeking to build a softer, less-combative image .... She was particularly fierce about insurers. ..... "Right now, insurance companies have free reign to cherry pick the healthiest patients and shut out anyone who seems to them like a bad risk," she said. "Insurance companies spend $50 billion a year on elaborate calculations and schemes to figure out how not to insure people. Fifty billion dollars trying to shut out those who need care the most." ...... Clinton took in $146,000 from drug companies and health product companies ; $991,000 from various health professionals, including doctors and nurses; and $353,000 from insurers
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Hillary's Health Care Do-Over TIME Instead of forcing people into big buying cooperatives — back then, she called them "alliances" — her new proposal allows people who like their health insurance to keep it. Her earlier plan would have established a big new government bureaucracy to determine things like what specific benefits should be required for all Americans; her new one does not. And while it contains a version of her earlier plan's controversial "employer mandate," requiring businesses to provide coverage for their workers, it exempts small employers. ..... only 48% of companies that employ fewer than 10 people provide health benefits .... Clinton is still likely to cross swords with the industry by requiring insurance companies to sell policies to anyone who applies and by barring them from charging sick people more. ..... allow people to buy into a government-run plan, similar to Medicare, which would amount to a test of both the support and feasibility of a "single-payer" system similar to Canadian and European systems. ........ The real battle will be convincing Democratic primary voters which candidate can actually turn his or her plan into reality. ..... The mismanagement of the effort in 1993 and 1994 has set back our ability to move toward universal health care immeasurably. ...... premium costs have risen 78% in the last six years, to an annual cost of $12,106 per family ..... the Massachusetts program, which is proving costlier and more difficult to implement than advertised.
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