The debate will be different this time around. When Hillary Clinton first attempted an overhaul of our health sector, she was no learned hand at politics. But the health plan that her presidential campaign released last month is much more politically attuned and lacks the hubris of those 1,342 pages of legislation the White House dropped on Congress 14 years ago. Today’s talking points (at variance with the actual details of her plan) stress choice, affordable private insurance, and no new government bureaucracy.
Her proposal foreshadows the much larger debate to come over universal coverage and the role of government in our health sector. The debate is being ignited now by the fight to reauthorize legislation that provides health insurance for children, but it’s by no means the only change from years past.
Americans are unhappier today with private insurance and more worried about losing their own coverage than they were 14 years ago. The managed-care revolution of the 1990s, which many people equate with HMOs denying them care, has left a sour aftertaste with wary consumers.
Many American employers are eager to shed the responsibility of providing health insurance to their workers. With the cost of a job-based health-insurance plan for a family now topping $12,000 a year, many employers are nervous about whether they can continue offering coverage. As a result, even workers who have insurance today are worried about losing it in the future.
And we are being pilloried at home and abroad for having 47 million people without health insurance. Europeans truly believe that we have a permanent underclass of 47 million poor citizens who have absolutely no access to health care, and Michael Moore and others with a liberal agenda throw fuel on the fire by condemning the U.S. health-care system as one of the worst in the world.
So in this new climate, the debate has shifted. More people are worried and open to the argument that universal coverage is the solution.
The immediate debate has shifted to universal coverage for children. The children’s health-insurance legislation that President Bush has vetoed would, he believes, quickly have become a new middle-class entitlement.
There is ample evidence to support that: Under the legislation, states could extend government-provided health insurance to middle-income families, including families of four earning up to $83,000 a year in New York and $72,000 in New Jersey. Virtually any other state could put children in families earning $61,000 a year on this taxpayer-supported health-insurance program — crowding out the private coverage that many of them already have.
Expansion of government programs is a key element of the Left’s strategy. Senator Clinton’s plan would expand Medicare and SCHIP (the State Children’s Health Insurance Program) and create a new “Medicare-like” program for working Americans. But she, like most other Democratic presidential candidates, would try to achieve universal health-insurance coverage by requiring everyone to have coverage, either through a government plan, employer group, or a federal arrangement.
This “individual mandate” would mean that Washington would dictate the terms of the coverage and decide how much individuals and employers would be required to pay for the policy. The insurance market would quickly morph into a government-regulated utility. This would be a giant leap toward government control of our health sector and spell a loss of individual freedom over health-care and health-insurance choices.
So what is the alternative?
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