http://www.tnr.com/doc.mhtml?i=w070917&s=cohn091807by Jonathan Cohn
Will she flinch? For months now, that's been the big question about Senator Hillary Clinton and health care. Nobody questioned her command of the issue or her interest in the subject. She'd proven all of that in 1993 and 1994, when she headed up her husband's health care task force and then became chief spokesperson for his ill-fated plan. But precisely because she "has the scars" from that experience, as she likes to say, many people wondered whether she'd be up for trying all over again. Would she be vague, figuring she had the least to prove on the matter and that details could only come back to haunt her? Would she settle on something less than universal coverage, figuring the political support for it was too weak? Would she kowtow to the insurance and pharmaceutical lobbies, which had started donating to her campaigns?
The answer seems to be no, no, and no. In a speech before an Iowa audience today, Clinton unveiled a plan that, if enacted and implemented, would provide every single American with generous, but affordable, health insurance. It would do so by forcing both the insurance industry and drug-makers to change the way they do business, and requiring large employers to pay part of the nation's health care bill. It would also come with a serious price tag--for which she's identified serious sources of funding.
Broadly speaking, the Clinton plan is as ambitious as any plan touted by a major presidential candidate right now. Indeed, the basic structure of the plan--starting with a requirement that all Americans buy health insurance--is strikingly similar to the structure first proposed by former Senator John Edwards, which has rightly won him considerable praise.
That's not to say Clinton is trying anything like the plan she tried to sell 14 years ago. That scheme tried to do two things simultaneously: It tried to give everybody health insurance and to reengineer the entire medical care delivery system, so that it would deliver higher quality, more cost-effective care. It was a fine idea--a lot better, in fact, than its historical reputation suggests. But, in retrospect, it was more than the political environment would accommodate. This time around, Clinton is focusing first and foremost on getting coverage to everybody. While she hasn't given up on making our famously inefficient health system work better, she's nudging it towards more efficiency rather than shoving it.
The centerpiece of Clinton's health plan is what's come to be known as an individual mandate, although the term is a bit misleading in that it's really a two-way bargain between government and its citizens. The government starts by requiring every individual to secure insurance coverage of some kind. (That's the individual mandate part.) But government then promises to make insurance available to everybody--and at prices everybody can afford.
How would the government accomplish this second part? In Clinton's case, it would do so by creating a new purchasing pool through which any individual could buy insurance. Insurers who wanted to sell to this pool couldn't discriminate against people with preexisting medical conditions, by denying them coverage or charging them higher premiums.
FULL story at link.
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