Why Clinton Embraced Employer-Based Insurance

[question everything]

The Wall Street Journal

Why Clinton Embraced Employer-Based Insurance
Candidate Discovers Workers and Bosses Attached to Status Quo
By LAURA MECKLER
September 19, 2007

WASHINGTON -- Democratic presidential candidate Hillary Clinton said in drafting a new health-care plan she considered doing away with the employer-based system but concluded that people like it. "We looked at every permutation of how you get to universal health care," the New York senator said in an interview with The Wall Street Journal. "There's great attachment to the employer-based system, even though it is eroding."

(snip)

Sixty percent of employers offered health insurance this year, down from 69% in 2000. Large companies with 200 or more workers almost universally provide coverage, but there has been a marked decline among smaller companies, to 45% this year from 57% in 2000, according to a survey by the Kaiser Family Foundation and Health Research and Educational Trust.

"Many employees who had health insurance through their employees were also adamant they didn't want to give it up, which is why our plan starts with that reassurance. That if you like what you have we will just give you whatever you need to continue that. You've got the doctor you want, the hospital you prefer, that's fine." Mrs. Clinton said she was surprised to hear employers tell her that they didn't want to give up that role.

(snip)

Mrs. Clinton's plan, proposed this week, attempts to shore up the employer system, not replace it. The plan looks to lock up large businesses as insurance providers by requiring them to provide coverage or pay into a government fund. Small businesses would be offered a tax credit if they provide insurance. All employers would be given the chance to shop for plans in a new government-run network of private and public plans. Mrs. Clinton said that if large employers got organized, they could pressure health-insurance companies to make important changes, such as insisting on electronic health records and standardized forms. She promised that if elected president, she would do the same for the health plans that serve federal workers.

(snip)

Also, the Clinton campaign said Mrs. Clinton doesn't see punishment for people who remain uninsured but is not ruling it out either. She said she hopes that incentives, including tax credits, would be enough to get people to voluntarily get insurance... Next year, Massachusetts will begin fining people who fail to prove they have health insurance. Those fines will eventually equal half the cost of the least expensive plan available to them. For some, that figure would top $1,000 per year.


URL for this article:
http://online.wsj.com/article/SB119016234599131867.html

[hobbit709]

1. If you don't have it because you can't afford it

then you get fined? :wtf: Does this look wrong to you to?.

[question everything]

4. Apparently, it is in MA

and, I think, the Edwards plan mandates that everyone carries an insurance. On papers, it makes sense. Many of the 47 uninsured - and I have no idea how many - are young, healthy people who cannot join group insurance provided by employers. But, as with any pool, you need many healthy ones to keep the balance.

Which is why Universal health makes sense - everyone is in the pool.

[Trillo]

10. A living wage "makes sense" too,

funny how there's no chance for that, eh?

[WeCanWorkItOut]

35. The difficulty arises when they're young, healthy but relatively poor

We need to think hard about, are we building a system in which the health bills of the wealthy are to be paid by the disadvantaged young, or not so young, but struggling to build themselves a life?

It seems like there are two distinct issues people are talking about. (1) Do we want just want to avoid "free-riders"? Both Mitt Romney and Hillary talked about that. I'm not sure that requires mandated primary care.

(2) Do we want to "build the pool"? Then we really have to worry about increasing inequality. I'm concerned that to build an effective "pool," it's not the uninsured you want, so much as the already-insured who have plans they won't want to give up.

In either case, I believe the best way to not end up hurting the less well off, would be to work on reducing our inordinate health care costs. Hillary and her good friend Newt have just scratched the surface. The easy stuff.

[emilyg]

15. I wonder how many cell phones, cable TV's and all little luxuries could be given up to afford it

[ljm2002]

18. Yep, all those "luxuries"...

...because network TV tells us all we need to know, eh? And when I'm away from home and the car breaks down, I don't really need a cell phone, do I?

Yes indeedy, all them po' folk need to just buck up and quit indulging themselves in all those luxuries.

Sounds just like a Republic talking point. After all, they're the ones who used to go on about po' folk owning color TVs! Imagine! The nerve of some people!

[antigop]

19. Oh, good grief! That was pathetic. n/t

[antigop]

20. And how many of sHIllary's campaign contributions could be given up so we can have single-payer? n/

[flpoljunkie]

23. A. A lot! Average cost of a family's health annual insurance cost is now over $12,000.

http://www.post-gazette.com/pg/07254/816542-28.stm?cmpid=business.xml

Health insurance premiums rise 6.1 percent, top $12,000 a year for families

Tuesday, September 11, 2007
By Emily Fredrix, The Associated Press

Health insurance premiums paid by workers and their employers rose an average of 6.1 percent this year, outpacing inflation and pay increases and taking a bigger chunk out of families' budgets, according to a new survey.

Premiums for employer-sponsored health insurance for the average family topped $12,000 -- with employees picking up about one-fourth of that cost -- although the increase in premiums slowed for a fourth straight year.

Insurance costs probably will rise again next year, according to the survey released today by the Kaiser Family Foundation, a health care research organization that annually tracks the cost of health insurance. Many of the more than 3,000 companies surveyed said they planned to make significant changes to their health plans and benefits, and nearly half said they were very or somewhat likely to raise premiums.

This year, premiums reached an average of $12,106 for a family of four, with workers paying, on average, $3,281 of that. Premiums to cover a single person cost $4,479, with employees paying $694. The portions both families and single people pay in premiums has nearly doubled since 2001.

The companies reported that premiums for families increased 6.1 percent, on average. That's the lowest growth rate since 1999, when premiums rose 5.3 percent and cost an average of $2,196 for individuals and $5,791 for families. Health care premiums rose 7.7 percent last year, when individuals paid an average of $4,242 and families paid $11,480.

[Vinca]

39. This is the problem and big insurance isn't going to suddenly

drop their rates because Hillary Clinton wants them to. They've got investors to think of, not to mention fueling the private jets and hundred million dollar CEO salaries. Senators Clinton, Edwards and Obama are looking at this problem through rose-colored glasses. As for it being the "young and healthy" who are uninsured, I say: BALONEY! I'm older, self-employed and deal with many other older, self-employed people and I don't know any who can afford insurance. Have you noticed how many retirees you see working at service industry jobs? They're trying to foot the bill for supplemental insurance. The whole mess is obscene. A person's whole life revolves around funding a health insurance policy that will only cover 80% of a serious illness and will drive you into bankruptcy anyway.

[killbotfactory]

24. If health insurance was $40/month you may have had a point

All those little luxuries, that allow people to pretend poverty doesn't exist (you're not poor, you have a microwave!), are small one-time costs. Health insurance is a monthly payment that is many times more expensive that any one of those items.

It's like saying people can afford to live in a mansion if they just stopped buying burgers for the family every friday. Complete nonsense.

[emilyg]

30. Thanks all of you. Needed some ammo for my nasty repug friend.

[antigop]

34. Oh, pul-eez! Where did you say that the comment was from your friend?

Backpedalling, are we?

[emilyg]

36. oh-pulze - you must lie a lot.

[antigop]

37. So tell me where I lied... tell me. And you didn't answer the question. A diversion? n/t

[hedgehog]

31. Considering that a cell phone and cable television cost maybe $150 a month

I'll throw in internet access, too) that still won't buy a decent health care plan for an individual. if you know different, let me know. I have a daughter that's going to lose her coverage under my plan soon!

[Bette Noir]

38. When I was young and poor...

My entire full-time paycheck went to pay my rent and child care. I had a second job to pay for food. Which luxury was I supposed to give up in order to afford health insurance for my child and myself?

I had to get married to get health insurance.

Employer-based health insurance is a crock. I'm old and rich (relatively speaking) now, and disabled. Since I didn't apply for Social Security disability when I first became disabled, I am now ineligible. If my husband loses his job, we lose our insurance. That has already happened once this year, and could happen again.

The only reason our representatives advocate for the continued hegemony of the insurance companies is that the insurance companies give them money.

[dflprincess]

2. I especially liked employer based health care when I was unemployed

and couldn't afford to pick up the COBRA payments. :sarcasm:

[madrchsod]

8. ya those payments great when

it took my two week unemployment check to pay the cobra payment per month...since i can`t cobra now i guess under hillary`s plan i`m shit out of luck.

[Fovea]

14. You and me both.

The status quo is totally fucked. Of course those who get money from its beneficiaries, aka insurance companies, love it.

And of course if big corporations love it, so does the DLC.

[dflprincess]

16. I should have added that the irony of it all was

I'd been laid off from United HealthGroup.

[madrchsod]

3. well if the wall street journal is endorsing the plan

it must be the right plan for business

[burythehatchet]

5. Sometimes the derivative analysis is most precise

Mrs. Clinton, the "progressive" version, has left the building.

[question everything]

7. Sigh. Again, the news and the editorial departments of the WSJ

are two separate entities, providing first class coverage of news.

The WSJ does not "endorse" the plan, only reports it.

It would be nice if you could comment on the content of the story rather than on the vehicle.

[paulk]

12. I don't think you're going to get an objective analysis of this

on DU.

Which is too bad, really, 'cause I know I'm interested in just that - not only on Clinton's plan, but the plans of the other candidates also.

Thanks for posting this article, btw.

[madrchsod]

17. yup i was wrong about the endorsement

i still have no use for her plan in fact obama`s and edwards`s are not all that much better. i`ve been dealing with insurance issues every year since 2002 and i`ve come to the conclusion that universal heath care is the only viable way to cover everyone in the united states whether they work or not. why are insurance companies different than any other business in the usa?

[question everything]

29. And here is the WSJ Editorial

that I did not see when first posted. Far from endorsement


The Wall Street Journal

HillaryCare's New Clothes
September 19, 2007; Page A20

(snip)

The former first lady's 1993-94 health-care overhaul ended disastrously. Still, it poured the philosophical and policy foundations of the current health-care debate. As she unveils HillaryCare II, Mrs. Clinton likes to joke that it's "deja vu all over again" -- and it is, unfortunately. Her new plan is called "Health Choices" and mentions "choice" so many times that it sounds like a Freudian slip. And sure enough, "choice" for Mrs. Clinton means using different means that will arrive at the same end: an expensive, bureaucratic, government-run system that restricts choice.

Begin with the "individual mandate." The latest fad after Mitt Romney's Massachusetts miracle, it compels everyone to have insurance, either through their employers or the government. Not only would this element of HillaryCare require a huge new enforcement bureaucracy, it is twinned with a "pay or play" tax on businesses that don't, or can't afford to, provide health insurance to their employees. The plan also creates a new public insurance option, modeled after Medicare, and open to everyone, regardless of income. To keep insurance "affordable," HillaryCare II offers a refundable tax credit that limits cost to a certain percentage of income. Yet the program works at cross-purposes, because coverage mandates always drive up the price of insurance. And if the "pay or play" tax is lower than a company's current health insurance costs, a company will have every incentive to dump its employee plan and pay the tax.

Meanwhile, the private insurance industry would be restructured with far more stringent regulations. Mrs. Clinton would require nationally "guaranteed issue," which means insurers have to offer policies to all applicants. She would also command "community rating," which prohibits premium differences based on health status. Both of these have raised costs enormously in the states that require them (such as New York), but Mrs. Clinton says they are necessary nationwide to prevent "discrimination" that infringes "on the central purposes of insurance, which is to share risk." Not quite. The central purpose of insurance is to price, and hedge against, reasonably predictable risks. It does not require socializing every last expense and redistributing wealth.

(snip)

This is her strategy now. HillaryCare II is designed to cause minimal disruptions to current private insurance coverage in the short run, while dressing up the old agenda with slightly different mechanisms and rhetoric. Rather than fight small business, this time she is trying to seduce it with tax credits for small companies that provide insurance. Only later when costs rise will the credits shrink or other taxes rise. To court large manufacturers, like the auto and steel industries, she'll offer another, "temporary" tax credit to subsidize their health-care liabilities. Her plan, in short, is HillaryCare I in better clothes -- a transitional platform to shift people to the default option, which is government insurance.

What's striking about all this is how little new thinking there is. Like the other Democratic proposals, HillaryCare II would mark another major government intrusion into health care. It would keep all of the system's current problems, most of them created by government policies, and entrench and expand them. The creativity is all in the political repackaging.

URL for this article:
http://online.wsj.com/article/SB119016971585932036.html (subscription)

[antigop]

21. Of course. n/t

[Tom Joad]

6. because insurance companies will return the love, that's why.

[question everything]

11. The reality is that most people who are covered by their employers

are happy with what they have.

Perhaps not on DU, although on occasions some express these sentiments.

And why not? You have someone else, with more power and prestige negotiating on your behalf. You can join the group even with pre-existing conditions, in most cases you don't have to worry about what to do when it is time to renew the contract..

(A disclaimer - I have been carrying individual insurance because both of us changed jobs too many times and I got tired of dealing with different carriers, plus I don't think it is an employer's business to know what providers I see. And I don't have a face book, either..)

[Just-plain-Kathy]

9. We have to get rid of the middle-man...Why do we need insurance companies?

...her plan seems to make sure more people get involved with giving money to insurance companies.

[KT2000]

13. The reason I love it

is because when you get a major illness you get fired and lose your insurance.
Then you get to go on medicaid/welfare!
The best of all worlds!

[nealmhughes]

26. Well, if you are lucky -- and are able to wait 2 years for the disability claim to get approved.

In the meanwhile, you get to live with friends/family -- as a perm. houseguest! You get foodstamps, too!

Meanwhile you recover, then try to get a job and get blackballed for being "sick" after you are asked why there is a 2 year gap in your resume! It's a marvellous system for making a former "centrist" into a raving, ranting fullblown Sandinista. . . or at least it was/is me.

[KT2000]

33. Hey yeah!

People don't really get it until it happens to them.
Let's keep on ranting and raving though.
:headbang:

[killbotfactory]

22. Employer based insurance limits choice!

And it traps people at jobs they otherwise may want to leave.

People like their employer based insurance because the alternative is NOTHING.

And now they are going to start fining people in Massachusetts? All those working poor people flaunting their good health in people's faces by refusing to get health insurance have become a burden too great to bare? Yeah, I can see why Hillary would want something similar.

[CTyankee]

25. You may not know this, but you are currently "fined" by Medicare if you don't

sign up for Part B (drs visits; you get Part A hospitalizations for no extra cost) and have money taken out of your monthly SSI check to pay for it. They tell you if you don't sign up within a certain number of months after going on Medicare, you will pay a higher amount if you try to sign up later. They do make an exception if you are carrying other insurance, however, which is what I do because it covers more services such as prescription drugs and dental care than Part B and costs me less.

The reason is, I think, that they don't want people just not signing up, not getting the care they should get, and then winding up in the ER getting hideously expensive acute care. Tje fact that this happens in the 65 plus group is pretty amazing, given that you start getting all these problems around then.

Cheer up. If we get this plan and people start flocking into either Medicare or the federal employees plan, the insurance companies will find themselves with dwindling market share. Since they've been given a chance to "compete" and couldn'thack it, they have only themselves to blame for operating an obsolete industry that no one wants any more!

[killbotfactory]

27. How much extra is Part B?

My concern is that health insurance premiums won't come down significantly, like in Mass, and people will be stuck trying to find $500-1000/month in extra cash to pay for this mandate. There is also a problem with tying it to employers, as it shouldn't be tied to employers at all.

[CTyankee]

28. I think it is around $95 a month. My insurance, which I have through my

husband's employer, is $74 per month and I get more than with Part B as I described.

What is also of concern is that people wanted to keep the system we have, or at least those who currently have the employer based coverage. If this is what people are saying, we have a real job on our hands trying to persuade them that they'll do better under single payer. But even I have heard this sentiment among former coworkers who are afraid that they'll lose what they have now.

These are not people who post at DU, but we ignore their concerns at our political peril. And they are in the same boat as lots of DUers!

[fujiyama]

32. Umm...

Wow, I gotta say. These health care plans from all the candidates sound worse and worse.

On this issue, the only candidate that has it down completely is Kucinich. Sorry, but the health care system is so fucked up. So, now we're gonna have the government FINING people for not having health insurance? Incredible.