Hillary did NOT learn from her first healthcare screw up

[Armstead]

If you want an excellent overview of what happened to the Clintons' attempts at healthcare reform in the 1990's, I'd suggest you read a timeline that is on the PBS webpage.

http://www.pbs.org/newshour/forum/may96/background/health_debate_page1.html

It is quite clear that there was plenty of blame to go around for what happened, including the much larger forces of the Evil Empire crafted by the GOP.

But at least one important lesson that Hillary did NOT learn is how Mandates and tinkering style of reform to the private care system are incompatable.

The first attempts went through many variations over the years -- but one of the fatal flaws politically was Mandates. THAT was what the Republicans (and some conservative Democrats) and the private sector opponents used to undermine public support for any reform.

Personally, I believe that Mandates would make sense if they were part of a true effort to bring about Universal Health Care on a fundamental level (as in Medicare for All or Social Security).

However, they are counterproductive if they are merely part of a bureaucratic plan that leaves private insurance in control. They combine the worst of both approaches -- and thus make even private-sector reforms unpalatable to a significant portion of the public.

That is where Obama "gets it." By making it optional (except where kids are concerned) he is at least closing one of the major arguments that the GOP will trot out when the real fight comes.

I'd rather see the Democrats unify behind TRUE universal care, as in every other civilized industrial nation.

But if the will to take that on is lacking, at least we should be smart in how attempts at meaningful reform are undertaken. And mandates will undermine that, as Hillary should have learned last time around.

[UALRBSofL]

1. Unfortunately this is the right wing kind of stuff

I would expect on Free Republic. You fail to understand her plan failed because majority congress was republican and wouldn't even let it get off the ground. And, if you aren't aware, republicans are anti UHC.

[dkf]

2. I thought Dems controlled both houses back then?

Am I wrong?

Ha! From Wikipedia:

Starting on September 28, 1993, Hillary Clinton appeared for several days of testimony before five congressional committees on health care.<9> Opponents of the bill organized against it before it was presented to the Democratic-controlled Congress on November 20, 1993.<9>

In August of 1994, Democratic Senate Majority Leader George J. Mitchell introduced a compromise proposal that would have delayed requirements of employers until 2002, and exempted small businesses. However, "Even with Mitchell’s bill, there were not enough Democratic Senators behind a single proposal to pass a bill, let alone stop a filibuster."<24>

A few weeks later, Mitchell announced that his compromise plan was dead, and that health care reform would have to wait at least until the next Congress. The defeat weakened Clinton politically, emboldened Republicans, and contributed to the notion that Hillary Clinton was a "big-government liberal" as decried by conservative opponents.<25>

The 1994 mid-term election became a "referendum on big government — Hillary Clinton had launched a massive health-care reform plan that wound up strangled by its own red tape."<26> In that 1994 election, the Republican revolution led by Newt Gingrich gave the GOP control of the House of Representatives, and the Senate too, ending prospects for a Clinton-sponsored health care overhaul. Comprehensive reform aimed at creating universal health care in the United States has not been seriously considered by Congress since.

http://en.wikipedia.org/wiki/Clinton_health_care_plan

[Armstead]

6. Part of the time

Then it flipped

[WilyWondr]

7. They were

102nd United States Congress

Session: January 3, 1991 –
January 3, 1993
Speaker of the House: Tom Foley
Members: 435 Representatives
100 Senators
5 Territorial Representatives
House Majority: Democratic
Senate Majority: Democratic



Just more mis-information.

[Name removed]

5. Deleted message

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[OzarkDem]

3. Hard to count how many ways you are wrong

Clinton is not leaving private insurance companies in control. Her plan gives individuals and employers a choice between private and public insurance plans (like Medicare). It forces private insurance to compete w/ public insurance.

http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx

Her original attempt at health care reform failed because it was torpedoed by dishonest advertising by the insurance, pharma and medical industries.

Mandates that provide choice between public and private plans are both fair and cost-efficient, lowering the cost of insurance and health care. Any plan that doesn't require everyone to be covered, like letting people avoid paying into Social Security until they're ready to retire, dooms the program to failure.

[Armstead]

10. Politically it will be opposed no matter what the content

I posted the timeline above, because it illustrates that point exactly.

That is why a starting point should not be mandated care. All that does is feed the opposition to any kind of reform.

I believe that if reform and a mixed system is the goal, then it should at least start with that without mandates.

Keeping it optional could at least garner more support -- instead of starting with the least popular aspects of what opponents will inevitably call "bureaucratic socialized medicine."

[OzarkDem]

21. No mandates will be a poison pill

The system will be so lopsided it will fail very quickly, especially if the only people who opt into the system are those already ill with high health care costs.

It will actually accellerate the failure of the system much more quickly than the status quo.

It will also destroy any chance for single payer reform by allowing those opposed to real reform to say "See we tried to do it and it failed. Market based health care is the only option".

[Armstead]

28. How will it be anymore lopsided than it is now?

[OzarkDem]

39. Govt subsidies to buy health insurance w/no mandate

Both plans call for subsidies to help people buy insurance. Without a mandate, it will increase enrollment of uninsured people with high health care costs into the system. If people don't have to pay into the health insurance system until they get sick, it places a disproportionate cost burden onto either public or private plans. Obama's plan also has no mechanism to "cap" premium increases in private insurance plans (Clinton's does).

The influx of sick people buying into insurance plans combined with the federal subsidies that will follow them will cause the cost of government spending to increase. For private insurance, this influx of sick people paying into the system will result in higher premiums and pressure for more matching federal money.

We've already seen this happen in the Mass plan - one that didn't offer everyone a public insurance option. Only people with high health care costs enrolled and costs skyrocketed.

Basically, Obama sacrificed the integrity of his health care reform plan in exchange for political expediency. He put forth a plan he knew would likely fail, but preferred to do so because he thought it would look good.

[kevsand]

19. "Her original attempt at health care reform failed because..."

...it was way too complicated, created an entirely new, massive federal bureaucracy, and clearly set up the government as gatekeepers for care. In other words, it was a typical policy wonk wet dream, rather than a practical attempt to find a real world solution.

I was the Administrative Director of a prominent health care consumer group at the time, and Hillary deliberately excluded input from anyone with experience on the consumer side of things. It was an ignorant, arrogant mistake on her part, and the country paid the price.

The insurance companies and their allies would have opposed any plan, to be sure, but Hillary made sure that her plan was tailor made for their attacks. She walked right into it, and set back the cause of health care reform in this country by at least twenty years.

None of the health care organizers I know have ever forgiven her for it.

[OzarkDem]

24. Have you looked at her current health care reform plan?

Its not complicated, doesn't create massive bureaucracies and doesn't set up the government as a gatekeeper. Before you criticize, become informed:

http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx

[kevsand]

42. I wasn't talking about her current health care "reform" plan.

You made an inaccurate statement about her original proposal, which I am very well informed about, and I corrected you. Her current plan would be an entirely different discussion.

[dkf]

23. What makes you think dishonest advertising won't torpedo her again?

That is why you need a great communicator, not a wonky "solutions" person to make the case and seal the deal.

[OzarkDem]

33. I'm sure they'll try

but they won't be able to make their case as well this time around. With a plan that calls for competiton between public and private insurance, they can't use the "government control of health care" argument as effectively.

And if you're referring to Obama as the great communicator, his plan is inferior and destined to fail and will actually set back the effort for real reform by many years.

[goodgd_yall]

30. Good post---this is what people need to understand

They believe that the private insurance companies will be operating business as usual and people will be forced to pay the high premiums they are now paying. But her plan will work to lower premiums that the private insurance companies charge.

[OzarkDem]

43. Offering a public plan like Medicare is also attractive

IIRC, Medicare operating expenses are about 33% lower than private insurance. Imagine the benefits of telling an employer or individual they can get Medicare quality coverage for 1/3 less than private insurance.

Hey, I'd sign up tomorrow and I have private insurance now.

[John Q. Citizen]

36. no, you are wrong. The "public" money is used to buy private insurance. The

government isn't setting up it's own insurance pool. It just collects money and buys private insurance.

[OzarkDem]

48. You're thinking of FEHBP

You're confusing it with another option she has which allows people to buy into the same insurance plan that Congress has through FEHBP - which is private insurance purchased by the federal governemt.

Clinton's public insurance option actually calls for setting up a new government insurance plan similar to Medicare that people and employers can buy into.

http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf

See page 2, page 6,

[bluestateguy]

4. HillaryCare I was too bossy

And by pledging to "go after" people's wages who don't play ball, that shows that HillaryCare II is also too bossy.

People will not support a health care plan that orders them around, tells them what to do, and imposes mandate after mandate upon their lives.

[UALRBSofL]

8. bluestateguy do you think UHC is not a mandate???

Look at europe and the ones who have UHC. They pay for it out of tax's and it is a mandate but people on DU just don't get it.

[Armstead]

13. It's a mandate based on principle and which makes sense

[Cameron27]

9. How is Hillary's plan different

from John Edwards' plan? Both plans rely on mandates to keep the costs down, and to assure that everyone will be covered.

[OzarkDem]

14. They're the same

Nearly identical in every respect.

An important benefit of Clinton's plan, not covered in others, is that it also exempts employer paid insurance from being taxed as income for those who earn less than $250,000 yr.

That exemption is not included in Obama's plan. His will subject you to income tax based on the value of your employer paid plan.

[truedelphi]

44. Something he may have overlooked, but I'm sure he is as willing to do

the right thing as Hillary is.

Perhaps more so.

[OzarkDem]

46. Then he should fix his plan now, before the election

I'm not ready to go on faith and trust that he would "fix it later". I wouldn't trust any candidate to do that, not on an issue this difficult.

[truedelphi]

47. As far as fixing things, he does a lot of that.

I'm hoping the fixing spirit doesn't die out after he becomes the next POTUS

I keep hearing the tune "So we don't get fooled again" in the background.

[OzarkDem]

11. Like Social Security?

Where everyone is mandated to participate in the program that they receive benefits from?

That "mandate" seems to work very well.

Or is your only problem with the fact that a woman is proposing it?

[tokenlib]

15. If universal health care had come in the 30's....

...when the AMA and corporate health care were not so powerful we wouldn't be in this mess today. But the political climate today is not so condusive to government "forcing" people to participate. So comparisons between SS and healthcare need to take that into consideration.

[OzarkDem]

17. It can be done, it has to be done

Without real, meaningful reform now, our entire health care system is going to be in big trouble. Health care providers can no longer absorb the rapidly growing cost of uncompensated care.

Enough people are worried about health care that they're willing to overlook the fearmongering by special interests.

[Armstead]

26. If so, why not go for the real thing?

Why not unify the Democrats to sell and push for a meaningful form of truly universal public healthcare?

If you say the public is "not ready" for that, then my point is that if you're going to adopt partial measures then at least don't start with the most politically controversial part of universal care, which is mandates to buy insurance.

[OzarkDem]

29. The plan forces private insurance to compete w/ public insurance

A much easier case to make by saying let the market decide between public and private plans. Public plans are inherently more competitive because they're more efficent, cost less to administer and no profit motive is built in.

Its much more difficult for the private insurance lobby to demonize when they're not in the position of being shut down overnight and are forced to compete with the government.

I'd love to see a single payer system put in place overnight, but its not going to happen. Better to have a plan like this that, in essence, offers a single payer system, but leaves the choice there for employers and consumers.

[Armstead]

34. I agree with that to an extent

But an even easier case can be made if people don't feel like they are being forced into it from the start.

My point has more to do with basic fairness plus basic salesmanship.

I live in Massachusetts, and I know how much the mandatory aspects of the system here is poisoning the well of support for any kind of meaningful reform or universal coverage.

Among other problems it is scaring the hell out of -- and financially penalizing -- the very people who most need help, and those who would otehrwise be mist likely to support something meaningful.

[OzarkDem]

40. Couple of things

the federal government has more leeway to put public money into either helping people buy insurance or expanding access to Medicaid for lower income people who have the hardest time paying premiums. Mass also didn't offer much of a deal to allow people and employers to buy into a public insurance plan - something the federal government is better equipped to do.

States don't have the fiscal leeway to offer these kinds of plans and back them up with funds to help people participate. The mandatory pill is a little easier to swallow if the government is willing to offer you a public plan with a lower premium and help you pay the premiums, too.

[Armstead]

50. I think we see it similarly except for the mandates

My perspective is that keeping it optional would not necessarily screw up the costs and related issues much more than they are already screwed up -- and could actually reduce those problems if it were handled carefully.

The basic problem with access to care is not the impact on the poor. They already have access either through Medicaid or through "free care" policies and requirements.

It's the people who are on the margins -- who don't qualify for subsidies but still can;t afford insurance. Or even people who are reasonable comfortable but still get stretched too thin by coverage costs.

Also, the cost crunch is often unrelated to that. The elderly and others who are insured but require care far beyond other people. That is probably a bigger problem (for which there are unfortunately no easy answers). They are inherently unprofitable, whether they are covered by insurance or not.

Such reasons are why I personally believe we must take profits out of the equation.

But short of doing that, any reform of the present system ought to at least make the first steps toward meaningful reform as politically palatable as possible. IMO, allowing it to remain optional at least would make the first steps more likely to actually succeed, instead of dying on the vine as happened in the 90's.

[madrchsod]

22. all i know is that my parents

had supplemental insurance and medicare and they were never denied treatment and never paid a bill.the only thing that cost them was the drugs.it`s the only sane way to provide health care to everyone in america.

[madrchsod]

12. neither plans have a chance in hell to pass

their plans will be sliced and diced by the k street boys. taking our money to hand over to the insurance companies is a big joke on the american people,especially the people who can least afford it

[OzarkDem]

16. With a strong, committed president and a Dem controlled Congress

Yes it could pass. But you need to have a president who is strongly committed to it and willing to twist some arms in Congress to make it a reality.

[dkf]

20. Nope, it will happen if the people strenuously support it.

That is why it needs a great communicator to pass...someone who is better at it than all crap the corporate money will throw.

[OzarkDem]

25. If you're referring to Obama, his plan will be a disaster

See the "poison pill" reference above.

[dkf]

27. Actually, I really don't like his plan.

I prefer single payer and I see both plans as an obstacle.

But I do believe he has a better chance of getting his passed than she does.

[goodgd_yall]

32. Better chance of getting his passed?

Why? Because Republicans would support it?

[Armstead]

37. Unfortunately, that's a reality that has to be dealt with

And if you read the timeline I provided, you will see that there was also differences within the Republican party over health reform. The GOP moderates got skunked by the extremists, which might not have happened if there had been more of an effort to find a middle ground.

[dkf]

38. Because it helps people afford it without forcing them to buy it.

People hate mandates. Or should I say I hate mandates...and I am a people...person...whatever.

[OzarkDem]

45. Obama's plan would do more harm than good

It has inherent flaws that would cause the whole program to fail in a year or two by placing so many people with high health care costs into the system and by having no caps on insurance premiums.

It will be such a disaster, it would actually set back the effort to get single payer for years. One step forward and about 3 steps back.

At least Clinton's plan (similar to Edwards) allows for an organic, natural progression to a single payer system over time. Private insurance companies can't compete w/ public insurance.

[dkf]

51. Obama's plan also builds upon the "same insurance Congress has".

But like I said, I don't like all this insurance garbage. I want single payer.

[truedelphi]

49. Neither BIll or Hillary were able to counter the crap that came up before

We have to hope that a new face will bring forth new and better results.

[dkf]

18. Seriously, if we are so stretched paying for health insurance

how are we going to pay our actual health care costs?

Even with my health insurance, my acid reducer is $30 bucks for a month's worth as was my claritin before it went otc.

My uncles pills, which I have been buying for him, are $180 bucks, with some at 1 month and others with 2 months refills.

[madrchsod]

31. i do not want any insurance company involved

in my health care again. the one my wife has decided to not pay my 28,000 dollar bill for going on 7 months now. the collection agency called us and wonder what in the hell was going on. the lady at the hospital billing told me it`s standard practice for insurance companies to wait at least 2 or 3 months before paying.my case is whether it was a medical necessity...they will send everything to a company that does nothing but review claims.

[dkf]

35. Exactly... Health Insurance does not solve our problems

Indeed they are part of the problem.

[truedelphi]

41. Expresses a lot of what I am thinking & feeling abt Hill's Health Plan