Share this article

print logo

GOP should improve on Clinton's insurance plan

Hillary Clinton had barely stepped off the stage in Iowa after unveiling her health care plan when the Republicans started smacking it around.

"Lesson Learned? Just Like '93, Hillary's Plan Full of Washington Mandates and Costs that Don't Add Up," declared a Republican National Committee press release.

The knee-jerk response is understandable given the memories of her disastrous 1993 proposal. But Clinton has learned some from her past mistakes. Her new proposal is far from ideal, but it's an improvement. Some of its ideas could actually lead in a market-friendly direction. Republicans would be far better advised to engage Clinton -- and then steer her plan even further toward market solutions.

The health care debate is stymied by the fact that most still get their insurance from their jobs, and are happy with it. Forcing people to give up something they like is always a tough sell.

Clinton's new plan grasps this. "If you have private insurance you like, nothing changes -- you can keep that insurance," she has declared.

At the same time, her proposal seeks to offer alternatives through tax credits and expansions of Medicare and the program used by federal employees.

Intentionally or not, she has hit on the pathway out of the current employer-led model -- expanding the choices available without forcing people to change coverage.

Republicans should see this bet and raise her, by proposing a plan that replaces the current subsidy for employer-provided insurance with an individualized tax credit or similar mechanism. Republicans could then attack frivolous mandates, which dramatically drive up the cost of care.

Despite Clinton's positive steps, her proposal still contains far too much government compulsion. For example, her plan promises "fair prices" for pharmaceuticals. That means price controls.

And with provisions for guaranteed issue and community rating -- meaning no one can be denied coverage and everyone must pay the same rate -- many of the cost savings from electronic records would vanish as a result of higher prices for private insurance. Further, it's impossible to see how a plan with so many requirements could be adopted without expanding the bureaucracy.

Republicans can point out these facts only if they engage the debate. And for many Americans, health care is the most important political issue -- so the GOP doesn't have a choice.

If the political right doesn't step up with workable, market-oriented plans that bring down the number of uninsured, America could very well end up with the type of government-run single player plan that has left millions in Canada and Europe with waiting lists, rationing and denied access to care.

Clinton's plan is not perfect. But ignoring and lambasting it will not help her conservative opponents. Outlining how to improve it will.

Robert Goldberg is vice president of the Center for Medicine in the Public Interest.

There are no comments - be the first to comment