Looks like the insurance lobby is running for president

[Medmech]

In Health Debate, Clinton Remains Vague on Penalties
By KEVIN SACK
Senator Hillary Rodham Clinton inched closer Sunday to explaining how she would enforce her proposal that everyone have health insurance, but declined to specify — as she has throughout the campaign — how she would penalize those who refuse.
Mrs. Clinton, who did not answer Senator Barack Obama’s question on the topic in a debate last Thursday, was pressed repeatedly to do so Sunday by George Stephanopoulos on the ABC program “This Week.” When Mr. Stephanopoulos asked a third time whether she would garnish people’s wages, Mrs. Clinton responded, “George, we will have an enforcement mechanism, whether it’s that or it’s some other mechanism through the tax system or automatic enrollments.”She then added that the focus on enforcement clouded a more important point, that her proposal to cover the uninsured was superior to Mr. Obama’s because she would mandate coverage for all, while he would require it only for children.
What might seem a mundane debate over health policy has taken on outsized importance in the approach to Tuesday’s voting because it is one of the few substantive differences between the two leading Democratic presidential candidates.
Polling has found that health care is a top concern of Democratic voters, and that they rank covering the uninsured as more important than reducing health costs or improving quality.
Mrs. Clinton, therefore, has argued that her plan, because of its mandate, would achieve universal coverage while Mr. Obama’s would not. She has taken recently to calling universal coverage “a core Democratic value and a moral principle.”
Mr. Obama asserts that his plan, which is like Mrs. Clinton’s in its use of government subsidies to reduce the cost of insurance, would effectively guarantee coverage to anyone who wants it.
But about 20 percent of the uninsured have household incomes of $75,000 or more, according to the Census Bureau, meaning they presumably can afford coverage but prefer to take the risk. Mrs. Clinton argues that these “free riders” impose a hidden tax on the insured because their uncompensated care must be factored into medical charges and insurance rates.
Mr. Obama’s campaign has tried for months to move from defense to offense by pressing Mrs. Clinton to explain how she would enforce her mandate. A recent study published in the journal Health Affairs concluded that compliance with government mandates varied greatly, both in the United States and in other countries. But compliance is greatest, the authors wrote, when “penalties for noncompliance are stiff but not excessive.”
A group of doctors and health policy analysts, including a number of Obama advisers, pointed out in a letter released Thursday that Massachusetts, the only state with an insurance mandate, has thus far failed to enroll nearly half of its uninsured despite imposing a modest first-year tax penalty of $219 (the fine increases significantly this year). Because the Massachusetts program is less than a year old, it is not yet possible to fully judge the effectiveness of its mandate.
Mr. Obama raised the Clinton campaign’s ire late last week by charging in a voter mailing that “Hillary’s health care plan forces everyone to buy insurance, even if you can’t afford it... and you pay a penalty if you don’t.”
Mrs. Clinton argues that she can make premiums affordable for low-income workers by spending $110 billion on subsidies and cost-saving devices. Like Mr. Obama, she would pay for her plan primarily by allowing the Bush tax cuts to expire for the wealthiest Americans. She would not allow exemptions from the insurance mandate, as Massachusetts does for those who cannot afford even subsidized premiums.
Aides to Mrs. Clinton had said previously that she would consider garnishing people’s wages, and that the uninsured could be automatically enrolled when they present themselves at hospitals or government offices. But Mrs. Clinton, who faced criticism in the 1990s for not adequately consulting Congress on her husband’s health plan, has typically said she would leave such details to negotiations with lawmakers.
She said Sunday she would not impose fines, as Mr. Obama has said he would to enforce his insurance mandate for children. “We want them to have insurance,” she said. “We want it to be affordable.”
The reason for the continuing vagueness is simple, said Robert J. Blendon, a Harvard professor of health policy and political analysis. “Whenever you talk about penalties, you lose some number of people who support the principle of universal coverage,” he said. “It’s the equivalent of candidates proposing new programs that may lead to a tax increase but never wanting to discuss it.”
The Obama campaign hopes to make Mrs. Clinton pay a price, not just on health policy but on the issue of character. Bill Burton, the Obama campaign’s spokesman, said on Sunday that Mrs. Clinton had “again refused to directly answer the question,” and added, “America needs a leader they can trust, not someone who will avoid hard questions.”

[Mistress]

Ouch.

[tankdriver]

That's what you get for all that Washington experience.

[dynalow]

COMMENTARY


My Plan for Shared ProsperityBy HILLARY CLINTON
February 4, 2008; Page A15

Throughout my campaign, I have been listening to the voices of people across America. I met one man who told me, "I don't know what I did wrong. I got my education and I worked hard. I've been at the same company for 12 years now, but I've just been asked to train my successor because my job is moving to another country."

Another woman said to me, "I just can't make ends meet. My health care premiums have doubled, college tuition is up. How am I supposed to make it as a single mom?"


I am running for president to bring those voices to the White House and give people a chance to achieve the American Dream: having a good job, owning their own home and living with financial security. That means tackling our toughest challenges -- rising inequality, stagnating wages and a growing sense that too many middle class families are just one pink slip away from financial devastation.

My measure of economic success will never be a single, dry statistic. Rather, success means an economy that allows those at the bottom to work their way into the middle class, without pushing anyone out. It means leaving people better off when I finish than when I start. In short, success means an economy that shares its prosperity with all.

In the 1990s we saw how smart economic plans could help spur the economy to create 22 million new jobs and income growth across the board. For the past seven years we've seen the opposite. Corporate earnings have been impressive, but the average income of workers has declined. The typical household is paying $2,000 more in energy costs. Health care is nearly twice as expensive, with the number of uninsured rising to 47 million. Five million Americans have fallen into poverty.

Because of the Bush administration's neglect, the forces of globalization and technological change -- which should represent opportunities for economic growth -- have weakened America's great middle class.

Simply put, since 2001, our economy has failed the shared prosperity test, and we need decisive, experienced leadership to get us back on the right track.

As president, I will not hesitate to take swift, bold action to address our immediate challenges, starting with a strong stimulus package and a comprehensive solution to our housing crisis. And I will have a long-term economic plan that creates jobs, strengthens the middle class, and allows everyone to share in our economic growth.

- Shared prosperity means providing greater economic security and opportunity for middleclass families.

American families don't need new government bureaucracies; they need new tools to help them climb the economic ladder. This begins with health care, because rising costs erode workers' savings, make insurance less affordable, put businesses at a competitive disadvantage, and threaten our fiscal future.

And let's be clear: Unless we cover all Americans, we will never end the hidden tax that the uninsured pass on to the rest of us when they end up in the emergency room and we wind up footing the bill. Of all the candidates in either party, I have the most aggressive plan to lower health-care costs. It steps up prevention and chronic-care management, cuts unnecessary spending, creates electronic medical records, and ends health discrimination by insurers. And by providing sensible and generous health-care tax credits, I will ensure that everyone can afford to be covered.
Shared prosperity also means doing something about the cost of education. My plan will make college affordable again by more than doubling the Hope tax credit, increasing Pell grants, enacting more sensible loan repayment schedules, returning to direct loans with stable and low interest rates, and allowing those who perform community service or pursue a public interest career, like teaching, to get a break on college costs.

We must also encourage America's families to save. Research confirms that when you make savings easy and automatic, and give generous incentives to save, more people will save. So my American Retirement Accounts plan will offer up to $1,000 in matching tax cuts, and will give employers new incentives to automatically enroll their employees in savings accounts.

- Shared prosperity means addressing the root causes of poverty.

I thank John Edwards for his role in making poverty a central focus of this campaign. Ensuring that all Americans, especially our children, have a decent life is central to the goal of shared prosperity.

The cause of children in need has been the passion of my life, fueling my interest in early childhood education, foster care reform, and children's health care and combating poverty. It will be a top priority for my presidency.

We will fight for universal pre-school to close gaps in cognitive development. We will improve our schools by ending the unfunded mandate known as No Child Left Behind, investing in mentoring programs for at-risk middle schoolers, and cutting the black and Hispanic high-school drop out rate in half.

We will raise the minimum wage, expand the Earned Income Tax Credit (EITC), and pass the Employee Free Choice Act. We'll take on the issue of homelessness, particularly for our veterans. And I want to say directly to the people of New Orleans: We will not forget you. So long as any of our neighbors remain in poverty, our nation's commitment to the "pursuit of happiness" for all cannot be fulfilled.

- Shared prosperity means restoring a strong climate for investment, innovation and job creation.

As president, I will foster job creation by restoring America as the world's innovation superpower. I will double investments in basic and applied research, extend broadband throughout our country, and encourage more women and minorities to pursue careers in math, science and engineering.

In the face of high energy costs and a climate crisis, we can turn a grave challenge into a historic opportunity by developing green technologies and energy-efficiency solutions. That will drive productivity gains and help create at least five million new "green-collar" jobs over the next decade.

And finally, to restore a climate of investment, we must end the culture of waste. That is why I believe in making government more efficient and restoring fiscal responsibility so we can pay down the debt, quit borrowing money from countries like China, and deal with long-term challenges like Social Security. As a sign of that commitment, you can go to hillaryclinton.com and see exactly how I plan to pay for my economic plan.

If we listen to the voices of the American people, we can find common ground on solutions to provide economic security, fight poverty and move toward balanced budgets.

With shared responsibility we can have shared prosperity, and finally give all of our families the opportunities they need to live their dreams.

Mrs. Clinton is a Democratic senator from New York

[Medmech]

I'm for a universal health system...but not what she has in mind. Micheal Moore nailed it on this one.

[Botnst]

I'm for everybody individually paying their own way. If they don't pay, they don't play. That's universal and responsible. Chlorinate the gene pool.

B

[Dee8go]

My problem with the federal government handling that is that it would cost a lot more and we'd probably have less access to good healthcare than we do now.

[Botnst]

Originally Posted by Dee8go

My problem with the federal government handling that is that it would cost a lot more and we'd probably have less access to good healthcare than we do now.

Look what they've done for rail service and the postal service. And look how much medicine has improved since gov began mandates. The die is cast.

[Dee8go]

Yeah, ask anybody working in healthcare what they think of the HIPPA regulations! They make patient information about as secure as our national secrets are . . .






. . . . . Ha ha ha ha ha ha ha!

[Jim B.]

[Matt L]

Look at how much lower overhead there is to Medicare, compared to private insurance. The government can screw up things pretty bad, but big business can do it too.

[Dee8go]

Originally Posted by Matt L

Look at how much lower overhead there is to Medicare, compared to private insurance. The government can screw up things pretty bad, but big business can do it too.

Yeah, that's true, but at least with publicly traded companies the share holders get some of that money. With the government it all just gets frittered away and nobody knows where it went.

[Dee8go]

Also, the profit motive seems to be more of an incentive for private companies and their employees to offer better service than does the promise of retirement benefits for the lowly civil service workers in the government.

[OldPokey]

That's a damn big waffle. Would it be a Kerry brand waffle by chance?

[Skippy]

If the government would allow companies to offer and people to purchase health insurance policies that only cover what they want, the price of insurance would drop dramatically and more people would be able to afford it.