How Hillary could make ObamaCare worse

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AN ABC-Washington Post poll shows 61 percent of Democrats support Hillary Clinton for president in 2016, far more than other contenders. If she wins the White House, health reform could become even more painful than ObamaCare.

Clinton ducks questions about her views on health reform. But the plan she proposed in 1993, as first lady, raises concerns.

That proposal was even more coercive than ObamaCare. She put price controls on doctors and limits on how much health care the nation could consume annually and how much you could buy for your own family — even if you paid for it yourself.

True, that was 20 years ago. But it’s an important window into her thinking.

Before Americans choose candidates for 2016, they ought to ask how much power they want government to have over their health care and whether Clinton stands by the coercive plan she proposed the last time she was in the White House.

Start with whether the government should force us to have insurance. The Obama administration is using ads and street fairs to convince people to get covered. Millions are still saying “no.” ObamaCare penalizes the uninsured but also offers exemptions, including just pleading “hardship.”

The Congressional Budget Office estimates that 90 percent of the uninsured will not be penalized.

Clinton wouldn’t take “no” for an answer. If you failed to enroll or the plan you chose was oversubscribed, government would assign you one (Health Security Act of 1993, pp. 144, 146; the text is available online).

As for people not paying their premiums, Hillary told a House hearing back then that an equivalent amount would “be deducted from their wages or obtained through tax deductions in some other way.”

Under Hillary’s plan, to see a doctor you would have to prove you’re enrolled or get enrolled on the spot. The doctor could only be paid by the plan, not by you.

Government officials would put price controls on what doctors charge, barring them from charging more or accepting payments directly from patients (pp. 236-237). Why would anyone want to pay a doctor directly? Privacy for one thing. Access, for another.

Access would have been a problem. Her plan limited what you would be allowed to pay for insurance. That limits how much money is in the pot to take care of you when you’re sick. It turns insurers into rationers.

Princeton Prof. Paul Starr (Hillary’s Jonathan Gruber) said it would force doctors and hospitals “to manage under constraint.” Under HillaryCare, government could outlaw any plan that cost 20 percent above the average plan.

In contrast, ObamaCare doesn’t outlaw generous plans. Its Cadillac tax, scheduled for 2018, would discourage them, but union opposition makes that tax an uncertainty.

Under ObamaCare, people who can afford it pay concierge doctors extra to get care without waiting. But Clinton’s scheme effectively barred you from going outside the system to get better or faster care.

The biggest difference between ObamaCare and Hillary’s approach is how they rein in the nation’s health spending. ObamaCare tries payment innovations, such as Accountable Care Organizations, with little progress so far.

Federal actuaries predict health spending will increase rapidly, hitting a staggering 19.3 percent of GDP by 2023.

Hillary wouldn’t put up with that.

Her plan used coercion. At the time, she said, “We all must learn to live within a budget.” The government would impose a dollar limit on what the nation could spend.

If spending neared that limit, insurers and government payers would be legally required to cut payments to doctors, nurses and hospitals to avoid going over budget (p. 137). Such central planning — even in the face of unforeseen problems such as the flu or EV-68 — would risk patients’ lives and the livelihoods of doctors and nurses. Is that what Americans want?

Hillary may have discarded some of her radical ideas. And, of course, anything she proposes would have to get through Congress. Nonetheless, voting for Hillary before knowing where she stands on health reform could be dangerous to your health.

Betsy McCaughey is author of “Beating Obamacare 2014.”


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