Democrats & Liberals Archives

Hillary Clinton's Health Plan

Among the Democratic presidential hopefuls, Edwards has presented a full-blown healthcare plan. Now Hillary Clinton has presented the first of a three-part healthcare plan. It covers costs, and the future parts will cover quality and covering everyone. She expects her cost program to save $120 billion a year. And it looks as though it may.

There are 7 major points to Clinton's price-cutting healthcare program:

  1. PREVENTION - Preventing disease could save a bundle. For example, Clinton states that about 30% of the rise in healthcare costs during the last 20 years is linked to the doubling of obesity during that time. She would have a Preventive Service Task Force to study and recommend effective preventive practices

  2. IMPROVE HEALTH INFORMATION TECHNOLOGY - She would invest $3 billion so we have a system that's more useful to medical personnel

  3. FEDERAL COORDINATION OF CHRONIC CARE - According to Clinton, the care of people with chronic diseases such as heart disease and diabetes account for 75% of all national healthcare expenditures. Good coordination will save money by avoiding duplication and mistakes

  4. COMMUNITY PRICING OF INSURANCE - All applicants are accepted and people with previous conditions are not charged more. Insurance will be affordable for more people

  5. ESTABLISH "BEST PRACTICES" - She would start a Best Practices Institute which would finance research on the best way to treat various maladies. It would then recommend practice protocols

  6. REDUCE DRUG COSTS - Medicare will be able to negotiate better prices and to import cheaper drugs

  7. REVISE MALPRACTICE SYSTEM - Encourage health systems to give liability protection to doctors who disclose medical errors to patients
These are all good ideas. Each is bound to save money, some more than others. I'm especially happy with her emphasis on prevention and chronic care. Prevention will save money while keeping all of us in good health. Guaranteeing chronic care will keep middle class people from becoming paupers in order to take care of their frail elderly parents.

However, I'm not sure if Clinton favors a universal system, which is what I think we need. We'll have to wait until we see the other two parts of her plan.

Posted by Paul Siegel at May 25, 2007 5:48 PM
Comments
Comment #221306

Paul, I am in the insurance industry selling health, life and long-term care insurance. Insuring everyone without regard to their health requires no underwriting and results in well-people paying much more in premium to give a break to those not in good health. I have witnessed the destruction of Medicaid by having wealthy folks keep income and assets and qualify for benefits at the expense of the poor and needy who truly need government help. Your Item #4 above doesn’t work as evidenced by Medicare, Medicaid and the drug prescription plan. All of these huge federal programs cost more than expected and are all operating in the red. What H.C. is proposing is pure socialism and will destroy our medical system. I am all in favor of Item #1. As a tobacco user I am subsidizing a substantial part of care costs today by virtue of exhorbitant taxation of a legal product. I recommend that fat folks pay an exhorbitant tax on the burgers, fries, malts, etc. that they consume which cost our health care system a huge amount of money. Few fat people can blame genetics or disease for their condition. And, anyone practicing an unhealthy lifestyle that exposes them to disease should also face a huge tax for that choice. Finally, bloggers should pay a huge tax for the priviledge of sitting on their collective arses rather than being productive.

Posted by: Jim at May 25, 2007 6:20 PM
Comment #221317

Jim,

The best of us is no better than the least of us.

You can call that socialism if you wish.

You, because you are wealthy, do not owe me, because I’m poor, anything. However, if you allow me to die or suffer needlessly, and you could have prevented it, you have created an America that neither of us deserves, and since I’m dead, I can’t even complain about it.

Posted by: Marysdude at May 25, 2007 9:49 PM
Comment #221328

Marysdude
The best of us is no better than the least of us.

So why did Terri Schiavo have to die? She was brain dead, clearly among “the least of us.” If the best of us is worthy of life why not her? Apparently her condition made her so low she was unworthy of health care.

Why exactly should the government pay for health insurance? Why not provide for more pressing needs like food or shelter? Will the people who support universal health care now be calling for the government to provide housing for everyone 10 years from now? Government provided groceries in 20? Where does the left draw the line?

Posted by: Silima at May 25, 2007 11:32 PM
Comment #221343

Paul interesting post. I wonder if more study is really needed on prevention. We as a whole dont seem to follow the advice that exists on disease perevention.

Silima, Wasnt Terry Schiavo’s husband following her wishes by pulling the life support from her?

Posted by: j2t2 at May 26, 2007 9:40 AM
Comment #221347

Pleasepleaseplease folks, don’t turn this into a Terry Schiavo discussion. It’s over, it’s done, and whatever anyone believes on the subject aside, the federal government should not have gotten involved. Nuff said.

Back to healthcare. We live in a country dedicated to life, liberty, the pursuit of happiness, and the “proposition that all are created equal”. Our healthcare system, in it’s current state, violates these ideas. The wealthy are covered, the poor are not, and worst of all, the insurance companies are getting fat and sleek on the profits of our country’s addiction to fat, salt, sugar, and legal mind-altering substances. You can beat your breasts and call it “socialism” all you want, but we are talking about fairness to each other, not political systems. Anyone who says otherwise is just trying to obscure the discussion.

L

Posted by: Leatherankh at May 26, 2007 10:09 AM
Comment #221349

Paul

Any system that keeps private insurance exclusively involved is doomed to mediocrity at best.It is like inviting the local burgler over to ask them about home security.Insurance is NOT healthcare.Indeed the insurance industry is a large part of why we have a healthcare problem. They routinely deny claims until the patient dies. The amount of beaurcratic paperwork is staggering.Estimates show the expense involved is enough to cover the uninsured with actual healthcare. They treat their claims processing departments as profit centers,not services and regards payments for services as “medical losses”.Although Hillary’s plan contains some good ideas Edward’s plan is superior. He offers consumers a choice between government coverage and private carriers with strict guidlines as to what the private carrier must offer.He intends to pay for it by repealing the Bush tax cuts for the wealthy. Thats a little weak. I suspect much of the cost could be covered by the savings in paperwork.Bear in mind that healthcare providers have to have an increasingly large beuracracy to counter the insurance industry’s claims departments. This is one reason actual care cost so much.

Jim

This country,like all industrial countries, has a mixture of socialism and free market institutions. For some examples: Our transportation system,fire departments,military,postal system,sewer system,water departments etc. These are areas where the free market approach just does not make sense.Healthcare is another area where our experiment with free market approaches has broken down. The laws of commerce do not work when your loved one is sick. When you take your child to the emergency room do you negotiate price?There is no balance. The services your child recieve are automatically worth all the money you have,or will ever have.Competition is the magic wand of free enterprise,why it works so well in most social commerce. It is missing in regard to healthcare.Every other industrial western country has realized this and used other approaches to provide healthcare to its citizens,always cheaper and often better care than Americans are recieving on the whole.These are just facts. I understand it messes with your paycheck but your industry can and will shift paradigms and branch into new areas of insurance products,capital or flood insurance for example.

Posted by: BillS at May 26, 2007 10:42 AM
Comment #221351

Hillary and Bill were supposed to do something like this when he was in the W. H. Now it’s another thing that will never happen. PROMISES, PROMISES.

Posted by: KAP at May 26, 2007 11:22 AM
Comment #221353

I appreciate all the comments. Did I actually read someone making the case that our constitution guarantees health insurance for all because “all men are created equal?” I guess that interpretation means that everyone should expect government to supply the same housing, education, automobile, food, vacations, etc. What nonsense. You need to take that argument up with God as the creator…not government. Some have said our military, postal system, fire, water and transportation are mixtures of socialism and free market. Come on…that’s not even worthy of discussion. One writer went so far as to say insurance companies treat their claims departments as “profit centers.” While there may be some inexcusable instances of abuse by insurance companies, the overwhelming majority of companies do an outstanding job. If that were not true, why would folks continue to purchase insurance? Insurance companies will pay what they are contractually obliged to pay and not a penny more. And that is what we expect. Do you ever pay more premium than you are obliged to pay just because you think the insurance company is under charging you? Why does government continue to subsidize insurance for those who insist on building on property that is certain to be burned, blown or washed away, or be destroyed by virtue of being placed on an earthquake fault-line? The answer; because fools believe that you and I shoud subsidize stupidity. Stupitidy is constitutionally protected, me being forced to pay for it is not. We have ruined our education system with government interference and the medical system will face the same dismal end if taken over by government.

Posted by: Jim at May 26, 2007 11:46 AM
Comment #221354

KAP Bill and Hillary had a lot going against them then and we will have even more special interests going against us today on any attempt to fix our broken corrupt health care system.

This should be a major issue for all candidates come election time. All Americans should be aware of the Repub attempt to “fix” the health care system at the beginning of the W years. Much more important that flag burning amendments.

Posted by: j2t2 at May 26, 2007 11:48 AM
Comment #221358

Jim
Do not misquote me. Our military,transportation, fire dept,postal system etc. are not a mixture of socialism and free market to any great extent.. They are socialist institutions and we are all the better off for it. Rather than freak out about labels lets look at what works.Does it make semse for you to hire your own fire dept. in case you have a fire? Of course not but joining with your nieghbors to form one makes great sense. That IS socialism by definition wether you like it or not.

Posted by: BillS at May 26, 2007 12:07 PM
Comment #221368

I’ve worked in health care over the past 35 years. It has always seemed ridiculous to me to expect to be paid a lot by some sick person who can’t work because of ill health. Any good business model expecting a financial return should take into account the clients ability to pay, there is no reason to go after dollars where there are none.

It is stupid to expect businesses who extract good money from working folks, building up nice fat lifestyles for themselves, to then pay out when their clients can no longer pad their purses.

So if the individual can’t be paying cause he can’t work to earn money, who should be paying for his care? Who benefits if he can be cured and returned labor ready to the work force? Well he benefits but the State also benefits from his able-body, if “the state” has an able workforce it can attract business. The health of the whole State is also improved if individuals who are contagious are cared for and are not out infecting their neighbors. This is why the State needs to pay the Health Care bill, and it is the only system that makes any sense at all.

Posted by: erika morgan at May 26, 2007 2:37 PM
Comment #221428

Part of the measure of the advancement of civilization is how the society takes care of the least of them. There is nothing wrong about society taking over the health care aspect of that society. Somehow this idea has become demonized for a percentage of the US population. If there are problems in achieving this goal, that is something that will have to be dealt with. There were problems with every aspect of our government at one point or another. They were (and are being) dealt with; or hopefully will be. The fact that perfection will not be immediately achieved is not reason enough to refrain from trying.
Our civilization should be advanced enough at this point in time that the best health care is guaranteed to everyone, and is paid for by the entire collective. Anything less than that is unworthy and unacceptable.
The debate should not be about whether we should have universal health care, but instead should be about how best to implement it.

Posted by: Cole at May 27, 2007 10:34 PM
Comment #221449

Erika,

The health of the whole State is also improved if individuals who are contagious are cared for and are not out infecting their neighbors.

Where is kctim when we need one!?

I’m sure this statement will make him resorting his “my health is my individual responsability, period” theory once again. Against all nations’s health statistics.

Posted by: Philippe Houdoin at May 28, 2007 9:50 AM
Comment #221489

I have a hypothetical question that just crossed my mind. What would happen to medical costs if all insurance was eleminated tomorrow? Everyone rich and poor have to pay out of pocket. Obviously the richer you are the better services you could afford, but what would happen to medical costs? There aren’t enough rich out here to support the profession. My guess is thay would drop to well below 50% of what they are now.

Posted by: tomd at May 28, 2007 7:29 PM
Comment #221524

tomd,

My guest is that the newest medical progress will be so expensive that only the richest could afford it, and the oldest medecine will still be not free enough for the poorest to see improvment to their health. And drugs that are not anymore profitable will be stopped in favor of more profitable ones, many of them being just a new name for the same old molecule. MDs will focus on the most profitable acts and drop the least ones, like visiting people in isolated backcountry.
It needs only to see the lobbying against generic drugs to know how a free-market ruled health system will goes. Patient vs Customer. Any MD knows it’s easier to have one rich customer, er, patient per day to heal than ten in a line ten times poorer. The profit is the same, the time to make it is shorter.

Move health to a money equation only and everybody will focus on the best way to do the more money in the less time and investment possible, trying to create a monopole being the best solution. I fail to see how the poor patients could benefit from this. Just check how it doesn’t work fine in nations where there is no national health system, like many third world nations. Drugs are not cheaper. There are outdated ones recycled from developed nations and, still, sold at a very expensive price regarding people income there.

My guest is a darwinian system will increase the health gap between the most rich people and the others, not the reverse. Check WHO health systems ranking. All the top ranks are trusted by universal health systems, where both great health output and costs control are achieved.
That’s possible. The fact the current US one(s) doesn’t work fine doesn’t means nobody could do better. On this topic, “au contraire”, it’s means others does better. And with less money.

It just take the will to look at how they does it. Be open-minded, stop the partisan name-calling of everything that is not totally free-market ruled a s socialism failure, in particular when it does better than your current system.
In brief, be pragmatist, as americans used to be in the past for the better.

Posted by: Philippe Houdoin at May 29, 2007 3:55 AM
Comment #221528

Philippe,

I understand you like to push socialism, that’s not the question. My question is intended to take politics out of it. That’s why it’s hypothetical. I think insurance drives up the cost of medical care. Do you disagree?

Posted by: tomd at May 29, 2007 5:53 AM
Comment #221536

First, you misunderstood me, as I’m promoting pragmatism, not socialism, when I argue that’s a good idea to observe why and how health systems are working better and for a lower cost somewhere else than your current one. I’m not promoting only the french one here. Many health systems are considered better than the US ones by WHO. Could be a good idea to investigate the why and how on these ones, right?

I think the medical businesses drives up the cost, as businesses is after profit, not care.
Make medical care a business like every other business, and profit - not care, not costs, but profit - will drive it.

If you want to make profit neither by overpricing neither by underservicing your current market, what’s your option except increasing your market size, going after small profit but on a bigger market.

With health, it means massive numbers of people having health issue. Doesn’t look like a good health system achievement to me.

Hypothetically.

Posted by: Philippe Houdoin at May 29, 2007 7:40 AM
Comment #233686

No candidate appears to be addressing the future increased need for long-term care for those suffering from dementia/Alzheimer’s. There is no Medicare coverage for LTC needs, and LTC ins. is expensive. Who has a plan that addresses this need, I’d like to know???

Posted by: Dalene at September 20, 2007 10:44 PM
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