Commentary

The Return of Hillarycare?

In the wake of the Democratic victory in the midterm congressional elections, Hillary Clinton announced that Democrats would once again make health care reform a top legislative priority. “Health care is coming back,” Clinton said, apparently giddy with triumph, adding, “It may be a bad dream for some.”

Indeed, it may well be a nightmare for American health consumers. No one knows for certain what the new Democratic majority has in mind, but its initial proposals — expanding Medicaid and the Medicare prescription drug program — are certainly steps in the direction of more government interference in the medical marketplace.

Perhaps it has been so long that Americans have forgotten exactly what Hillarycare was. If so, it’s worth reminding them. Under the Clinton plan, the government would have taken control of nearly one-seventh of the U.S. economy. It would have established the world’s largest government program — dwarfing even Social Security — created a huge new bureaucracy and required massive tax increases.

Government knows best?

The entire idea behind the Clinton health care plan was that government knew best — better than businesses, better than doctors, and better than patients.The Clinton plan would have required every business in America to provide health care coverage to its employees, regardless of cost. The mandate would have devastated small businesses and cost thousands of jobs.

Clinton’s plan would also have forced Americans to give up their current health insurance, even if they were happy with it, in return for a government-designed standard benefit package that could be far more expensive.

What the policy covered would be determined not by consumer preference or even medical necessity, but by the lobbying power of various special interests.

Such policies would have been “community rated,” meaning that people would pay exactly the same premium regardless of whether they were healthy or on their death bed, practiced healthy lifestyles or smoked six packs a day. That would have meant a huge premium increase for young and healthy people.

The plan established rigid price controls through a series of premium caps and other measures. That, in turn, would have forced insurers to ration the care they provided. Clinton apparently hoped that indirect rationing through managed care would avoid the direct rationing that results from price controls under every other national health care system in the world. But just in case, the proposal would also have established a National Health Board, with back-up authority to ration health care directly if indirect rationing failed to reduce costs sufficiently.

And the Clinton plan would have forced all Americans into managed care, effectively denying them the ability to choose their own doctors. Indeed, the Clinton proposal actually included criminal penalties for people who tried to pay for unapproved health care out of their own pockets.

Needed: More choice, not less

There is no doubt that our health care system is badly in need of reform. Too many Americans lack health insurance. We need to do more to lower health care costs and increase access to care. The system is riddled with waste and the quality of care is uneven. Government health care programs like Medicare and Medicaid threaten future generations with an enormous burden of debt and taxes.

But the answers to these problems lie with more choice and competition, not less. More government regulation, subsidies, and control would simply drain the medical marketplace of the quality, dynamism and innovation that save lives.

Hillarycare would have put the health care equivalent of FEMA in charge of our health care system. Surely this is not what the American people voted for on Nov. 7.

Michael Tanner is director of health and welfare studies at the Cato Institute and coauthor of Healthy Competition: What’s Holding Back Health Care and How to Free It (2005).