Back to Clintoncare?


One little‐​noticed item came out of the Democratic national convention last week. Both the president and Hillary Clinton vowed that in a second term they would attempt to revive their plans for remaking the U.S. health care system. Therefore it’s worth remembering what the Clinton health care plan would have meant.

After more than a year of secret meetings, Hillary Clinton’s task force unveiled a plan that would have given the federal government unprecedented control over America’s health care. Indeed, under the Clinton plan nearly one‐​seventh of the U.S. economy would have been brought under government control.

The Clinton plan would have required every business in America to provide health care coverage to its employees, regardless of cost. Such a mandate would have been devastating to small business and cost thousands of jobs. President Clinton just signed a job‐​threatening minimum wage increase. Think about what it would mean if a health care mandate were piled on top of it.

Clinton’s plan would also have forced Americans to give up their current health insurance, even if they were happy with it, and accept a government‐​designed standard benefit package that could be far more expensive. What was covered under such a policy 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 were six‐​pack‐​a‐​day smokers. That would have meant a huge premium increase for young and healthy people.

Most important, 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.

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 caused by 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 sufficiently reduce costs.

Today Bill Clinton may say that “the era of big government is over.” But his health care bill would have established the world’s largest government program — dwarfing even Social Security — created a huge new government bureaucracy and required massive tax increases. The entire idea behind the Clinton health care plan was that government knew best — better than businesses, better than doctors, and better than patients.

Fortunately, the American people rejected the idea of government‐​run health care. In the end, the Clinton health plan didn’t receive a single vote in Congress. Now, however, the president is apparently hoping that Americans have a short memory.

There has been much speculation about how President Clinton would govern in a second term. Would he remain the centrist of recent months, or would he be pulled to the left, as he did in the first two years of his presidency? His stated desire to revisit health care reform should give us all an indication.

Michael D. Tanner

Michael Tanner is director of health and welfare studies at the Cato Institute.