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Both Hillary Clinton and Barack Obama want universal health care. She takes the more realistic route in getting there
Published on Thursday, Feb 28, 2008
There is one difference, much magnified in Ohio and elsewhere. The Clinton plan would require everyone to have health insurance. Obama would require all children to have coverage. There, his mandate would stop, Obama arguing that a less onerous option is available: Make insurance affordable, and practically everyone would purchase it.
Obama heightened the difference with a mailing that has angered the Clinton camp. He charged: ''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.'' The political calculation runs deeper, inviting the belief that universal coverage can be achieved with relative ease and little pain.
Clinton quickly pointed out that like the Obama plan, she would deploy subsidies to assist those who cannot afford coverage. The mandate? Clinton rightly admits some enforcement mechanism will be required to achieve universal coverage. She has left open the question of exactly how, arguing, correctly, that the benefits of universal coverage for the whole far outweigh the plight of ''free riders.''
To her credit, Clinton has been frank about the necessary steps to reach universal coverage, knowing that a single-payer system is politically untenable (for now). Obama cites the failure of a similar mandate in Massachusetts to achieve sufficient participation. To a degree, that is because the penalty isn't stiff enough. The consensus among health-care experts is that universal coverage will remain beyond reach without a mandate. Worth noting is that even when adequate subsidies are available, many eligible people do not take advantage of Medicaid and the State Children's Health Insurance Program.
With that in mind, Clinton contends that as many as 15 million of the 47 million uninsured would remain without insurance under the Obama plan. She didn't make up the number. Two respected analyses, one by John Sheils of The Lewin Group and another by Jonathan Gruber of the Massachusetts Institute of Technology, estimate the uninsured most likely would range from 15 million to 26 million.
That isn't to say that Clinton's approach is flawless. Both plans overstate the likely cost savings, though Clinton's is the more realistic (or less hopeful). Their campaigns have not made enough of the point stressed by the Partnership to Fight Chronic Disease, that chronic disease accounts for 75 percent of the country's health-care spending. Confront the doubling of obesity since 1987, and you will begin to spend health dollars more effectively and efficiently.
What Hillary Clinton and Barack Obama have been discussing is the real need for universal coverage. She has the more honest plan for getting there.
Get the full article here.
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