Hillary Clinton has spent years trying to erase the memory of her failed attempt to bring socialized medicine to the United States, but this week the ghost of Hillary Care was lurking in the wings again as she unveiled her new plan to overhaul the nation's health system. Touted as an "American Health Choices Plan," Sen. Clinton's proposal is short on choice but full of government mandates, including a new directive that every American purchase health insurance.
Like her Democratic rivals -- and even some Republicans running for president -- Clinton makes it sound as if we are facing a health care crisis, one that only government can solve. But what exactly is the problem?
Advocates of universal health coverage like to trot out the statistic that about 46 million Americans lack health care coverage, a number based on Census data from 2005. But the figure is misleading.
Most people, upon hearing that so many Americans lack health insurance, automatically assume it is because they can't afford it, but the Census study tells a different story. More than 17 million of those counted as uninsured earn more than $50,000 a year, including almost 9 million who make over $75,000 a year. Some of these people are, no doubt, self-employed, healthy and young, which is why they choose not to buy health insurance for themselves. Since there are few options out there for catastrophic coverage -- the kind that will take care of your bills if you're injured in a car crash or suddenly get cancer -- many of these Americans opt not to spend the money on expensive comprehensive health insurance, just as many people choose not to buy life insurance. Does it make sense to force them to do so?
What's more, nearly half of the 46 million uninsured remain so for only a brief time, on average four months. Many of these persons are between jobs and choose not to pay the premiums for continued coverage available to most persons covered by an employer-provided health plan if they lose or quit their jobs.
Finally, of the remaining uninsured, about 10 million are non-citizens, including an unknown number of illegal aliens.
So, when the numbers are dissected, the health care "crisis" comes down to, according to some estimates, fewer than 10 million Americans who lack long-term access to health care coverage. Yet to deal with this problem, Hillary Clinton wants to dramatically change the way the rest of us receive our health care.
Clinton's plan would force insurers to offer coverage at the same rates to everyone: smokers would pay no more than non-smokers; drug addicts and alcoholics would receive the same rates as the abstemious; obese people would pay the same as the physically fit -- even though all of these behaviors affect health and can be avoided. The consequence would be higher rates for those who choose to behave responsibly.
Moreover, to pay for the estimated $110 billion cost of the new Hillary Care, Clinton would raise taxes. First, she'd wipe out most of the Bush tax cuts, and then she'd tax employer-provided health care plans themselves for those she deems "rich."
Clinton likened her plan of forcing all individuals to purchase health insurance (and requiring the government to pay for those who ostensibly can't afford it) to some states' requirement that drivers maintain insurance in case they injure someone in an accident. But the comparison couldn't be farther off the mark. Car and property insurance don't cover routine maintenance, and premiums are tied to actual risk. You don't submit claims to your car insurer for tune-ups or brake repairs or to your home insurer for painting your house or putting on a new roof. And your premiums depend on whether you are a good driver and how much your house is worth.
But most people expect their health insurance to pay at least a portion of the cost of visits to the doctor for routine care when they get the flu or need vaccinations for the kids, and they don't want to pay more if they choose unhealthy lifestyles.
We do need a new system -- one that rewards individual efforts to stay healthy and provides incentives to get regular, prophylactic care. But Hillary's plan doesn't come close to doing that and will only result in higher taxes and rationed health care.
Linda Chavez is chairman of the Center for Equal Opportunity and author of Betrayal: How Union Bosses Shake Down Their Members and Corrupt American Politics .
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