Steve Chapman

The change would also make a huge difference. Mark Pauly, a health care economist at the University of Pennsylvania's Wharton School, says that with a credit of $2,000 per person, "I'd guarantee a 50 percent reduction in the number of uninsured." A larger subsidy could boost that figure to 85 percent.

Part of the value of this strategy is that it would vastly expand the individual insurance sector, which now performs poorly because it is so small, has such high overhead expenses and attracts so many high-risk individuals. Arming millions of healthy people with tax credits, Pauly ventures, would be a potent stimulus to competition and efficiency in the private market.

This is not a goal of those who favor government-run health care. So you wouldn't expect Hillary Clinton to embrace the idea. But her new plan says, "Working families will receive a refundable tax credit to help them afford high-quality health coverage." (How big, she doesn't say.)

Is that a change? Well, back in 1993, when we got the original version of HillaryCare, it was opposed by a coalition called Citizens Against Rationing Health, whose alternative plan included -- what's this? -- a refundable tax credit for the poor.

This is not to say that Clinton has joined the Milton Friedman fan club. Her program is still heavy on the kind of intrusive government dictates she has always found so alluring. It would fine large employers that fail to provide coverage for their workers, force insurance companies to offer policies to everyone, with no "excessive premiums," and order pharmaceutical manufacturers to sell drugs at "fair prices." It would force private insurers to compete with a government-sponsored program that could be priced at a loss to put them out of business.

When it comes to health care, Clinton has a long way to go. But conservatives can hope that she has only begun to learn from them.

Steve Chapman

Steve Chapman is a columnist and editorial writer for the Chicago Tribune.

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