Hillary’s Attack on Patients’ Choice

Congressman Charles  Boustany
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Posted: Sep 25, 2007 6:26 PM
Hillary’s Attack on Patients’ Choice

In 2004, Senator Hillary Clinton told her audience at a fundraiser in San Francisco: "We're going to take things away from you on behalf of the common good." Her recently announced healthcare plan, or HillaryCare II, does take things away from middle-class America but radically fails to provide any public good. Stripping patients’ choice and access in exchange for government-run healthcare is not the prescription America needs.

Coverage is only one component of our healthcare system. Another, often overlooked, aspect is access. Simply providing coverage to people does not ensure access to needed healthcare. Poor-paying, slow reimbursement systems force patients onto waiting lists, delaying care in habitually underserved communities. Coverage alone will not benefit anyone without providing access to quality care.

In contrast, Senator Clinton claims her healthcare plan would achieve universal coverage "without creating a new bureaucracy." She correctly implies new bureaucracies would create layers of red tape and remove healthcare decisions from patients. In fact, her plan would create several new bureaucracies, including another Medicare-type program and additional bureaucratic layers to the federal government’s Office of Personnel Management. It aims to expand Medicaid to include childless adults and expand Medicare, which already faces a funding shortfall of more than $32.4 trillion. She neglects the cost of these new bureaucracies and fails to provide a suggestion to pay for Medicare’s existing shortfall.

Her plan promises a "medical home" for patients to receive primary and preventive care, yet it fails to mention our nation’s life-threatening shortage of nurses and physicians. Many of her medical homes, while well intended, would be vacant due to staffing shortages. Her plan would also eliminate choices for seniors by imposing a $10 billion cut in Medicare. Many low-income seniors and minorities choose Medicare Advantage plans to receive additional help through reduced co-payments, deductibles and premiums. Her plan calls such help an "overpayment" and would force many seniors to lose this coverage option.

Further, she promises to "prevent premiums from exceeding a percentage of family income." Unfortunately, government-run programs have a poor track record in this area. Although the federal government pays 75 percent of Medicare Part B premiums, the average monthly premium borne by seniors rose from $43.80 to $93.50 between 1997 and 2007.

Senator Clinton claims her plan would expand healthcare "choices" for small business employees, consumers, and seniors. Her plan concedes that "small businesses face higher premiums due to limited purchasing power." Unfortunately, she continues to vote against legislation permitting small businesses to pool together for additional bargaining power. Her most recent plan denies small businesses this freedom, offering federal-benefit mandates instead.

Most regrettably, her plan assumes American consumers cannot be trusted to make choices about their personal healthcare decisions. It misleadingly claims adults who choose health savings accounts "are twice as likely to delay or avoid needed care."

Yet, research demonstrates these patients are more likely to receive diabetes care and screenings for cervical or prostate cancer. A Harvard Medical School study also found a reduction in emergency department visits among patients with these consumer-directed plans. According to a McKinsey study, patients with these plans manage their own healthcare savings and shop for quality and value: They’re more likely to get treatment for chronic conditions, improve their diet, exercise, and seek annual physicals. As one of their focus group respondents noted, "If I catch an issue early, I’ll save money in the long run." HillaryCare II ignores these findings and trusts bureaucrats to dictate patients’ private medical decisions.

Finally, Senator Clinton asserts she can pay for her plan through "balanced financing for health reform." Her plan proposes a $54 billion tax increase, but experts agree this would hardly be enough to pay for HillaryCare II. To raise this amount, she would "discontinue Bush tax cuts," even though they are already scheduled to expire in 2010. Economist Joe Antos of the American Enterprise Institute estimates the plan would cost a minimum of $1.7 trillion over ten years. He says, "I don’t care how hard you squeeze high-income people, you can’t get $1.7 trillion."

The former First Lady aims to "guarantee quality coverage," while "reducing costs," and "strengthening security." In fact, the plan limits patient access with artificial price controls and government rationing, forcing Americans to purchase insurance plans designed by Washington bureaucrats. This hardly guarantees quality, reduces cost or strengthens security for anyone.

This might be the right prescription to appease her liberal base, but HillaryCare II is far from the best prescription for America.