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Tipsheet

Clinton: Folks, Single-Payer Health Care Isn't Happening–But I Pretty Much Said It Was Inevitable In 1994

With the Iowa Caucuses happening today, Hillary Clinton made sure to remind Iowa voters that Sen. Bernie Sanders’ single-payer health care system is simply unrealistic, though she promised to fight hard for the Affordable Care Act (via CBS News):

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"I want you to understand why I am fighting so hard for the Affordable Care Act," she said at Grand View University after hearing from a woman who spoke about her daughter receiving cancer treatment thanks to the health care law. "I don't want it repealed, I don't want us to be thrown back into a terrible, terrible national debate. I don't want us to end up in gridlock. People can't wait!"

She added, "People who have health emergencies can't wait for us to have a theoretical debate about some better idea that will never, ever come to pass."

Derry O'Connor of Des Moines told CBS News that he plans to caucus for Clinton in part because of her stance on health care. He echoed Clinton's sentiments that a single-payer system is out of reach.

"I think if they ever got there, it would be very good," O'Connor said. "I don't see it happening. Look what happened when they tried to expand Medicaid to all the states in the country."

Yet, Mrs. Clinton seemed to think a single-payer system was inevitable when Clintoncare was the main battle for lawmakers on the Hill. The then-first lady delivered remarks to the Lehman Brothers Health Corporation on June 15, 1994, less than two months before the collapse of Clinton’s health care reform agenda, where she said during the question and answer period; that such a model was probably going to happen anyway. She certainly said it was one of three ways that would guarantee universal coverage, besides employer-based and individual mandates. The latter two would be incorporated into President Obama’s health care overhaul in 2010 [emphasis mine]:

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Question: This next question… comes from Scott Engstrom (phonetic) of Franklin Templeton Funds. He asks, it seems clear that everyone on Capitol Hill is in favor of “health care reform” and that if the Administration wanted to compromise, some legislation could be passed very quickly. Is the danger of that approach from your perspective that that you may be giving up a mandate at a specific period in history in which you may be able to effectuate radical change? Is it now or never for massive health care reform?

Mrs. Hillary Clinton: No, because what I think would happen if there is not health care reform this year, and if, for whatever reason, the Congress doesn’t pass health care reform, I believe, and I may be to totally off base on this, but I believe that by the year 2000 we will have a single payer system. I don’t think it’s — I don’t even think it’s a close call politically.

I think the momentum for a single payer system will sweep the country. And regardless of the referendum outcome in California [Prop 186], it will be such a huge popular issue in the sense of populist issue that even if it’s not successful the first time, it will eventually be. So for those who think that building on the existing public-private system with an employer mandate is radical, I think they are extremely short-sighted, but that is their choice.

There are many ways to compromise health care reform, and I don’t think that the President could have been clearer in every public statement he has made that he has one bottom line. It is universal coverage by a date certain. And he has basically told the Congress, you know, you’ve got different ways of getting there. Come to us, and let’s look at it. There are only three ways to get to universal coverage. You know, a lot of people stand up and applaud universal coverage, and they sit down, and you say, “Well, how are you going to get there?”, and they don’t want to confront that there are only three ways.

You either have a general tax — the single payer approach that replaces existing private investment — or you have an employer mandate, or you have an individual mandate. And there isn’t any other way to get to universal coverage. The market cannot deliver universal coverage in the foreseeable future, and any compromise that people try to suggest that would permit the market to have a few years to try to deliver universal coverage without a mandate that would take effect to actually finish the job will guarantee a single payer heath care system.

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In January of 1994, Hillary admitted that a single-payer system was much easier to explain to voters, so why the reversal? Her “we’re going to be Canada” by 2000 projection was way off, though ten years later we do have a health care system that mandates coverage, unless you pay a penalty to remain uninsured. Ironically, many Americans are finding that paying the penalty is much cheaper than enrolling into Obamacare, which has policyholders paying ever-rising premiums per month.

David Sirota at International Business Times and The Intercept found a possible reason for the 180 on health care–and it’s not shocking at all: money from the health care industry:

Between that declaration and her now saying single-payer can never pass, Clinton has vacuumed in roughly $13.2 million from sources in the health sector, according to data compiled by the nonpartisan Center for Responsive Politics. That includes $11.2 million from the sector when Clinton was a senator and $2 million from health industry sources during her 2016 presidential campaign. In a 2006 story about her relationship with the health industry, the New York Times noted that during her Senate reelection campaign, she was "receiving hundreds of thousands of dollars in campaign contributions from doctors, hospitals, drug manufacturers and insurers" and had become "the No. 2 recipient of donations from the industry."

This all coming from a woman who says she can’t be bought. It’s not the first time money to the Clintons or their organizations, like the Clinton Foundation, have raised eyebrows. Hillary was against the Columbia Free Trade Agreement over the nation’s poor record on labor union rights, which changed after the oil company Pacific Rubiales started cutting checks to the Foundation. Rubiales operated in Columbia, and yes, was at the center of a unionized labor controversy. The same could be said about the arms deals that were approved to nations who gave to the Clinton Foundation when she was Secretary of State. The recent development that Bill Clinton got mega bucks for speeches from interests that had “matters before Mrs. Clinton’s State Department” further highlights the ethical dilemma this power couple faces regarding donations and paid appearances. After all, cozy (and favorable) results usually befall those interests afterwards.

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Yet, getting back to health care, the Clinton camp is getting some help in undermining Sanders from the Washington Post editorial board, who called the self-described democratic socialist’s ideas as “half-baked.”

Mr. Sanders’s response to concerns over health-care costs was that other countries, such as Canada and France, spend much less than the United States per person on health care. That is true, but the question is how, specifically, he would make the model work here. The countries he praises ration care in ways that federal health programs in the United States, such as Medicare, do not. While there may be a fair case for a single-payer health-care system, Mr. Sanders does not make it. Instead, he promises comprehensive benefits without seriously discussing the inevitable trade-offs. That is not just bold; it is half-baked.

Health-care policy is only one place where Mr. Sanders makes solving the country’s difficult problems seem easy and obvious when reality is messier. He would use higher taxes on Wall Street and the rich to fund vast new programs, such as free college for all, but has no plausible plan for plugging looming deficits as the population ages. His solution to the complex international crises the United States must manage is to hand them off to others — though there is no such cavalry. This might not distinguish him much from other politicians. And that is part of the point: His campaign isn’t so much based on a new vision as on that old tactic known as overpromising.

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Clinton, on the other hand, wants to be a crusader for Obamacare, though she inadvertently highlights its flaws, specifically how the law is turning the country into a nation of part-time workers.

Guy wrote over the weekend about the latest Des Moines Register poll that had Clinton with a slim three-point edge over Sanders (45/42). Let’s see what happens, especially with the Sanders crowd given that his coalition, besides being overwhelmingly made up of white liberals, is dotted by “infrequent” voters.

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