Democratic Health Care Plans

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There are four competing Democratic approaches to increasing government control over health care:

All four plans include more spending and loss of access by patients to treatment. All four plans compel people to buy something (a type of health insurance) that they do not otherwise want to buy, which results in waste and interference with the free market. Commentators are predicting quick action by the Democratic Congress and Presidency in 2009 on this.[1]

Health care constitutes one-seventh of the economy, and there are 46 million residents of America lacking in health insurance. But no one in America may be denied emergency medical, because federal law (EMTALA) requires emergency rooms to accept and treat patients regardless of their ability to pay. Also, millions of the uninsured choose to decline expensive insurance; millions more are uninsured only temporarily; and still more millions in the statistic are illegal aliens.[2] The real liberal motivation to change health care, which was the first priority of Hillary Clinton when her president took office back in 1993, is to effect social change. Greater government control, abortion and the homosexual agenda can be advanced under the banner of health care reform in a way that would never pass otherwise.

None of the proposed plans are "single payer," at least not initially and publicly so. "[T]his option has been declared 'off the table' by Sen. Max Baucus, D-Mont., who's among those leading the charge for health-care reform in America. Top Democrats who will be deciding policy in America in 2009, including Baucus and President-elect Barack Obama, say single-payer is 'not politically feasible,' because the public won't strongly support it."[3] The biggest supporter of "single payer" was Michigan Democrat John Conyers,[3] but he lost a key committee chairmanship for the new Congress in 2009. But note that Baucus's approach does provided for a taxpayer-subsidized government plan to "compete" with private plans, and supporters of this approach may intend for the taxpayer-subsidized plan to squeeze out the private plans over time in order to become a "single payer."

Most of the plans do call for mandatory insurance purchases by individuals, and mandatory insurance benefits by employers. Currently, only three states have mandatory insurance:[4]

In Massachusetts, individuals must purchase health insurance or pay a tax penalty. Businesses must offer their staff insurance or pay $295 per worker to a fund for the uninsured. Vermont has a similar "pay or play" employer mandate, with a $365 penalty per worker. Hawaii requires employers to provide coverage to all employees working more than 20 hours a week.

Procedurally, Democrats could try to attach a massive new plan to their expected extension and expansion of "SCHIP", which is health coverage for children due to expire in spring 2009.[5] Alternatively, the Democrats could try to insert a massive government takeover of health into a jobs "stimulus" package supposedly to boost the struggling economy. Either approach would be consistent with Ted Kennedy's desire to move quickly before he leaves office for his own health reasons. More cautiously, the Democrats could take the entire year of 2009 and even 2010 revising and debating a new health care plan.

Each of the new Democratic plans is summarized below.

Contents

Ted Kennedy's Plan

Ted Kennedy has withheld details of his plan from the public, perhaps to avoid a build-up of criticism about it. But his staff has met with interest groups in 2008 and it is expected that Kennedy's plan will be similar to the Massachusetts Plan. Kennedy's plan will likely include taxpayer-funded abortion by requiring that insurance carriers cover abortion, and requiring or using the tax incentives and penalties to include participation by taxpayers.

Kennedy's plan will likely impose tax penalties on American citizens who decline insurance, but not impose any penalties on the millions of illegal aliens who lack insurance.

Tom Daschle's Plan

Tom Daschle, the former Senate Majority Leader who later became a health care lobbyist,[6] as did his wife, set forth his plan in a book entitled "Critical: What We Can Do About the Health-Care Crisis." Columnist Tony Blankley described Daschle's plan as follows:[7]

He proposes setting up a board to establish standards for health care delivery in the United States that would be modeled on how the Federal Reserve Board and Securities and Exchange Commission oversee banks and corporations. Technically, it only would oversee the public health systems (Medicare, Medicaid, Veterans Health Administration, etc.), which provide about 32 percent of health care nationwide.

Under Daschle's plan, "political hacks appointed to the Health board will decide whether your cardiologist is allowed to image your arteries and, if they find blockage, try to treat it successfully."[7]

In his book, Daschle proposes leaving the details out of the legislation, as he considered the details to have been the fatal defect in the Clinton approach of 1993-1994. Instead, Daschle seeks to delegate the details to an administrative agency. With Daschle as Secretary of HHS, he may seek delegation of authority to HHS to write regulations containing the important details.

Throughout the nation Daschle is coordinating a series of "Health Care Community Discussions" during the last two weeks of December.[8]

Max Baucus's Plan

Montana Senator Max Baucus has proposed the most comprehensive and detailed plan. His approach would require individuals "to enroll in a private or public health care plan or face a sanction, most likely a tax penalty. Large employers would have to offer employees coverage or pay into a fund to help the uninsured. Small firms would be exempt."[9] Baucus's plan is similar to the Massachusetts plan in requiring individuals to purchase insurance.

CATO critiqued Baucus's plan as follows:[10]

Under the Baucus plan, private insurance would still exist, but it would largely be private in name only. Health insurance would be reduced to little more than a public utility, operating much like, for example, the electric company, with the government regulating and controlling every aspect of the operation.

Baucus's plan would create an unusual type of "competition" between a taxpayer-subsidized government insurance plan and existing private insurance plans. But with the government able to regulate the private insurance plans, it is doubtful that this competition will have any positive effect. Both, for example, would likely be required to pay for abortion.

Ted Kennedy was reportedly critical of Baucus's early release of his plan, which indicates that Kennedy (and, presumably, Obama) is not likely to support Baucus's plan.

Barack Obama's Plan

Barack Obama did not support universal coverage during the campaign, to contrast his approach with that of Hillary Clinton. It is doubtful that he will want to stick with his own campaign plan, as his priorities lie elsewhere. Most likely he will agree with the consensus view among Kennedy, Daschle, and Baucus, and the plan that prevails among this group will most likely be Kennedy in light of his greater power.

References

  1. http://www.statesmanjournal.com/article/20081203/OPINION/812030387/1049/OPINION
  2. A similar claim that there are 6.5 uninsured Californians was described as "hogwash. First, the study the governor quotes DOES NOT say that there are 6 1/2 million Californians without health insurance. It says that 6.5 million Californians don’t have health insurance AT SOME POINT DURING THE YEAR. But 45% of those Californians have it within four months. So 45 percent of these people are not chronically uninsured individuals – they’re people changing jobs. And of those 6.5 million – 45 percent of whom WILL HAVE health insurance within four months — 2 ½ million are illegal aliens; 2 million earn over $50,000 per year, 1 million are already eligible for MediCal or Healthy Families.[1]
  3. 3.0 3.1 http://www.helenair.com/articles/2008/12/03/state/80st_081203_column.txt
  4. http://www.investors.com/editorial/IBDArticles.asp?artsec=16&issue=20081119
  5. http://thecaucus.blogs.nytimes.com/2008/12/05/daschle-begins-leading-health-care-reform/
  6. http://www.bhpioneer.com/articles/2008/12/02/opinion/doc49356b800d2d4411203208.txt
  7. 7.0 7.1 http://www.citizen-times.com/apps/pbcs.dll/article?AID=200881201056
  8. http://thecaucus.blogs.nytimes.com/2008/12/05/daschle-begins-leading-health-care-reform/
  9. http://www.investors.com/editorial/IBDArticles.asp?artsec=16&issue=20081119
  10. http://www.cato.org/pub_display.php?pub_id=9801
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