Hillary Clinton is talking about her healthcare plan:
Senator Hillary Rodham Clinton said in an interview on Wednesday that if elected president she would push for a universal health care plan that would limit what Americans pay for health insurance to no more than 10 percent of their income, a significant reduction for some families.
In an extensive interview on health policy, Mrs. Clinton said she would like to cap health insurance premiums at 5 percent to 10 percent of income.
The average cost of a family policy bought by an individual in 2006 and 2007 was $5,799, or 10 percent of the median family income of $58,526, according to America’s Health Insurance Plans, a trade group. Some policies cost up to $9,201, or 16 percent of median income.
The average out-of-pocket cost for workers who buy family policies through their employers is lower, $3,281, or 6 percent of median income, according to the Kaiser Family Foundation, a health research group.
A cap on premiums has been part of Mrs. Clinton’s universal coverage proposal since she announced it in September. Her published plan did not disclose her thinking on where to place the cap. She also said in the interview that she preferred to set the limit at a single level for all Americans rather than varying it by income.
How does she plan to get the $110 billion per year that the plan will cost?
About half would come from savings generated by improvements in prevention, chronic disease management and electronic record keeping. The remainder would be produced by rolling back President Bush’s income tax cuts on people earning more than $250,000 a year.
I’m afraid Sen. Clinton is ignoring the fundamentals. First off she isn’t going to save $50 billion annually through prevention or chronic disease management. That was the same promise as the one 25 years ago when HMO’s were authorized. The savings didn’t materialize then and they won’t materialize now. And then there’s the problem I’ve been complaining about since the Democrats started talking about universal health care: the present system doesn’t have the excess capacity to handle more patients.
Even without health-care reform, the demand for family physicians is expected to surge by 2020, when the nation will need 140,000 family physicians, according to the American Academy of Family Physician’s 2006 Physician Workforce Report. That’s a 40% increase over the 100,000 family doctors at work in 2006.
Low payments to primary care doctors are discouraging those of us in practice and are dissuading new doctors from entering the field. Medicare’s proposed 0.5% fee increase to family doctors like me for the remainder of 2008 is well below inflation. None of my office expenses will rise less than 0.5% this year.
To me, universal coverage looks like an empty promise. Just nationalizing health insurance by declaring Medicare for all isn’t going to get the job done. Medical insurance coverage without a doctor to see is another big health problem — not a solution.
We need reform in our health care system. But the reform must start with reforming the way health care is delivered. Anything else is just a fantasy.
No matter how Clinton describes her plan, it will be a heavy TAX burden. Public monies turned over to for profit corporations where the tax payer has no say on how the money is used.
It is quite likely that one way of reducing the burden of health costs on Americans is something that may sound completely irrelevant – and won’t be done, as the people involved have an extremely powerful lobby, including many Congresspeople no doubt. That way is to outlaw “no win no fee” arrangements with lawyers, and possibly make the advertising of legal services illegal.
How is this going to help? Simple. One of the major reasons for high health costs is over-testing; the tendency of doctors to test for everything, no matter how unlikely, because not doing so leaves them open to malpractice suits conducted by ambulance-chasing lawyers if something goes wrong. This also puts up the cost of professional insurance, which means the doctors need to charge more to make a living.
This is not just a matter of money, either – some of the tests carry their own risks.
In the UK, until a few years ago, advertising by lawyers was illegal and “no win no fee” arrangements were against the rules of the legal profession’s governing bodies. Until the Lord Chancellor, himself a lawyer and in charge of the legal profession in the UK, changed both regulations – with predictable results. All types of insurance are now much more expensive than previously – for example commercial liability insurance, car insurance, and also insurance for special events. Which has in turn led to the demise of many traditional local ceremonies, some of which have been held regularly for centuries.
“What do you call a line of 5000 lawyers at the bottom of the sea?” “I don’t know, what do you call them?” “A good start.”
Sometimes an accident really isn’t anyone’s fault, and sometimes if your health takes a bad turn it isn’t your doctor’s fault, either.