Monday, October 24, 2016

A Vote for Hillary Is a Vote for Single-Payer

Throughout this election cycle, Hillary Clinton has insisted that she doesn’t favor single-payer health care. Prepare yourself for a shock — she’s lying. As early as 1994, she described the future of our medical delivery system thus: “I think the momentum for a single-payer system wllsweep the country … if it’s not successful the first time, it will eventually be.” Nineteen years later, her affinity for single-payer hadn’t faded. Emails published by WikiLeaks early this month show that, in a 2013 closed-to-the-public speaking engagement, Clinton was still touting the cost savings allegedly achieved by single-payer systems in Scandinvia and Canada.
Now that she’s running for the presidency again, however, Clinton would have us believe that she has had a change of heart. Indeed, during her battle with Bernie Sanders for the Democratic presidential nomination, she denounced the Vermont Senator for advocating the replacement of Obamacare with single-payer, saying that such a system “will never, ever come to pass.” Her public position is that she will “defend” Obamacare and “improve on its successes.” But another batch of emails published by WikiLeaks last week shows Clinton exchanging ideas with her advisors concerning the most effective way to facilitate “the unraveling of ACA.”
Specifically, in a September 2015 email stream about bipartisan support for repealing Obamacare’s 40 percent excise tax on high-dollar health care plans, she writes: “I’ll support repeal.… But we have to be careful that the R version passes which begins the unraveling of the ACA.” A few days following this email exchange, Clinton announced that she would “encourage Congress to repeal the so-called Cadillac tax.” Now, why would a presidential candidate ostensibly committed to defending President Obama’s “signature domestic achievement” support any congressional measure that she believes would lead to its eventual demise?
The actual result would be to force the few remaining private insurers willing to sell policies through the exchanges out of the health insurance market. The public option would sell coverage at taxpayer-subsidized rates that no legitimate enterprise can offer without going bankrupt, so the last holdouts would simply follow Aetna, United Healthcare, and dozens of other insurers out the door. This would quickly convert the Obamacare “marketplaces” into mere enrollment stations for yet another government-run health care plan, which would be entirely consistent with the overall goal of getting every American on some form of government coverage.

Given Clinton’s propensity toward
  prevarication, the obvious answer is that she is being less than candid about her plans for our health care system in general and Obamacare in particular. And her plan to “fix” Obamacare supports that conclusion. A major feature of her proposed repair job is that perennial progressive panacea, the public option. The brilliant idea behind this proposal is to have a government-run insurance plan available in every exchange to compete with private insurers. This would, according to its proponents, force insurance companies to offer fair prices to Obamacare enrollees and thus hold down premiums and deductibles.
This project is already well underway, of course. The taxpayers already pick up the tab for nearly two-thirds of the nation’s health care expenditures, and the share of the U.S. population on some sort of government health plan has increased dramatically during the past decade. As John Merline points out atInvestor’s Business Daily, quoting data from the Centers for Disease Control, “the share of the population that gets insurance coverage directly from the government… jumped from 18.1% in 2007 to 25.3% in 2015.” During the same period, the percentage of Americans with private health insurance coverage has actually gone down.
This shift from private coverage to government-run plans will accelerate if Clinton is successful in getting another of her Obamacare “fixes” enacted. Clinton has proposed what has become colloquially known as “Medicare-for-More.” The proposal, which she unveiled last May in response to the enthusiasm among progressives for Sanders’ proposals, would extend Medicare eligibility to adults in their fifties. The details have remained remarkably vague, but Avalere Health estimates that 13 million Americans could become eligible to buy into the Medicare program under the plan, an increase in the number of beneficiaries of 25 percent.
And the beat goes on. The good news is that, unless Clinton wins the election in a landslide large enough to sweep the Democrats back into power in both houses of Congress, it’s unlikely that she will be able get many of her awful policy ideas passed. Neither the expansion of Medicare, which is already hurtling toward bankruptcy, nor the public option will go anywhere. The last time her accomplices tried to get the latter passed, they described it as “stealth single-payer.” How fitting that it is being reintroduced by Hillary Clinton, a stealth advocate of single-payer, a system that the voters revile and which no amount of subterfuge can make succeed.

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