Hillary Care - A Must Say Opinion

"Hillary Care" -- Senator Clinton's healthcare plan that's all about the 2008 presidential election -- is not the godsend to Republicans that it was in the early 1990s and deserves some attention.

What do I think about it?

First, let me define my stance in life: I'm the nation's only quasi-libertarian Democrat, a political schizophrenic who easily accepts that the U. S. government wastes incredible amount of money, and is inept at a majority of the things Congress asks the bureaucracy to do after responding to lobbyists.

I also believe that government, in this country, must have a heart -- even if it gets in the way of its head. It's the price we pay for the unfettered ability to make choices, accumulate wealth and make our lives successful. Enough said about where I'm coming from.

Clinton care is warmed over SOS -- same old "stuff" not exactly the right translation for the term coined by GIs to describe creamed chip beef, on toast -- standard Army fare for generations.

Senator Clinton emphasizes choice, the forcing of insurers to accept all comers, government subsidies for those who cannot afford healthcare insurance and a continuing role for employers.

Each point makes sense but taken together it just can't work. Why?

Simply enough, cost. Consumer choice plus government subsidies plus new technology plus retiring baby boomers means this plan will fail because of cost. The laws of economics are not murky and this plan will lead to an acceleration of healthcare inflation -- more people demanding more services and products, which equals higher prices, just as sure as there is gravity.

And if (when) costs go up, insurance rates go up. And if (when) consumers can't afford it, there will be larger government subsidies -- and more taxes -- and then, essentially, more inflation.

And if (when) the government steps in to regulate the prices insurers can charge, there will be fewer insurers, fewer choices, and, well, there you go.

Hillary Health is an incremental, "elect me and we will worry about reality in my second term" plan.

Hillary is smarter than that -- regardless of what you think about her politics -- and we need a better plan. I'm terrified I am going to be means-tested out of Medicare (this begins this year) and unable to buy insurance when my time comes for eligibility. It serves me right for voting Democrat my whole life.

My father referred to it as voting for Mr. Lincoln's party and I feared his hand would pop out of the grave and choke me if I did. The funny thing is he loved Lincoln and my great grandmother actually met him, but my father would never have voted for him.

So what could Hillary do that would work?

It is not sane to assume a consumer, even the most informed consumer, can make rational choices in times of a medical emergency or serious illness. It can't happen and won't happen.

But consumers can make rational choices about their insurance plan, so let's change the way we buy and regulate insurance.

Here is Michael Care, which I should package and deliver across the street to my neighbor who does Obama's advertising (and did Mr. Clinton's in 1992 and 1996).

Michael Care would:

• Force consumers to buy insurance with their own or government dollars or a mix of both. They would be tax free dollars which means ending the deduction of healthcare expenses from business taxes. Transition time: three to five years.

• All insurance companies would have to insure most comers -- excluding super-high-risk consumers who would go into a pool, like auto insurance, and have capped prices or government subsidies. Medical insurance would be regulated nationally. Transition time: three to five years.

• End all government subsidies that are hidden, such as those for teaching hospitals in the Medicare system. Let the market and private carriers figure it out. Transition time: three to five years.

• All physician fees and prices would be posted -- no hidden discounts for non-hospital fees and products. Do this right now.

• Patients and providers are guaranteed reimbursement within 30 days. Insurance companies who routinely reject claims or paperwork to delay payment are fined thrice (nice word, that) the amount of the delay and, in time, will be put out of business. Do this right now.

• All hospitals must post their performance. All hospitals have a patient ombudsman (Sweden does this) to represent the infirm who come in without relatives etc. Do this right now.

• Physicians would submit all their patient records, without patient names, via computer so the government can track the efficacy of treatments, treatment regimens and doctors. The incentive to do this? Doctors doing this become part of a national pool of malpractice insurance and their rates are cut drastically. Great incentive, that for the, mostly, very good doctors. Transition time: It wil take five years to set up, five years to screw up and we will actually get it right in about 10-15 years.

• Send between 500 and 1000 doctors to jail for fraud or negligent homicide. This would greatly reduce government expenditures and malpractice costs. It would probably also make the vast majority of good docs very happy to be rid of the harmful jerks. Do this yesterday.

• Do the previous point again - and this time send 200 tort lawyers with the bad doctors for using fake patient claims to make money in stupid courts in stupid tort states like Alabama. Do this the day before yesterday.

• Give insurance companies the right to raise rates for consumers who do not take care of themselves: diabetics who are able but don't medicate properly, people who smoke, etc. Do not do this for the obese as long as obesity is being treated a disease, which it is. Sadly, this must be done now.
  

Speaking of the interesting but potentially unwise, my plan is a lot like Rudy's. I think his also includes a provision for coverage for ex wives if you divorce them publicly and they fall ill from the shock.