NationStates Jolt Archive

With health care in the United States, we do have some government programs like Medicare, Medicade, the State Childrens' Health Insurance Program, and the Federal Employees' Health Benefits Program. However, most Americans get their coverage via private insurance, mostly through their jobs/workplaces, thanks to a federal tax break granted to private employers.

In Britain, there is the National Health Service (a government agency), which owns and operates the hospitals in that country. Doctors and dentists work mainly for the N.H.S., but they sometimes do extra work in the private sector. Although health care is mainly a government operation, there is actually private health insurance in Britain. While American critics denounce British health care as socialized medicine, it's NOT a total government monopoly.

In Canada, hospitals are mainly owned and operated privately, and doctors and dentists are mainly in private practice. However, private health insurance is banned here, making the financing of health coverage a government monopoly. That's why the Canadian system is called single-payer. The American critics also denounce the Canadian system as socialized medicine, though it, like the British system, is NOT a total government monopoly.

Which brings us to Hillary Clinton's current (2007) version of health care reform. A common misconception about the second edition of Hillarycare is that it would lead to a government monopoly (more or less) of American health care. What Hillary Clinton as U.S. president would do for American health care:

1)Allow Americans to keep their current (mostly private) coverage
2)Expand Medicare to include non-elderly
3)Expand the Federal Employees Health Benefits Program, which is a joint public-private partnership between the federal government and private insurance companies
4)Does NOT, NOT, NOT include the the mandatory insurance cooperatives ("alliances") from the original (1993) plan
5)Require larger private businesses to provide insurance to their workers or pay a tax, with smaller businesses exempt from the employer mandate
6)Give tax credits to families and small businesses to obtain insurance
7)Make insurance mandatory for Americans, with individuals given a choice to obtain private insurance or joining a government program
8)NOT, NOT, NOT ban private insurance as they do in Canada
9)NOT, NOT, NOT promote a government takeover of private hospitals as happened in Britain decades ago

Although critics of Hilaarycare are dead wrong if they think Hillary wants a government monopoly of health care, since clearly she has become MORE MODERATE on the issue over the years, they do have a point about whether or not it would lead to higher taxes or larger budget deficits.

If I may point out, Senator Clinton should she become President will have to secure Congressional approval for her plan. Having a plan and getting it passed are completely separate.

Her moderation is most likely a product of an electorate that didn't want and doesn't want her 93 version of Universal Healthcare. I suppose one might argue that shows moderation, I'd vote that it shows more political savvy and a hope on her part that incrementalism will take over as it often does in government programs.

I do think it's a basis for further discussion though.

With health care in the United States, we do have some government programs like Medicare, Medicade, the State Childrens' Health Insurance Program, and the Federal Employees' Health Benefits Program. However, most Americans get their coverage via private insurance, mostly through their jobs/workplaces, thanks to a federal tax break granted to private employers.

In Britain, there is the National Health Service (a government agency), which owns and operates the hospitals in that country. Doctors and dentists work mainly for the N.H.S., but they sometimes do extra work in the private sector. Although health care is mainly a government operation, there is actually private health insurance in Britain. While American critics denounce British health care as socialized medicine, it's NOT a total government monopoly.

In Canada, hospitals are mainly owned and operated privately, and doctors and dentists are mainly in private practice. However, private health insurance is banned here, making the financing of health coverage a government monopoly. That's why the Canadian system is called single-payer. The American critics also denounce the Canadian system as socialized medicine, though it, like the British system, is NOT a total government monopoly.

Which brings us to Hillary Clinton's current (2007) version of health care reform. A common misconception about the second edition of Hillarycare is that it would lead to a government monopoly (more or less) of American health care. What Hillary Clinton as U.S. president would do for American health care:

1)Allow Americans to keep their current (mostly private) coverage
2)Expand Medicare to include non-elderly
3)Expand the Federal Employees Health Benefits Program, which is a joint public-private partnership between the federal government and private insurance companies
4)Does NOT, NOT, NOT include the the mandatory insurance cooperatives ("alliances") from the original (1993) plan
5)Require larger private businesses to provide insurance to their workers or pay a tax, with smaller businesses exempt from the employer mandate
6)Give tax credits to families and small businesses to obtain insurance
7)Make insurance mandatory for Americans, with individuals given a choice to obtain private insurance or joining a government program
8)NOT, NOT, NOT ban private insurance as they do in Canada
9)NOT, NOT, NOT promote a government takeover of private hospitals as happened in Britain decades ago

Although critics of Hilaarycare are dead wrong if they think Hillary wants a government monopoly of health care, since clearly she has become MORE MODERATE on the issue over the years, they do have a point about whether or not it would lead to higher taxes or larger budget deficits.

Republican translation of "Socialized Medicine" == "When everyone has access to the same quality healthcare"; because, as they all know, peoples access to life sustaining services should be strictly controlled by those with lots of money.

One small point about British health care. GP's and the Dental practices are Privately owned and operated. GP's receive their payments via the NHS but can also operate privately, the majority are not owned by the NHS.
Dentists are, on occasion, contracted by local PCT's (Primary Care Trusts) through the NHS to operate and provide NHS treatment, however the majority of Dental Practice treatment throughout the Country is private. NHS dentists, who are directly affiliated to the NHS tend to be in hospitals or care centres rather than standard practice.
They are ALL self employed private businessmen (barring specialists in hospitals).

One small point about British health care. GP's and the Dental practices are Privately owned and operated. GP's receive their payments via the NHS but can also operate privately, the majority are not owned by the NHS.
Dentists are, on occasion, contracted by local PCT's (Primary Care Trusts) through the NHS to operate and provide NHS treatment, however the majority of Dental Practice treatment throughout the Country is private. NHS dentists, who are directly affiliated to the NHS tend to be in hospitals or care centres rather than standard practice.
They are ALL self employed private businessmen (barring specialists in hospitals).

yes, however private dentists' costs are usually subsidised by the NHS, and visiting the GP's surgery won't (usually) cost you a penny thanks again to the NHS.

one of the things i find most incredible about the US system is the price of medications. here, again, the NHS subsidises the price of buying meds at pharmacies, meaning they tend to be cheap (i get 2 months supply of my meds for £6) or free for children or pensioners.

i believe that would certainly be a good step if the US were to adopt a wider-ranging system of government help in the health sector. is this in Hillary's current proposal by any chance?


btw, its also worth noting that there are still private hospitals in the UK which run alongside the NHS system. however they tend to be more expensive, and are often where you'll have to go for non-medical stuff (like cosmetic surgery, etc). the NHS is more efficient providing essential services and not that kind of thing.

As a supporter of universal health care, I agree with the system laid out by Hillary Clinton. I'm not convinced that her own claimed budget for the system will be enough, but I do like the way the funds will be raised, by rolling back President Bush's tax cuts for the richest Americans and reforming the system where large businesses receive subsidies for providing insurance with a system where they get taxed more for not providing insurance. I'd also say its superior to the other Democratic candidate's proposed healthcare plans as it seems to combine the best of both Obama and Edwards' own initiatives.

Nothing justifies robbing Peter to pay Paul.

The individual is an end in himself, and has no obligation to provide for others.

Thus, socialized medicine in any form is pure evil.

1)Allow Americans to keep their current (mostly private) coverage

This is great, a nice improvement over her Universal Healthcare plan from '93.


2)Expand Medicare to include non-elderly

This already exists, its called Medicaid, and provides insurance coverage for welfare recipients. Problem is that it is run by the states, with Federal money, and the past several administrations, including the Clinton adminstration have cut funding for this.


3)Expand the Federal Employees Health Benefits Program, which is a joint public-private partnership between the federal government and private insurance companies.

This is an excellect way to eliminate Medicare, and Medicaid, and improve healthcare coverage across the board.


4)Does NOT, NOT, NOT include the the mandatory insurance cooperatives ("alliances") from the original (1993) plan

Good....I guess


5)Require larger private businesses to provide insurance to their workers or pay a tax, with smaller businesses exempt from the employer mandate.

California already has this requirement, the problem it ran into with this was deciding on a definition of large and small. If I remember correctly, it determined that large was any company with more than 50 employees. Basically, unless her plan is specific, it will be stopped under litigation and left to the courts to determine the specifics. I hope she has more sense than she did last time, and actually defines things far better.


6)Give tax credits to families and small businesses to obtain insurance

This is just plain common sense. It has been suggested, and tried, but somehow the legislation never passes. When the Dems are in power, the GOP finds a way to stop if and vice versa. I wish her luck, but don't see much hope for it.


7)Make insurance mandatory for Americans, with individuals given a choice to obtain private insurance or joining a government program

Great in practice, but wait. Currently medical care is manditory for all Americans. Its called the Emergency Room, and hospitals are forbidden from turning anyone away that comes to the Emergency Room. This is a key reason as to why Healthcare in this country is so expensive as the hospitals have to recoop their loses for free healthcare to uninsured individuals. Her plan does nothing to address this problem, except provide insurance for everyone. Now, instead of paying higher medical costs, I am paying higher taxes to cover all the "formerly" uninsured. Either way, everyone still gets their healthcare, and the hardworking tax payers are still footing the bill.


8)NOT, NOT, NOT ban private insurance as they do in Canada

Good, because we can't simply eliminate an entire industry.


9)NOT, NOT, NOT promote a government takeover of private hospitals as happened in Britain decades ago

Another "benefit", but there is more to her plan than you mentioned. Lets look at it more closely.

From Hillary's web page (http://www.hillaryclinton.com/).

Americans who are satisfied with the coverage they have today can keep it, while benefiting from lower premiums and higher quality.

Reducing Costs: By removing hidden taxes, stressing prevention and a focus on efficiency and modernization, the plan will improve quality and lower costs.

Strengthening Security: The plan ensures that job loss or family illnesses will never lead to a loss of coverage or exorbitant costs.

End to Unfair Health Insurance Discrimination: By creating a level-playing field of insurance rules across states and markets, the plan ensures that no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums.

This all sounds good, and if quite impressive until she gets to the last part. "End to Unfair Health Insurance Discrimination" She plans to "creating a level-playing field of insurance rules across states and markets" Without further detail from her plan, which does not exist at this time, it sounds like she intends to take control of how states regulate insurance within their own borders. See currently the states are in charge of inter-state commerce, and as such they control how companies operate within their borders, regardless of the size or industry of the company. This plan inherently takes that control away from the state, with regard to insurance companies, and as such will never fly without specific assurances to state's rights.

Relying on consumers or the government alone to fix the system has unintended consequences, like scaled-back coverage or limited choices. This plan ensures that all who benefit from the system share in the responsibility to fix its shortcomings.
Insurance and Drug Companies: insurance companies will end discrimination based on pre-existing conditions or expectations of illness and ensure high value for every premium dollar; while drug companies will offer fair prices and accurate information.

Individuals: will be required to get and keep insurance in a system where insurance is affordable and accessible.

Providers: will work collaboratively with patients and businesses to deliver high-quality, affordable care.

Employers: will help financing the system; large employers will be expected to provide health insurance or contribute to the cost of coverage: small businesses will receive a tax credit to continue or begin to offer coverage.

Government: will ensure that health insurance is always affordable and never a crushing burden on any family and will implement reforms to improve quality and lower cost.

Again, great stuff. Health Insurance will work like Auto Insurance, except, the Federal government will work to make sure that it isn't too expensive. But here is the problem. What happens if someone fails to make their regular insurance payments. Do you get fined, like you do for driving without Auto Insurance? Are you forbidden from using the healthcare system?

Comparing this to Auto insurance, millions of people drive without insurance, so what is going to be put in place to require someone to get health insurance? One would think it would be common sense, but honestly, not everyone has common sense.

And we are going to require employers to contribute to a system, the government healthcare system, which none of their employees may use? Does that make sense? For those that are employed, the healthcare system is working quite well, for those that are not employed it sucks. Granted employed people are paying higher insurance premiums, but in days where 47 million people are using the Emergency Room for their healthcare, can this really be surprising? If you eliminate those 47 million uninsured, we will automatically see the decrease in our costs. So why should employers pay into the goverment healthcare plan, besides paying their already exhorbinant taxes?

Provide Tax Relief to Ensure Affordability: Working families will receive a refundable tax credit to help them afford high-quality health coverage.

Limit Premium Payments to a Percentage of Income: The refundable tax credit will be designed to prevent premiums from exceeding a percentage of family income, while maintaining consumer price consciousness in choosing health plans.

Create a New Small Business Tax Credit: To make it easier-not harder-for small businesses to create new jobs with health coverage, a new health care tax credit for small businesses will provide an incentive for job-based coverage.

Strengthen Medicaid and CHIP: The Plan will fix the holes in the safety net to ensure that the most vulnerable populations receive affordable, quality care.

Launch a Retiree Health Legacy Initiative: A new tax credit for qualifying private and public retiree health plans will offset a significant portion of catastrophic expenditures, so long as savings are dedicated to workers and competitiveness.

Most Savings Come Through Lowering Spending Due to Quality and Modernization: Over half the savings come from the public savings generated from Senator Clinton’s broader agenda to modernize the heath systems and reduce wasteful health spending.

A Net Tax Cut for American Taxpayers: The plan offers tens of millions of Americans a new tax credit to make premiums affordable-which more than offsets the increased revenues from the Plan’s provisions to limit the employer tax exclusion for health care and discontinue portions of the Bush tax cuts for those making over $250,000. Thus, the plan provides a net tax cut for American taxpayers.

Making the Employer Tax Exclusion for Health Care Fairer: The plan protects the current exclusion from taxes of employer-provided health premiums, but limits the exclusion for the high-end portion of very generous plans for those making over $250,000.


What is the deal with the refundable tax credit stuff? Honestly, either tell me you going to give me the tax break, or increase my taxes, but don't play games with the wording. Put is in plain terms, I will pay more in taxes in order to pay less in healthcare costs. While I doubt the two will balance out, as I expect to pay much more in taxes that I would receive in decreases to my healthcare costs, I do see the benefits.

Also, if there plan works as it really should, there so no longer be a need for Medicare, Medicaid, or CHiP. They can be eliminated, or be rolled up into this more comprehesive plan. Don't bother strengthen them, just give the current recipients of that plan the same benefits as government workers and be done with it. Eliminate the additional buracracy and simplify the process, and decrease costs. Everyone wins. No, she would rather strengthen an already dying program, instead of moving that program into a broader more capable system. OK


The rest I like.

OK, I may be nitpicking her plan, but what I am trying to get at, her plan is by no means our best option. It is step in the right direction, and a huge leap better than her original 1993 Universal Healthcare plan. But she still has a long way to go before it actually become viable, in my opinion. Especial in the areas if Inter-State Commerce.