Magic Asterisks And Clinton’s Healthcare Plan

With all of the attention paid to Sanders’ single-payer healthcare plan proposal, the details of Clinton’s healthcare plan have gone unexamined (boldface mine):

While policy analysts, news anchors, and columnists have been engaged in an intense debate over Bernie Sanders’s “Medicare for All” proposal, Clinton’s incremental alternative has escaped almost all scrutiny – even among those who say they prefer it…

None have mentioned a single Clinton healthcare proposal as a point of comparison – merely that she supports a philosphy of incremental reform….

What would happen if the media lifted the curtain on Clinton’s healthcare platform and introduced any level of scrutiny to her proposed improvements on the Affordable Care Act? They would find two categories of Clinton proposals: some that are so vague they’re difficult to evaluate, and other more concrete plans that follow in the footsteps of one of Congress’s most practiced healthcare incrementalists: Senator Bernie Sanders.

Here are the similarities:

For example, one of Clinton’s clearest incremental proposals is to repeal the Affordable Care Act’s poorly named “cadillac tax” on health plans with high premiums. She announced this proposal on September 29, drawing the ire of White House spokespeople. The move, however, followed in the footsteps of a Senate bill to repeal the Cadillac tax introduced by Bernie Sanders and seven Democratic Senators just a few days previously on September 24. Clinton’s position was correctly seen by reporters as necessary if she didn’t want to lose labor union support to Sanders.

Many of Clinton’s well-defined healthcare proposals are rolled into a package of prescription drug reforms, which she released on September 22, 2015. They bear a striking resemblance to the Sanders prescription drug plan announced on September 1, filed as legislation on September 10. Both would legalize importation of prescription drugs from Canada, where costs for identical drugs are much lower due to Canada’s single-payer healthcare system. Sanders was a pioneer of importation, and in 1999 started driving busloads of American patients who couldn’t afford breast cancer drugs across the Canadian border. Both candidates call for empowering Medicare to negotiate drug prices – even Donald Trump jumped on board in January. Both would ban “pay-for-delay” deals between brand-name and generic drug makers, and increase prescription drug rebates for Medicaid and/or Medicare.

But the best part is that magic asterisks aren’t for Paul Ryan any more:

Take the proposal to expand the use of Accountable Care Organizations. How? According to Clinton’s December policy brief: “In the coming months, [Clinton] will provide full detail on her plans for delivery system reforms that drive down costs.” With the primaries drawing to a close, no such details have been released. The same could be said of another proposal to “create a fallback process” to review insurance premium rate hikes in states that don’t already review rates. There has been no explanation of how such a plan would work, or whether it would require new legislation.

Could you imagine the shitstorm that would ensue if Sanders justified his program–one similar to those found in other countries and that works in those countries–with “delivery system reforms that drive down costs”? Might as well invoke pixie dust.

There are reasons to vote against Sanders, and there are reasons to vote for Clinton. But enough with the ‘Clinton is pragmatic’ bullshit. Her healthcare plan has enough vagueness to be worthy of Paul Ryan’s magic budgetary asterisks.

Between the ‘me-too-ism’ and the vagueness, one might think she really doesn’t want to change anything. Which is fine*, as long as you’re one of the people who can afford healthcare.

*Actually, it’s not fine at all. Between the massive wealth redistribution to healthcare administrators and healthcare insurers and the hassle of use (which is a feature, not a bug, as people will tend to give up trying to get reimbursed), it’s a shitty system.

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One Response to Magic Asterisks And Clinton’s Healthcare Plan

  1. Janice in Toronto says:

    You guys need to look north of your border. Socialized medicine isn’t perfect, but it’s light years ahead of anything you currently have. I works for us…

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