In a series of speeches last week to debut the third and final piece of her healthcare reform platform, Democratic presidential hopeful Sen. Hillary Rodham Clinton (D-N.Y.) spanked the insurance lobby, the GOP and a White House that supports tax cuts for drug companies instead of healthcare for every child.
But in speeches and in practice, Clinton has shown an understanding that all three of those forces will be needed if she wants her healthcare platform to pass. The idea is not to put the health insurance industry out of business, but to help it find a better way to make a living, she said during a closely watched Sept. 17 speech at 89-bed Broadlawns Medical Center in politically important Des Moines, Iowa.
And maybe because of that, the return fire from the healthcare industry seemed almost tepid in comparison. The new Clinton plan includes important ideas to make coverage more affordable (but) unfortunately, some of the divisive rhetoric seems reminiscent of 1993, said Karen Ignagni, president and chief executive of Americas Health Insurance Plans.
Both the American Hospital Association and the American Medical Association released statements lauding the senator for addressing the issue of universal healthcare, though neither group endorses candidates.
Clinton walks a finer line than the rest of the presidential field when it comes to health reform, given her failed effort when she was first lady.
Jacob Hacker, professor of political science at Yale University, said that while the overall climate has changed since Clintons first attempt at reform, some of the same barriers that worked to scuttle her plan the first time still exist.
Under Clintons new American Health Choices Plan, individuals would be allowed to keep their current health insurance policies if they want, or choose private health plans. A public option, similar to Medicare, would also be included, she said.
While every individual would be required to have insurance, large employers are also on the hook to offer coverage and to pay for employee healthcare costs, Clinton said. Small businesses, however, would be exempt from the mandate, but would be asked to parlay tax credits to help pay for costs.
Clinton said she expects at least half the $110 billion estimated cost of the plan to come from public savings generated from modernizing the health system and reducing wasteful health spending. Extra savings would come from rollbacks to Bush administration tax cuts and by limiting tax breaks for people making more than $250,000 a year.
Central to the plan is a mandate that health insurance companies stop what Clinton called the discriminatory practices they use to deny coverage to people with pre-existing conditions or those who are genetically predisposed to illness.