A look at Hillary Clinton’s Health Care Plan taken from prepared remarks for a speech at George Washington University on 5/24/07 and the corresponding document plan on her Web site.

Why We Need It
“Our present system is outdated, ineffective, and unsustainable. But we know we can spend far less and create an efficient, high-quality health care system for all Americans.”

With millions of Americans uninsured and millions more paying more for care this issue has been for many years and will continue to be a major one in presidential campaigns. So what does Sen. Clinton propose?

What It Does
Clinton has a three part approach
- First, lowering costs for everyone.
- Second, improving quality for everyone.
- Third, insuring everyone.

Her speech focused in on part 1 which is what we will focus on here.

Clinton says we spend $2 trillion a year or 16% of our GDP on health care and she uses an estimate that says by 2016 it will be over $4 trillion. This is more than any other “wealthy” nation in terms of cost per individual. Why?

1) She says, 30% of the rising cost is caused by obesity.
2) Administrative costs. She says “64% of private insurance plans’ administrative costs are dedicated to underwriting health risks, sales, and marketing.”

Meanwhile we waste money on care that isn’t necessary. She points to a study that shows 1 in 5 X-Rays & lab tests are done because the doctor doesn’t have access to previous results.

So we spend on administrative costs but poor service and poor administration we receive in exchange leads to additional higher costs.

We pay more than the rest of the world but our health care system is ranked very low. Clinton says “Our health care system is plagued with under-use, overuse and misuse.”

Seven Point Plan
The first part of her three part proposal has a seven point plan. Get out your bullet points!

Those seven points are:

• First prevention. Clinton wants to see everyone have access to the best preventative care. An example. Insurance companies won’t currently pay for someone who is pre-screened for diabetes to goto a nutritionist. They will however pay for that person to get their leg amputated from diabetes. Proper nutrition/exercise etc. could prevent a great deal of expensive long-term spending. Insurance companies would be given incentives (not sure what kind) to support preventative care.

  “Under my plan, all insurers who are already participating in a federal health program like Medicare or Medicaid or the federal employee’s health benefit plan will have to cover prevention as a condition of doing business with the Federal government.”

  In addition the hope is to put more responsibility on individuals. Patients need to actually follow a doctors prescription, take all medicine and follow along with preventive care to lower costs. That sounds like a very difficult task.

• Second modernization. Clinton wants to see the reliance on paper records end and the health care industry to modernize. (IBM & others are already doing a lot of research and work on this). Currently it costs $1.60 to $2.20 to process a paper claim. Estimates say it will cost $.85 to process an electronic claim.

  Information technology can also be used to disseminate research directly to clinicians.

• Third coordinate & streamline chronic care. She proposed “homes” - “That’s why my proposal would require that Americans with costly, hard to manage illnesses have access to state-of-the-art chronic care coordination models under federally-funded plans, like Medicare and the Federal Employees Health Benefits (FEHBP) plan”.

  Basically a patient would goto one state of the art source that would coordinate all of their care. So every doctor would know what the other doctors were doing and health care could be given completely and in sync.

• Fourth offer individuals & small business the ability to join larger market “pools” to lower their insurance costs. Small businesses and individuals without a corporate plan currently pay more and workers can be denied coverage if they have pre-existing, chronic illness. By spreading the “risk” into larger pools costs ideally would go down as they do in corporate environments.

• Fifth create an “independent public-private Best Practices Institute”. This partnership between the public and private sector would work “to finance comparative effectiveness research, so that doctors, nurses and other health professionals — as well as consumers and businesses — would know what drugs, devices, surgeries and treatments work best”.

  Part of this “will provide incentives to encourage doctors to keep up with the research and prescribe the most effective treatments.”

• Sixth lowering prescription drug prices. She would allow Medicare to negotiate lower drug costs which would in turn help lower them for everyone. Would allow for the importation of foreign drugs into the marketplace. Breakup the biotech pharmaceutical companies monopoly and allow generic biotech drug makers to get into the market.

• Seventh reform medical malpractice. Pass a “National Medical Error Disclosure and Compensation (MEDiC) Act” which would “encourage physicians, hospitals and health systems to provide liability protections for physicians who disclose medical errors to patients and offer to enter into negotiations for fair compensation”.

Why Should We Buy Into It?
Senator Clinton has tackled health care reform before, specifically very early on in her husbands presidency.

“Now, I’ve tangled with this issue before — and I’ve got the scars to show for it.”

Clinton says she has learned from her mistakes. What did she learn?
“One is that we can’t achieve reform without the participation and commitment of health care providers, employers, employees and other citizens who pay for, depend upon, and actually deliver health care services.”

She also says:
“I think we finally have a recognition that everyone sees there is an economic imperative to rein in costs. There is a moral imperative to extend coverage to all Americans. And, there is a practical necessity to promote wellness and prevent illness wherever possible. I plan to put those lessons to work to ensure every single American has quality, affordable health coverage.”

Why Shouldn’t We Go Along With Her Plan?

Because Senator Clinton has tried to do health care reform before, specifically early into her husbands presidency and it was a massive failure. She says she has learned but we’ve seen little real movement on this issue since 1992/93. Clinton says we have finally reached a point where everyone understands the necessity, if that were true the scores of others trying to reform the system would probably have made some progress.

Bottom Line
Obviously this is the beginning of a plan but in many ways its one of the most important. Reducing costs is what Americans need right now. There are some good ideas here, nothing too original but in her seven points there are things people are starting to come into agreement on.

The medical industry has traditionally been against modernizing (point 2). There is a growing movement, especially amongst those in the technology field, to force the industry to modernize. Every other industry on the planet has modernized and accepted electronic record keeping. The health care industry, for various reasons has not. With that said it is obviously something that they will one day or another have to accept. A national push from the president could really help.

Prevention (point 1) is something that could easily get warped. Its perhaps the most important of them all BUT I could easily see people running ads saying “Hillary Clinton thinks paying for massages and Yoga classes is the best way toward Health Care reform.”

The prescription drug plans again aren’t going to make her too popular with the health care lobby BUT it is something most Americans undoubtedly will embrace regardless of the candidate pushing it.

Overall it is a rather balanced, conservative but still forward thinking plan. The real explosive stuff, if there will be any, should be under the “health care for everyone” title.

Related

See Barack Obama’s Health Care Plan