February 15, 2008
Update: The plot thickens, as the indispensible Grace-Marie Turner reminds us:
Hillary Clinton criticized an individual mandate in 1994, saying, "The individual mandate...makes it very difficult to determine and monitor who is in the system and who is out. It would require tracking individuals as they move in and out of jobs, as they move in and out of the insurance market. It would require, in our view, the IRS to engage in an enormous administrative oversight of our health care system."***
Senator and presidential candidate Hillary Clinton (D-NY) has made “health care for all Americans” a major plank in her policy platform since the beginning of her run for President last year – though, as those who are familiar with the junior Senator from New York and former First Lady’s history will recall, radical changes to America’s health care system have been a cause dear to Mrs. Clinton’s heart for the better part of the last two decades at least.
The program Mrs. Clinton is currently touting as her solution to the problems in America’s health care system – particularly its high number of uninsured citizens – is officially called the “American Health Choices Plan,” though it is less-than-affectionately referred to by some as “HillaryCare II” in reference to her failed attempt to push a government health care system on the nation during the first years of her husband’s presidency. Under this program, the government alone, with no input from the free market, responsible for the regulation and management of health care. Oxymoronically, the plan whose formal title includes the term “choice” is built around what is known as an “individual mandate” – a government requirement that all Americans, regardless of income or choice, possess at least a (government-established) minimal level of health insurance.
The inclusion of this individual mandate means, of course, that should this plan go into effect, choice at its most basic level – the choice whether or not to have a certain level of coverage (or to have coverage at all) – would be eradicated.
Further, though there would still be Americans who cannot afford health coverage, the mandate would apply to them as well, causing them to be in violation of federal law simply because they cannot afford to comply.
This situation would be exacerbated by the fact that, with every single individual in our nation of the 300 million being required to purchase coverage, demand will become an inelastic element in the economic equation that determines the pricing of health insurance. In other words, prices would continue to rise in response to a new law requiring every person in the nation to purchase insurance regardless of that service’s price.
Mrs. Clinton’s opponent in the Democratic presidential primary asked about this at a debate, saying, “You can mandate [that every American must have health insurance] but there will still be people who can’t afford it. And if they can't afford it, what are you going to fine them? Are you going to garnish their wages?”
The question was answered soon after, as Mrs. Clinton told George Stephanopoulos on ABC’s Sunday morning show that her “enforcement mechanism” could indeed include “going after people’s wages.”
Mrs. Clinton’s admission that she does indeed intend to force every American to have a government-decreed minimum level of health coverage – and that she intends to enforce this by using the power of government to go after working Americans’ income – belies the “choice”-based title of her proposed program. If government mandates that every American purchase something, and uses its power of taxation and wage garnishment to enforce this, then the resulting system may well be closer to being “universal” than any past program, but any semblance of that program’s having a voluntary nature or allowing “choice” has gone right out the window.
This inability to reconcile the opposing natures of universality and choice (or voluntary participation) is, unfortunately, not a new problem for Mrs. Clinton. In 2005, she gave a speech (which was later reprinted as an op-ed in several newspapers) based on Martin Luther King’s famous “I have a dream” oration. In this speech, she envisioned America’s future after her fictional presidency. Among other musings, Mrs. Clinton said that a look at our country after her terms would show that “our universal, voluntary national-service program includes civil-defense workers who supplement our brave first-responders and share the burden of vigilance at home.”
At the time, she shed no light on just how she planned to accomplish the feat of making her national-service program both universal and voluntary. This would, of course, be quite an accomplishment, as obviously a universal program includes all and is thus not voluntary, and a voluntary program will always be far short of universal.
Likewise with her “universal” health care “choice” plan. The fact that Mrs. Clinton currently intends to build her health care plan through forced enrollment – to the point of forcibly taking earned income from American workers to pay for it – while still invoking the theme of consumer “choice” shows that she has still not learned that “universal” and “voluntary” are mutually exclusive attributes.
In reality, Mrs. Clinton’s individual mandate is a call for government to use its power to force people to accept and enroll in a program they may not want or be able to afford. When the fact that the ranks of our uninsured are filled primarily with people who lack health coverage for precisely one of these two reasons is taken into account, this proposal is shown for the undesirable overreach of government responsibility that it is.
Rather than continuing down this path of bigger and more intrusive government that regulates and interferes in people’s lives and wallets, Mrs. Clinton should spend a few minutes studying the free market and learning how things like choice and volunteerism really work. If she is interested, we can point her in the right direction to get started.
Jeff Emanuel is a fellow with The Heartland Institute and managing editor of Health Care News.
- At 1:52 PM, said...
Jeff-in case your health plan is free and you are not aware that many of us, I would ad..most of us are already paying into our health care plan. We are paying for a lot of nothing. $1000. deductables and no choice..all for almost 500. per month. Guess what? I have yet to use the insurance but continue to pay and eah year my premiums are increased.
That is one of the problems and Mrs Clinton is addressing this. You may not contribute to your health plan but it is a lot of money that many of us pay. Wouldn't it be better if we all paid some but less? Wether it is my responsibility, my employer (if you are lucky enough to have an employer who can contribute) or a combination is better that no health care like the hundreds of homeless men and women I see sleeping on the streets every night..with children Jeff. I don't mind paying if I am assured those children, single Moms and Vets are covered. Unlike you Jeff, they obviously cannot take care of themselves. I will gladly pay my fair share and a little extra for those who cannot pay. I would prefer to see my tax dollars spent on Americans first....Jeff please pay attention to what you are talking about. Look around. There are alot of people who need help with the burdens of life.