by John M. Curtis
(310) 204-8700

Copyright September 14, 2007
All Rights Reserved.

lose to revealing her new national healthcare plan, Democratic presidential candidate Sen. Hillary Rodham Clinton (D-N.Y.) offered few clues about her new proposal, hoping to avoid past mistakes, where she watched her last attempt in 1993 crash-and-burn. With healthcare costs spiraling out of control and with around 47 million Americans without insurance, Hillary hopes to ride a national wave toward universal coverage. Back in 1993, Hillary's plan failed because the powerful insurance lobby opposed key provisions requiring employers to foot the bill, demanding employees join HMOs. It's not clear why her plan was opposed by the insurance industry when they stood to gain with the government demanding more coverage. Hillary's old plan would have placed an undue burden on employers, specifically small businesses—the backbone of an entrepreneurial society.

      While the GOP looks for raw meat, Hillary must present a proposal that already has a dependable track record. Republican candidates are blasting Democrats' universal plan as fiscally unsound and bad medicine. They accuse Democrats trying to turn the best system in the world into another socialized boondoggle, like the plans in the U.K., Europe and Canada. Presidential candidate former Sen. John R. Edwards (D-N.C.), who wants to expand Medicare to cover every eligible man, woman and child in the U.S, offered an intriguing plan. Whether the GOP admits it or not, the U.S. has had single-payer national healthcare since 1964, when former President Lyndon B. Johnson passed Medicare, covering seniors and the disabled. Medicare offers a single-payer system, allowing beneficiaries to see the doctors of their choice. Medicare also offers the option of joining HMOs.

      Hillary stakes her candidacy and reputation on pulling off a new national healthcare plan. Voters following her campaign expect her to produce the most viable plan of all serious presidential contenders. “It's very tricky for her,” said Robert Blendon, professor of health policy and political analysis at Harvard University in Cambridge, Mass., knowing the extent of the nation's divisions. “But she's not going to get elected president unless she can get through to people on healthcare,” said Washington policy analyst Bob Laszeweski, overstating the importance of Hillary's healthcare plan. Picking the wrong plan like she did in 1993, would give other Democratic candidates an opening. So far, her candidacy has been relatively error-free, solidifying her front-runner status. When she floats her plan next week, it's expected to be more cautious.

      Democratic presidential candidate Sen. Barack Obama (D-Il.) has already backed a plan to cover the nation's uninsured children. Barack wagered most his capital on ending the Iraq War, showing less fervor on universal care. While he's trying to avoid Hillary's mistake in 1993, his current proposals don't go far enough. “She's working against an impression,” said Andrew Stern, president of the Service Employees International Union, believing her new proposal will be more palatable. Her 1993 “Hillarycare” placed too much burden on employers and forced employees into HMOs, the wrong place to invest healthcare dollars. If she follows Edward's lead, she'd have far fewer objections, especially from Republicans leery of more socialized programs like government clinics and HMOs. Whatever plan emerges will come with the conundrum of how to finance it.

      Increasing the payroll tax for Medicare or any other tax hike would give the GOP ammunition to beat Hillary in the general election. With the economy teetering and the Fed poised to lower interest rates at its Sept. 18 Open Market Committee meeting, tax increases would be seen as harming the economy. “I intend to dramatically reign-in the influence of insurance companies,” said Clinton during a Sept. 12 Internet forum on Yahoo.com. “They have worked to the detriment of our economy and our healthcare system,” raising the prospects of another bitter fight. Hillary's plan shouldn't blame the insurance industry but show how her plan intends to make them money. Edward's plan of expanding Medicare offers insurance companies the prospects of thriving by offering more senior HMO plans. Universal coverage could offer insurance companies an unexpected windfall.

      Iraq War-fatigue has galvanized interest in new domestic proposals, especially the prospects of universal healthcare. War-fatigue has also given a flu-bug to GOP candidates showing allegiance to the Bush policy. With so many lives lost and so much tax revenue wasted, voters look toward exciting new domestic programs that directly benefit them. If Hillary rehashes her old plan and tries to pass the problem onto employers and push subscribers into HMOs, history will repeat itself. If, on the other hand, she uses Edwards' blueprint of expanding Medicare—the nation's most successful healthcare program—she'll find greater receptivity. It's going to be difficult selling national healthcare when the government spends $10 billion a month on Iraq. Hillary will have to find a way to pay for her plan without punishing middle class voters and harming the economy.

About the Author

John M. Curtis writes politically neutral commentary analyzing spin in national and global news. He's editor of OnlineColumnist.com and author of Dodging The Bullet and Operation Charisma.

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