Health Care is THE critical issue for me. I believe in Health Care for Everyone and I've judged all candidates since 1992 on that issue. I wasn't happy with Hillary last year when she implied that it wasn't a priority for her -- that it would be sometime in her second term before she could promise universal access. It was Edward's health care plan with its public option (giving us the choice of bypassing private insurance companies) that drew me to him. Now that he's out of the race, I've got to figure out if either of the two remaining candidates have anything comparable.
I don't particularly like the way Obama has attacked the concept of "mandates" in Hillary's plan. But I didn't immediately dismiss it either. Because -- affordable or not -- the idea of a law requiring us to buy private health insurance is deeply repugnant to me: it's just another government give-away to corporations. So I went to Hillary's site to read her plan for myself.
I was pleasantly surprised. We've heard her say that she'd give us all the option to buy into the Federal plan. But did you know that Hillary has added an idea similar to the Edwards Plan -- that she's now proposing a public option (similar to Medicare)?
- Keep Current Health Care Coverage: Americans who are satisfied with the coverage they have today can keep it. Nothing would interfere with their insurance or their relationship with their health care provider. The only significant change they will see will be lower costs and higher quality health care as the modernization initiatives to improve value in our health care system take effect and as the achievement of seamless coverage reduces the hidden tax on premiums that comes from current cost-shifting.
- A Choice of Health Plan Options: Businesses, employees, and the uninsured will have the option of buying group insurance through a new Health Choices Menu. This Menu will give all Americans the same set of insurance options that their Member of Congress has. Without creating new bureaucracy, the Menu will be part of the Federal Employee Health Benefit Program (FEHBP), which includes numerous, high-quality private health insurance options. The Health Choices Menu will have the purchasing power of millions of Americans in securing high-quality and affordable insurance. States will also have the option of banding together to offer the same type of choices in a region of the country if they wish. The benefits will be as good as those offered to Members of Congress. Such coverage includes mental health parity, and many plans offer dental coverage. In addition, as a condition of doing business with the federal government, insurers must cover high priority preventive services that experts agree are proven and effective. This focus on prevention will improve health and lower costs in the long run.
- A Choice of a Public Plan Option: In addition to the array of private insurance choices offered, the Health Choices Menu will also provide Americans with a choice of a public plan option, which could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options in the Health Choices Menu without creating a new bureaucracy. The alternative will compete on a level playing field with traditional private insurance plans. It will provide a more affordable option, in part through greater administrative savings. It will not be funded through the Medicare trust fund.
I'd rather we had single-payer health care, but considering the political realities, these options make this plan it a winner for me. If we have the option of getting a Government managed program -- then I'm in almost whole-heartedly.
Addressing the issue of affordability, on page nine she acknowledges that the average family is now spending over $12,000 a year for insurance & that's way too much:
Americans value health care and coverage, but its cost is often prohibitive. Over half of the uninsured in a recent survey said they couldn't afford it.(viii) This is not a surprise. The average family premium for employer-based coverage (including employer and employee contributions) is over $12,000.(ix) For half of Americans, this total premium accounts for at least one-fourth of their annual income.(x) This helps explain why two-thirds of the uninsured have incomes below 200 percent of the poverty limit (roughly $40,000 per year for a family of four). The cost of insurance is a serious barrier to coverage for people
with high health care needs or limited access to job-based insurance.
I've read about the Tax Credits as a way to make her plan affordable and I know that a lot of people have problems with their effectiveness in making this insurance (and is it insurance if you've chosen the public plan?) affordable. I do too. But she goes on to say that under her plan premiums will be capped at a Percentage of Income which (depending on the percentage) I think is entirely reasonable:
The American Health Choices Plan will make health insurance more affordable for the millions of Americans who want it. It includes a number of straightforward policies to achieve this end:
- Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have skyrocketed over the last several years – nearly double since 2000. The American Health Choices Plan helps working families afford coverage through refundable, income-related tax credits to ensure that accessible, high-quality health coverage is affordable to all.
- Limiting Premium Payments to a Percentage of Income: This credit will ensure that securing quality health care is never a crushing burden for any working family. This guarantee will be achieved through a premium affordability tax credit that ensures that health premiums never rise above a certain percentage of family income. The tax credit will be indexed over time, and designed to maintain consumer price consciousness in choosing health plans, even for those who reach the percentage of income limit. (emphasis mine)
Ordinarily I'd be deeply skeptical of the phrase, "certain percentage of family income" because past experience tells me that wealthy politicians have wildly different assumptions about affordability than I do. But Clinton's acknowledgment that a quarter of our income is too much makes me hopeful that she'll have a realistic percentage when she makes the actual proposal.
Her plan and the Health Care Resources (see the sidebar) Are impressive:
There's her Agenda for Reproductive Health Care:
On Anniversary Of Roe, Clinton Announces Agenda For Reproductive Health Care
"When I'm President, I will appoint judges to our courts who understand that Roe v. Wade isn't just binding legal precedent, it is the touchstone of our reproductive freedom, the embodiment of our most fundamental rights, and no one - no judge, no governor, no Senator, no President - has the right to take it away."
(snip)
"On the 35th anniversary of Roe v. Wade, I am reaffirming my commitment to safe, legal, and rare abortion, and unveiling an agenda for decreasing the number of unintended pregnancies in the U.S. through honest and complete sex education and expanded access to contraception and family planning," said Clinton.
(snip)
Enacting the Freedom of Choice Act - Hillary will sign into law the Freedom of Choice Act, which would codify Roe v. Wade and send a renewed signal to the courts that the will of Congress and the President is to keep abortion legal.
Increasing access to family planning services. Hillary will expand the national family planning program (Title X) and extend Medicaid coverage for family planning services to women who are eligible for pregnancy-related care.
Ensuring that private health plans offer the same level of coverage for contraception as they do for other prescription drugs and services. Massive shifts have occurred in the number of women with access to contraception through their health insurance over the past 15 years. In 1993, according to testimony by the Executive Director of the Women's Research and Education Institute, women typically spent 68% more in out-of-pocket health care costs than men, a difference that was largely accounted for through reproductive health services.
Ensuring that women who survive sexual assault have access to emergency contraception (EC) upon request. Emergency contraception is a safe and effective way to help women who may be at risk for an unintended pregnancy. Yet, according to seven years of data from the Centers for Disease Control, fewer than half of all women who visited an emergency room after a sexual assault received emergency contraception
Implementing important public education initiatives about EC. Emergency contraception is a safe, effective back-up birth control method that reduces the risk of pregnancy by 75% [Boonstra, AGI, 2002]. Despite the widely acknowledged safety, efficacy, and acceptability of EC, many women do not know EC is an option for them and only 6% of women have ever used it [Kaiser Family Foundation, 2005]. Hillary would support efforts to increase awareness so that women can have full information about this proven option.
Restoring the discount for birth control on college campuses and community health centers. The Deficit Reduction Act of 2005 eliminated the ability of college health clinics and about 400 community health centers to receive deep discounts on contraception and pass those savings onto students.
And the page goes on... And THAT's only one of the resources she's put together. See the sidebar on this page for even more details.
For me it's enough to justify my decision to stand up for her at my Kansas Caucus on Tuesday. And I offer this diary to those who might also be interested in this issue.