Senator Clinton would require Americans to have health insurance, and she would provide expensive new government subsidies to help households pay the premiums.
But what would she do to slow health-care cost inflation? Not much, it seems. Her answers (for now) — better health-information technology, more disease management, prevention initiatives — are politically safe but unlikely to put a significant dent in costs.
Premiums will therefore continue to rise faster than household income, leaving her with three options: higher premiums for consumers, more spending on subsidies by the government, or government-imposed cost controls on insurers. Does anyone doubt a Clinton administration would eventually choose to impose limits on premiums to spare consumers and the government the added cost? That’s when her plan becomes government-run health care.
Moving to a functional, market-based health-care system requires complete reform of the tax treatment of health care, as most Republicans now recognize. It also requires fixing the Medicare and Medicaid entitlements to encourage price competition rather than ever higher use of services.
Senator Clinton’s plan does none of this (save for a token limit on upper income tax subsidies). Like 1993, she would inevitably turn to the government to control costs.
— James C. Capretta, a fellow at the Ethics and Public Policy Center, was an associate director at the Office of Management and Budget from 2001 to 2004.