By Jennifer Popik, JD, Robert Powell Center for Medical Ethics
Former President Bill Clinton is turning heads after a surprise attack on the Obama Health Care law (Obamacare). Clinton told a crowd at a campaign rally in Michigan on Monday
You’ve got this crazy system where all of a sudden 25 million more people have health care, and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half and it’s the craziest thing in the world…Figure out an affordable rate and let people use that. Something that won’t undermine your quality of life, won’t interfere with your ability to make expenses and save money, and let people buy into Medicare or Medicaid.
While many of those who have seen undesirable changes to their healthcare over the past few years under the Obama Health Care Law might see this as a welcome statement, something potentially worse is lurking under a Hillary Clinton presidency.
Secretary Clinton has promised a plan that expands government control of healthcare and, contrary to her husband’s claim, takes aim at those perceived as having a low “quality of life.”
Bill Clinton is correct that the Obama healthcare law has not lived up to its many promises. You do not have to look far to see a staggering number of problems piling up.
Insurers are leaving the exchange markets all across the country, and people are seeing plans that cover less and less every year.
Robert Pear’s New York Times October 2, 2016, article entitled, “Ailing Obama Health Care Act May Have to Change to Survive” notes
The marketplace faces a major test in the fourth annual open enrollment season, which starts on Nov. 1, a week before Election Day. In many counties, consumers will see higher premiums and fewer insurers, as Aetna, Humana and UnitedHealth have curtailed their participation in the exchanges, and many of the nonprofit insurance cooperatives, created with federal money, have shut down.
This comes as no surprise to the many legal observers, National Right to Life included, who warned that the Obama health care law over-promised, under-funded, and contained multiple provisions meant to reduce American’s health care usage.
The dramatic flight of insurers from the state exchanges made national headlines this past August. While many are quick to blame insurers, the real culprit is likely an Obamacare provision: exchange bureaucrats must exclude insurers who offer policies deemed to allow “excessive or unjustified” health care spending by their policyholders.
Insurers are quoted as having their eye on managing rates hikes, in spite of the fact that these rate hikes are often necessary to maintain access to the best doctors and hospitals. This has been particularly difficult, or impossible, due to the fact that people who signed up had previously gone without insurance and tend to be less healthy than average.
To borrow the words of Bill Clinton, the ‘craziest thing in the world’ is not the failing health care law, but that candidate Hillary Clinton and many of her allies are calling for even more government control of health care in order to deal with the ongoing problems.
While Secretary Clinton is often accused of pandering to whatever audience she hopes to cull for votes, government control of healthcare is one example where she does not need to be persuaded.
While on the campaign trail, Mrs. Clinton has issued repeated calls to resurrect the defunct “public option” and to allow people to buy into Medicare and Medicaid. In addition, on her campaign website she writes, “Hillary believes that workers should share in slower growth of national health care spending through lower costs.”
While this certainly sounds appealing (who wants higher costs?), the sort of mechanisms that will be used can and will lead to the rationing of life-saving health care.
Looking back to 1993, then-first lady Hillary Clinton played an integral role in developing “Health Security: The President’s Report to the American People.”
Testifying about the plan, Mrs. Clinton told the Senate Finance Committee on Sept. 30, 1993, that under the proposal, “[P]eople will know that they are not being denied treatment for any reason other than it is not appropriate–will not enhance or save the quality of life.” [emphasis added]
In short, she admits that poor “quality of life” will be a basis for treatment denial. Based on Clinton’s current proposals, we can expect that this will still be a guiding principle.
From the pro-life standpoint, arbitrarily denying treatment is especially troubling because of the tendency of health care providers to allocate health care based on assumptions about various individuals’ so-called “quality of life” — which usually amounts to discrimination based on age, disability, or condition of dependency.
While Mrs. Clinton’s plan had many obvious sinister elements at the time, such as numerous unaccountable health care boards that would decide what treatments Americans would and would not be denied, her plan today is suffused with softer talking points but many of the same ideas.
Put another way, it is simply a wolf in sheep’s clothing and we can expect those perceived as having a low “quality of life” to suffer the worst.
Look at one example from her current plan–Secretary Clinton’s call for premium caps. But premium caps will rise far less than health care cost inflation. The resulting cost squeeze will force rationing.
Each year the health plan you select (be it a private plan or a public option) will have less money in “real” dollars (the value of the dollar adjusted for health cost inflation). Something will have to give: the health plan will have to cut down more and more each year on the treatment and access to specialists it makes available.
With one of the most hotly contested elections looming, many Democrat members of Congress are calling for changes to the Obama health care law and nearly all Republican members are calling for repeal and replacement of most of the law.
Secretary Clinton’s desire to expand the government’s role in health care is clear.
Donald Trump has a dramatically different plan to return much of the control of health care choices to the public. Details of his plan can be found at donaldjtrump.com/positions/healthcare-reform
We cannot allow four more years in which the Obama health care law, or a potential expansion of it, chokes out American’s access to insurance and life-saving medical care.