Clinton's Health Plan: Lofty Goals, Few Specifics

NCPA'S Goodman Says Mandating Insurance Doesn't Work

DALLAS, Sept. 17 /PRNewswire-USNewswire/ -- Presidential candidate Hillary Clinton unveiled her long awaited health care plan in Iowa today. The following is a response to the plan by National Center for Policy Analysis (NCPA) President John C. Goodman:

"Universal coverage at a minimum requires a credible plan. So far, no presidential candidate -- Hillary included -- has come up with one. We can't mandate our way to universal coverage. Even if health insurance is absolutely free, mandates don't work. If anything, they may make matters worse."

Here are five principles politicians tend to overlook:

-- Employer mandates don't work. Hawaii has had an employer mandate
for more than 30 years; and the uninsurance rate in Hawaii is higher
than in several states that have no mandate. A mandate is a tax on
labor. Employers respond by economizing on labor as well as by
turning to part time and contract workers. Pay or play mandates
(insure your employees or pay a fine) have the same effect.

-- Individual mandates don't work. All but three states mandate auto
liability insurance. Yet the national uninsurance rate for drivers
is only a point or two below the national uninsurance rate for health.

-- A mandated benefit package only makes things worse. Health insurance
mandates almost always specify a package of benefits that people must
buy. The problem here is: the cost of the package is going to grow at
twice the rate of people's incomes. So the mandate will absorb an
increasing share of family income or will require increasing tax
subsides. Things are made even worse as special interests lobby to
include particular services and procedures in the package.

-- Insurance in name only is not universal care. The most important
barrier to care for low-income patients is not lack of insurance or
price rationing. It is rationing by waiting. Further, the uninsured
and Medicaid and S-CHIP enrollees often get care from the same
doctors and same facilities. Indeed one reason why so many eligible
people fail to enroll in government insurance plans is that
enrollment often doesn't expand access to care.

-- Pay or play for individuals is not enough. Making individuals pay
more in taxes if they are uninsured is not unreasonable. In fact, we
do that already under federal income and payroll tax laws. But as
Massachusetts is currently finding out, many people will pay the fine
and remain uninsured anyway.