- The Washington Times - Monday, September 24, 2007

And now a few kind words about most recent model of Sen. Hillary Clinton’s health plan. Yes, you read that right. There are some good, even important features, about her “American Health Choices Plan.” That they are there means that Republican presidential candidates are going to have to do a lot better to compete against Hillary in the health-care department.

Mrs. Clinton is perfectly willing to let Sen. Barack Obama and former Sen. John Edwards, etc. pander to the far left of her party on health care. She has learned bitterly from that mistake, and so this time she stole from the conservative playbook by refusing to herd people into regional health plans as did the Health Security Act (President Clinton’s unsuccessful 1993 health-care initiative). Not only can Americans keep the health care they have, but they can take it with them from job to job. And just so we are clear, she is telling everyone there is no new bureaucracy, only a public-private partnership. Not only is this version of the Clinton health-care express a hybrid, but it leaves the heavy load of Michael Moore’s government-run health system in Hollywood so it will run more efficiently in the general election.

To be sure, it also runs on a lot of hot air. The numbers don’t add up. Mrs. Clinton asserts her plan will cost $110 billion a year. But that doesn’t count the $50 billion in SCHIP spending for families with incomes of up to $80,000 a year in Democratic congressional proposals. While she estimates that computerizing health records and adding an undefined menu of preventive care will generate $300 billion in savings, you first have to pay for them and the Congressional Budget Office rarely “scores” an expenditure as saving money. She buries the additional cost of forcing insurance companies to cover people who are buying insurance just to get a procedure paid for. That will drive up premiums and dump people into the waiting arms of government-run health plans. And since you get the same rate whether you are sick or healthy, whether you take care of yourself or not, the savings of preventive care are pretty much out the window. In a matter of years, Medicare and Medicare will be the dumping ground for most of us as private-sector premiums of one-size-fits-all plans that we have to sign up for become pretty much unaffordable. At that point Mrs. Clinton’s Best Practice Institute will become Central Command for rationing and price controls.

But much of that deconstruction is beside the point if the Republicans fail to come up with a bold health-care proposal of their own (a note to former Massachusetts Gov. Mitt Romney: a PowerPoint presentation doesn’t qualify). Such a proposal should make health care affordable, convenient and continuous. The GOP is locked into an esoteric debate over tax credits and tax deductions no one except Kool-Aid drinkers care about. In the past, Republicans have always used a mix of credits and deductions to promote consumer choice and investment in housing, education and child care.

Now, all of a sudden, if you support health-care tax credits you are no longer conservative? To quote Ronald Reagan: “Those who would sacrifice principle to theory, those who worship only the god of political, social and economic abstractions, ignoring the realities of everyday life. They are not conservatives.” At least one group of Republican lawmakers realize that the goal of policy-making is to advance ideas that increase opportunity instead of maintaining loyalty among ideological shock troops. Sens. Richard Burr, North Carolina Republican; Tom Coburn, Oklahoma Republican; Mel Martinez, Florida Republican; and Bob Corker, Tennessee Republican have developed the The Every American Insured Health Act. It take the tax subsidy for health insurance that now goes to corporations and give it individuals in the form of a tax credit.

The credit could be deposited automatically in an account much like a health savings account or flexible spending account to buy insurance or medical care anywhere in the United States tailored to their budget and medical needs. For the first time health plans could reward doctors for preventing disease and compete for customers by keeping them healthy and happy. The legislation reflects a Republican vision for health care that offers people choice and hope.

To that end, the senators should introduce their proposal in the wake of an anticipated presidential veto of the current SCHIP bill. Add on a provision to let Medicaid and SCHIP families convert their coverage into cash for private insurance. As a kicker they should add a provision giving people in the Veterans Administration (VA) health system the right to enroll in private plans. After all, as Mrs. Clinton told John Stossel of ABC News early this year, the VA health system is a model for health care everywhere.

It will lose, but let the Democrats — and some Republicans — vote against personalized, convenient and portable universal health care for all Americans. There was bipartisan opposition to the Kemp-Roth tax-cut proposal prior to President Reagan taking office. Defeat should be no deterrent to a bold idea. Mrs. Clinton’s GOP opponent will need a uniquely American health-care system to counter her slimmed down version of Michael Moore’s socialist solution. The Every American Insured Health Act can be the foundation of a forward-looking response. Simply trying to scare Americans about Hillarycare is not enough.

Robert Goldberg is vice president of the Center for Medicine in the Public Interest.

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