Clinton Unveils Health Care Plan
DES MOINES, Sept. 17 - Sen. Hillary Rodham Clinton (D-N.Y.) unveiled her long-awaited proposal for health-care coverage here on Monday, describing a plan that would pair government resources with private insurance plans to help insure all Americans. She emphatically declared that her program would "not create a single new government department, agency or bureaucracy."
"It is not a government takeover of health care," Clinton said.
More than 13 years after she failed, while first lady, in an attempt to overhaul the national health-care system, Clinton's speech marked an important moment in her presidential race, as she sought to capitalize on her reputation as a health-care advocate and turn her earlier defeat into an advantage. Clinton earned credit at the time for confronting the health-care system on behalf of her husband, President Bill Clinton, but the ordeal also shaped her image as a polarizing figure.
Clinton has often joked about having "scars" from her 1993 attempt. In her speech today, she took it a step further, mapping out an approach that she said reflected political lessons learned.
Although the program would require individuals to obtain insurance and large companies to help insure employees, the program would also rely on tax credits and allow satisfied patients to retain aspects of the current system. It would expand Medicaid, and be paid for, at least in part, by allowing tax cuts for taxpayers earning more than $250,000 a year to expire.
Clinton used the words "choice" or "choose" more than a dozen times in her approximately 45 minute address. But her goals, she said, were sweeping: to provide health insurance for every American, including the 47 million who are currently uninsured, and to make it affordable and cost-effective.
"I know just how hard this fight will be," Clinton said at Broadlawns Medical Center. "But that is why I'm running for
president - because I'm ready, with you, to help write a story, the story of how we finally put aside our differences and faced up to our challenges, a story of how people of good faith and good will came together and worked out a solution."
She said: "We can no longer tolerate the injustice of a system that shuts out nearly one in six Americans. Ultimately this is about who we are as a people and what we stand for. We can talk all we want about freedom and opportunity and life, liberty and the pursuit of happiness. But what does all that mean to a mother or a father who can't take a sick child to the doctor?"
Clinton and her advisers said that for middle class families, health-care premiums will never exceed a certain percentage of their incomes, the result of a tax credit specially designed to make health care a more reasonable part of a family budget. They said repeatedly, in her speech and in a briefing that followed, that patients satisfied with their care would be allowed to leave things as they are.
"The first rule of medicine is 'do no harm,' and we will do no harm to the parts of our system that are working, and we will build on them," Clinton said.
Her rivals quickly pounced on the proposal, saying her failure in the early 1990s had already done enough damage.
"While she talks about the political scars she bears, the personal scars borne by the American people are far greater," said Sen. Christopher J. Dodd (D-Conn.), who is running for president. "The mismanagement of the effort in 1993 and 1994 has set back our ability to move toward universal health care immeasurably."
Former senator John Edwards (D-N.C.), who proposed a universal health-care plan earlier this year, said Clinton's plan failed to take on the insurance industry strongly enough.
"The lesson Senator Clinton seems to have learned from her experience with health care is, 'If you can't beat 'em, join 'em.' I learned a very different lesson from decades of fighting powerful interests - you can never join 'em, you just have to beat 'em," he said.
Sen. Barack Obama (D-Ill.) issued a statement lauding Clinton's effort but suggesting that he would be better suited to accomplishing a healthcare overhaul because of his ability to achieve consensus.
"I commend Senator Clinton for her health care proposal," Obama said. "It's similar to the one I put forth last spring, though my universal health-care plan would go further in reducing the punishing cost of health care than any other proposal that's been offered in this campaign. But the real key to passing any health-care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change."
Gene Sperling, a campaign adviser who worked on the first Clinton health-care effort when he served on the White House staff, said the Clinton plan would be financed by letting elements of the Bush tax cuts affecting high-income earners expire, although he said over time that her proposals for reducing medical costs would also help pay for the program.
"She felt very strongly it was important to show we were reversing the irresponsibility we've seen over the last years," Sperling said.
Sperling said there were at least three major differences between the 1993 proposal and the current one: It would not require patients to enter into a national alliance, but instead allow people to keep their existing coverage; it would not have a single government entity making decisions; and it would not penalize small businesses for failing to provide insurance but would instead encourage them through tax credits.
"It is a simpler plan," Sperling said. "It allows people who are happy with their coverage to keep their coverage. It not only doesn't have any major new bureaucracy, it relies much more on choice and competition to keep prices down."
"We're not writing every single detail of this plan," said Laurie Rubiner, Clinton's top health-care policy adviser, adding that Clinton learned her lesson in trying to be overly prescriptive. "We're going to leave a lot of this to the congressional committees."
--Anne E. Kornblut and Perry Bacon
For more on Clinton's health plan, read her discussion with David Broder.
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