Politics & Policy

Bad Medicine

It's still Hillary's party.

For nearly 14 years, Democrats have tried to persuade Americans that, after the disaster of 1994, they were no longer interested in making sweeping changes to the nation’s health-care system.

No one has worked more tirelessly to create this impression than Hillary Clinton. The woman behind the party’s colossal embarrassment in 1994 became a spokesperson for a series of inoffensive health-care causes, like cosponsoring legislation with Sen. Bill Frist on standardizing medical records, or writing opeds with Newt Gingrich deploring the high number of medical errors.

In May of last year at Georgetown University, Sen. Clinton gave her first major campaign speech on health care in which she expressed concern that Americans are too obese and committed to seeing Americans lose weight when she’s elected president. Last September, Senator Clinton gave another major health-care speech, and again she avoided controversial details: in fact, her whole plan totaled only ten pages — and emphasized consumer choice. Though not quite as innocuous as she claimed, the plan was still a far cry from the HillaryCare of old.

But Clinton’s drift to the middle ended abruptly in 2008: as the primary campaign wore on, and a frontrunner emerged to her left, Hillary herself banked left and embraced more and more government activism. By the spring, she was championeing a series of hard-edged proposals that would leave Washington setting the price of pharmaceuticals; dictating to insurance companies what products they can sell, to whom, and at what profit; capping the amount Americans pay for health care based on their income; forcing them to buy insurance even if they don’t feel it necessary (i.e., mandates); and hiking taxes to pay for it all.

To some extent, her policies were motivated by politics: with a candidate running to her left, she banked left. But she isn’t the only one to favor government solutions. Sen. Barack Obama supports mandates too (if not quite as expansively) and a major expansion of government.

Welcome to 2008: Across the country, Democrats are talking again about health care. From New Jersey to Minnesota to Colorado, they are proposing an aggressive agenda that promises to insure more Americans by employing mandates and price controls.

Republicans need to take note — and take action.

The Dems’ Misdiagnosis

Health-care costs are soaring. Since 2000, insurance premiums have more than doubled — hitting working Americans right in the pocketbook. Median family income has dropped by a thousand dollars a year every year since the beginning of the decade. As David Frum notes in his book, Comeback, “[The cost of] employing a typical, median worker jumped from $19.85 per hour in 2000 to $25.67 in 2006. That’s a raise of more than $5 per hour, or 25%. Yet the average worker saw none of the money. Every dime — and then some — was gobbled up by the rising cost of employer-provided heath insurance. . . . ”

Not only are health-care costs up, but we don’t seem to be getting much more in return. Would even the slickest lobbyist claim that American health care is twice as good as it was in 2000? If anything, our health-care woes seem to have worsened. More people go without insurance, total patient satisfaction is down, and the number of medical errors is staggering.

Americans have had it. Polls show that they now consider health care one of the biggest domestic issues, usually second only to the overall strength of the economy. Even a majority of physicians, who during the 1940s stood as the strongest opposition to President Truman’s plans for national health insurance, support government-run health care.

The Democratic party is comfortable talking about the issue and well positioned to address it. In some ways, the current debacle seems to vindicate their failed efforts of the early 1990s. Moreover, the party is by far the more trusted in this area: In the last Wall Street Journal/NBC poll on issues, Americans choose Democrats on health care over Republicans by a 37-percent margin (the largest gap on any issue, save global warming). Which is why Barack Obama — and every other Democrat — is talking about health care again.

But what are they proposing? Barack Obama advocates further government subsidy and regulation of a health-care system already drowning in both.

Obama proposes that Washington cover large medical bills, leaving taxpayers on the hook for the most expensive care. He offers a plan that wouldn’t fundamentally alter the underlying economics of the health-care system. Costs are likely to keep rising under this proposal, albeit with a heavier taxing of the treasury, pushing the U.S. towards a Europeanization of health care.

It’s worth noting that the sharpest point of contention between Clinton and Obama in their now-finished race — whether people should be forced to buy health insurance — amounted to a lovers’ quarrel: Obama favors the idea for children, while Clinton champions it for adults, too. Even that distinction is fuzzy, though, since Obama has suggested before that he’d endorse a mandate for adults eventually, should too many remain uninsured after his first term.

Herein lies an opportunity — for Republicans — who should recognize that Democrats are overreaching. It’s not simply that Democrats are missing the big issue — the feverish rise of health-care costs — but that they are prescribing a series of unhelpful measures.

But to turn the health-care debate their way, Republicans need to do a simple, elemental thing — which they have been loathe to do for much of the past 14 years: talk about the issue.

– Dr. David Gratzer, a physician, is a senior fellow at the Manhattan Institute. His latest book, now in paperback, is The Cure: How Capitalism Can Save American Health Care.

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