Wednesday, March 16, 2016


Spat about Universal Health Care in 1993

I don't know whether Senator Sanders and Secretary Clinton actually penned the accusations or whether their staff members did, but no matter, here is my attempt at summarizing the quarrel:
Clinton:  Senator Sanders today espouses universal health care legislation.  In 1993 and 1994 he was no help in trying to enact the health care system my husband and I put together.  In fact, he opposed the proposal.
Sanders:  I proposed then and I propose now the adoption of a single-payer plan, like the one in Canada.  I could not support the Clinton plan in 1994.
Clinton:  It was politically impossible to have enacted a single-payer plan in 1993 or 1994.  The only plan that had a chance of passing was the one that we put together.  Senator Sanders should have supported it.
My comment on this exchange is that (1) there was no chance of enacting the Clinton plan either.  It was too complicated and nobody understood it.  It was developed in secret, by experts, with no public input or comment; (2) In addition to the Clinton plan and Single Payer, neither of which gathered any support from Republicans, there was a Republican plan, put together by Senator John Chafee of Rhode Island.  The Chafee plan was later enacted in Massachusetts when Mitt Romney was governor of that state.  It is also the basis of the Affordable Care Act, enacted when Barack Obama was President.  It's now called "Obamacare."  The term "Chafeecare" would be more appropriate.

Chafee put together a plan that used the features of the existing scheme of insurance to cover medical costs.  He added the requirement that everyone should buy health insurance, just as houses and automobiles are protected by universal insurance coverage.  That way, an unexpected medical expense could be paid by an insurance system in which everyone contributes money in the form of premiums.  With universal coverage, those premiums would be affordable, just as home and auto insurance premiums are.  I have not seen Chafee's plan and know only that the Romney plan in Massachusetts was based on it.

My point is that President Clinton made a strategic blunder in not trying to incorporate Chafee's plan into what he proposed.  He should have persuaded Chafee to get some Democratic Senators to sign on to his plan and make it truly bipartisan.  We could have had "Chafeecare" in 1994 if President Clinton had been willing to share the credit with a Republican senator.

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