health care reform in the 1990's

Employees thus have a strong incentive to take more and more of their compensation in the form of health coverage instead of cash wages because the health coverage is not taxable. For every dollar spent on health coverage, you receive a full dollar of coverage; whereas with every dollar received in other forms of compensation a portion has to go to the government. Employees covered by employer health plans could no longer exclude employer paid premiums from their taxable income. Although likely to benefit the insurance industry, this approach would not significantly reduce the number of uninsured or health care costs. Employer mandates would have required employers to either provide health insurance for their employees or to pay into a government fund to provide the insurance. Another program would have underwritten the costs of long-term care.

Employers would be expected to either offer health insurance or contribute to the cost of covering their employees. Both plans would expand federal SCHIP and Medicaid programs and create a new health plan that's similar to what is offered to federal employees, with subsidies to make it affordable. Employers and the government became alarmed with rapidly rising healthcare expenditures as far back as the 1960s and 1970s. During our great national debate on healthcare reform in the early 1990s, few seemed to remember that President Nixon had proposed a sweeping national healthcare plan more than twenty years earlier. Employers and employees each pay half of a member's premiums, which in the first half of the 1990s averaged between 12 and 13 percent of a worker's gross earnings up to the income ceiling. Premiums are set according to earnings rather than risk and are not affected by a member's marital status, family size, or health; they are the same for all members of a particular fund with the same earnings.

Employers that chose to enroll their workers would be free to supplement Health Care for America benefits, allowing them to provide better coverage at a lower cost. Yet, unlike many other approaches promising business savings, this approach would guarantee that every employer either provided good private coverage or enrolled its workers in a broad insurance pool and contributed to its cost.

Inflation means, for state governments as well as individuals, that it costs more to get the same amount of goods and services. Population growth puts pressures on spending for elementary or higher education as enrollments grow, on long-term care for an increasingly aged population, and on roads and rail as more people put pressure on transportation systems, for example. Inflation, which was virtually nonexistent during the Communist era, has been endemic for the past seven years. When the Democratic Union government raised energy prices in September of 1996, the annual rate of inflation rose to 53%.

Public-sector reforms include reinventing government and defense reconversion, which have allowed previously low-productivity resources to be shifted to more productive uses, and welfare reform. Public financing of healthcare is critical in both developed and developing economies. A political economy based largely on private health financing can create adversities for health not only for poorer sections of society but also the middle classes.

Clinton camp has already raised this issue, so why is she so worked up about them today. Was this a planned event for some tactical reason? Clinton was appointed by her husband, then-President Bill Clinton, to chair a commission on health care reform in 1993. Just 25 percent of all voters, and 15 percent of Democratic primary voters, say that experience will hurt her. Clinton’s plan would merely allow those that would like to have a choice in their health care plans access to the exact, same set of *private* health care plans that Congress and federal employees get access to right now. These our health care plans at a reasonable cost, period.

Clinton's bravura performance at the initial congressional hearings and the submission of the bill, the White House focused entirely on the principles of reform and made little effort to defend the parts of the proposal. The administration had gone to the trouble of writing a bill and then left it like a foundling on the doorstep of Congress. Clinton has said that Obama's plan would leave millions more uninsured than hers, because it lacks a requirement that all adults obtain coverage (a so-called individual mandate). Meanwhile, Obama's campaign has countered -- in a mailing that's, sadly, a preview of what Republicans will say about mandates of any sort -- that a mandate would amount to forcing people to buy coverage they can't afford. Clinton asked the Democratic National Committee to create a grassroots campaign in favor of health care reform in the summer of 1993. But their effort fell apart amidst media scrutiny of their proposed "educational foundation" and after that stumble, never found the funding to seriously continue.