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Press Release

    Issue Analysis 68 - Clinton's Health Care

    01/28/1998

    What about the rights of the 600,000 Americans who would lose their health coverage if Clinton's health care "Bill of Rights" becomes law?

    Before a medical student becomes a doctor, he or she must take the Hippocratic Oath, a medical code of ethics that begins, "First, do no harm." In contrast, members of President Clinton's Advisory Commission on Consumer Protection and Quality in the Health Care Industry took no such oath.

    This was evident when the commission unveiled its "Consumer Bill of Rights," which -- if President Clinton has his way -- would require consumers to buy over a dozen government-mandated benefits and make health coverage unaffordable for another 600,000 Americans.

    A commission on a mission. In 1994, the American public rejected President Clinton's plan to put a government bureaucrat between every American and their doctor. Yet, the president remains committed to the cause of government-run health care:

    I'm glad I tried to do the health care plan. ... Now that what I tried to do before won't work, maybe we can do it in another way. That's what we've tried to do, a step at a time, until eventually we finish this.1

    Thus it was no surprise when Clinton charged his health care commission with designing the next few "steps" and packed the panel with regulators and other cheerleaders for government-run health care. Many commissioners represent special interests that would benefit from greater government regulation of health coverage. Some rode Clinton's "Health Security Express" bus as it toured the countryside promoting government-run health care in 1994. A few commissioners even attended the White House's now infamous coffees.2

    The president asked the commissioners to come up with a list of benefits they believe should be included in all health plans. The commission settled on the benefits (including emergency care coverage, direct access to specialists, elaborate information disclosure and appeals processes, etc.) enumerated in the "Consumer Bill of Rights."

    The commission never advocated laws or regulations to enforce the "Bill of Rights." As one reporter noted, "The panel would never have achieved consensus if members had known that their recommendations would be the basis for new laws."3 Yet, President Clinton called on Congress and the executive branch to do just that, in effect declaring the "right" to these health benefits so great that consumers should be forced to buy them, whether we want to or not.

    You have the right to buy unwanted coverage. In the real world, these are called mandates. They played a starring role in the original Clinton health plan, which would have required all Americans to buy a one-size-fits-all standard benefits package, regardless of their individual needs. To date, state legislatures have passed over 1,000 laws that require consumers to buy coverage for everything from hair transplants (Minnesota and New Hampshire) to massage therapists (Florida and Washington).4

    Most people understand that more Americans could afford health insurance if they were allowed to choose only the benefits they want. Unfortunately, most people were not on the president's health care commission.

    You have the right to pay higher premiums. Not only do these mandates restrict consumer choice by forcing consumers to buy unwanted coverage; they also make coverage less affordable. One study found the 12 most common mandates increase the cost of health coverage by 30 percent.5

    You have the right to lose your health insurance. If Clinton succeeds in turning the commission's proposals into consumer mandates, consumers could see their premiums increase by as much as three percent. This may seem like a pittance to some commissioners, but it would be a tragedy for the 600,000 Americans who will no longer be able to afford health coverage.6

    What did the commission have to say to these 600,000 Americans? One commissioner complained, "To have any of these 'rights' meet the test of not increasing the number of uninsured would tie our hands and not allow us to do anything." In other words, they should at least be allowed to make health coverage unaffordable for some people.

    So much for Hippocrates.

    Fundamental rights do not come with a price tag. Another objection raised during the commission's deliberations was that costs should not be considered, for the same reasons the Founding Fathers did not do a cost-benefit analysis before writing the original Bill of Rights. However, the original Bill of Rights does not force anyone to buy anything. In fact, it was meant to protect us from people who try to force us to do things. (Oddly, not one of the commission's many lawyers raised this point.) On the other hand, the "Consumer Bill of Rights" is being used to force consumers to buy particular goods -- so of course costs do matter. The commission's recommendations are closer to a "Bill of Goods" than a "Bill of Rights."

    Address the quality problem at its source. By embracing new mandates, the president ignores the fact that America's health care problems are the result of existing government restrictions of consumer choice.

    Most Americans cannot leave their employer's health plans because government has made it twice as expensive for them to buy coverage on their own.7 Employees cannot switch from an employer plan to an individual policy without being hit with a huge tax penalty. By creating and maintaining this system, the federal government has granted employer-based health plans a captive clientele.

    Under this system, health plans can get away with practices they never could if they had to worry about individual consumers taking their business elsewhere. Consumers rightly feel trapped in this system, and it is precisely this frustration the president and his commission hope to tap with their cruel hoax of even more restrictive mandates.

    If Congress really wants to discipline health plans that are unresponsive to consumers, it should allow all individuals to purchase health insurance with pre-tax dollars, just as businesses do. Giving Americans the ability to walk away from employer-based health plans will force all health plans to compete to offer high-quality coverage.

    President Clinton claims his "Consumer Bill of Rights" would promote health care quality and curb abuses with just a little more federal regulation. He should resist the Washington reflex to regulate and simply let consumers choose. Two hundred-seventy million Americans can keep a much better eye on the health insurance industry than the few thousand bureaucrats President Clinton's approach would require.

    1 Federal News Service, "Remarks by President Clinton at Service Employees International Union Legislative Conference, Hyatt Regency Hotel, Washington, D.C.," September 15, 1997. Emphasis added.

    2 Eric Weissenstein, "Week in Health Care: Quality Panel Has Strong Coffee Flavor," Modern Healthcare, March 31, 1997.

    3 Robert Pear, "Clinton Plans New Health Care Fight," The New York Times, November 24, 1997.

    4 Susan Laudicina, et al., State Legislative Health Care and Insurance Issues: 1996 Survey of Plans, BlueCross BlueShield Association, December 1996.

    5 John C. Goodman and Merrill Matthews Jr., "The Cost of Health Insurance Mandates," Brief Analysis, National Center for Policy Analysis, August 13, 1997.

    6 Portions of the "Consumer's Bill of Rights" mirror provisions of H.R. 1415, the "Patient Access to Responsible Care Act" that are estimated to increase the cost of coverage by three percent (see Timothy D. Lee, et. al., "Actuarial Analysis of the Patient Access to Responsible Care Act (PARCA)," Milliman & Robertson, Inc. (Brookfield, Wisconsin), November 7, 1997, p. 1,2). Further, one commissioner estimates that implementation of the "Bill of Rights" would increase his employees' premiums by three percent. Every one percent increase in the price of health coverage due to mandates causes over 200,000 Americans to lose their health coverage (see U.S. Congressional Budget Office, CBO's Estimates of the Impact on Employers of the Mental Health Parity Amendment in H.R. 3103, May 13, 1996, p. 2,4).

    7 Joseph L. Bast, Richard C. Rue and Stuart A. Wesbury, Jr., Why We Spend Too Much On Health Care, The Heartland Institute (Chicago), 1993, p. 63.