This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.
CNN TV One Democratic Presidential Town Hall
CNN, March 13, 2016
QUESTION (from Teresa O’Donnell, an office coordinator from Powell, Ohio): I have voted for Obama, and then my health insurance skyrocketed from $409 a month to $1,090 a month for a family of four. I know Obama told us that we would be paying a little more, but doubling – over doubling my health insurance cost has not been a little more. It has been difficult to come up with that kind of payment every month. I would like to vote Democratic, but it’s cost me a lot of money, and I’m just wondering if Democrats really realize how difficult it’s been on working class Americans to finance Obama care.
HILLARY CLINTON: Wow, Thank you for asking me that, because. May I ask you, before you were buying your family health insurance in the individual family market? Were you getting it through the employer? How were you insured before?
QUESTION: I was purchasing it privately, because we both had bouts of unemployment.
CLINTON: So you were going to a broker and buying a health insurance policy.
CLINTON: And in effect, it nearly tripled after you went on to the exchange and bought a policy under the Affordable Care Act, is that right?
QUESTION: We could not do that. It was much more expensive than just purchasing private insurance from the insurance company.
CLINTON: So you are still buying private insurance directly?
CLINTON: OK. Well, first of all, let me say I want very much to get the costs down, and that is going to be my mission, because I do think that for many, many people, but there are exceptions like what you are telling me, having the Affordable Care Act has reduced costs, has created a real guarantee of insurance, because if you’d had a pre-existing condition under the old system, you wouldn’t have gotten affordable insurance.
So it has done a lot of really good things, but, it has become increasingly clear that we are going to have to get the costs down. And what I would like to see happen for you and your family is that if we can get the co-pays down, the deductibles down, get the prescription drug costs under control, that you would find an affordable plan on your exchange.
And one thing that I would like you to do, and I’m not saying it’s going to make a difference, but I would like you to just go shopping on that exchange. As I understand it, Ohio has the federal exchange, is that right, Joyce? Because they did not set up a state exchange.
So you have the federal exchange. And to go on and keep looking to see what the prices are, because we have to get more competition back into the insurance market. One thing that I want to work on with my friends from Congress who are here is we’ve got to get more non-profits that are capable of selling insurance back into the insurance market.
You know, Blue Cross and Blue Shield used to be non-profits. And then they transferred themselves into for-profit companies. And there was some effort made under the Affordable Care Act to get some competition from non-profit institutions, some of them worked and a lot of them didn’t.
I want to know what we can do, because if you could get a range of insurers, some of who were not-for-profit companies, that would lower costs.
So there is a number of things I am looking at. And what I want to assure you and your family of is I will do everything I can as president, working with members of Congress where necessary, to try to get the costs down.
But I do want you to keep shopping, because what you are telling me is much higher than what I hear from other families, and so I want to be sure that if there is a better option out there for you, you’re going to be able to take advantage of it.
And then I’ll work as hard as I can to get the costs down for everybody, and that includes prescription drug costs, which are skyrocketing and increasing costs for everything else.
Hillary Clinton says that one of her proposals is to bring health care costs down. This town hall exchange is significant because it reveals the depth, or lack thereof, as to how she might accomplish this.
She says that she would lower co-pays and deductibles. But the question was about high premiums, and the market is using higher deductibles and other cost sharing to lower premiums. Lowering deductibles will cause higher premiums, not lower.
She says that we need more non-profit insurers like Blue Cross and Blue Shield used to be. But if you compare premiums in California for for-profit Anthem Blue Cross and non-profit Blue Shield, they are the same. The non-profit insurers share the same inefficiencies and administrative excesses as the for-profits.
She says that she wants more competition in the exchanges so that less expensive plans will be available for diligent shoppers, but, again, lower premiums are possible only by reducing coverage – higher deductibles, less accessible narrower networks, etc.
Private plans competing in the marketplace is what we already had before the Affordable Care Act was passed. We merely continued the same system. Adding exchanges did very little except to enable the administration of subsidies and credits for lower-income individuals. For those not eligible for government subsidies and credits, nothing was done to control the very high costs of health care and the insurance products that pay for that care.
Unfortunately, Hillary’s proposal is more of the same. Perpetuate the fiction of lower prices through competition while manipulating the insurance products to have either lower premiums or poorer coverage. In fact, included in ACA is the excise tax (Cadillac tax) which is designed to prevent the marketing of full benefit plans. Making health care less affordable through greater out-of-pocket cost exposure is the exact opposite of where Clinton says she wants to take us. The problem is that the current financing infrastructure will not allow us to go there.
If we want affordable care for everyone, we need a single payer improved Medicare-for-all which will control costs and make the financing more equitable.
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