The New York Observer, September 18th, 2007
Hillary Clinton's health care speech was a deliberate, no-frills address. She gesticulated rarely. Read carefully. And eschewed the bright blue and yellow jackets she's been wearing lately for a sober gray blazer and pearls.
But there was one little-remarked portion of the speech in which she abandoned the hard numbers, pure policy and sad-but-grounded anecdotes to articulate a sort of Brave New Health Care World/Insurance Doomsday vision.
"Insurance companies spend $50 billion a year on elaborate calculations and schemes to figure out how not to insure people. $50 billion trying to shut out those who need care the most. And every day they deny people coverage because of preexisting conditions or the results of genetic testing. Think about what this might mean down the road with advances in genetic testing. The vast majority of us could wind up being bad risks. Because genetically most of us will probably show that we are susceptible to something. And therefore we will become uninsurable."
The point, Hillary said, was that the discrimination had to be stopped before it became too late.
One health care expert I spoke to who generally approved of Hillary's proposal thought that particular passage a bit flighty.
"It collapses of its own logic," said Paul Ginsburg, President of the Center for Studying Health System Change, a non-partisan group that advocates better health policy. "If insurance companies are going to find reasons not to insure everybody, they won't have any business."
Ginsburg said the concern over insurance companies discriminating against the sick with background tests into pre-existing medical conditions (a process known as medical underwriting) was often overstated, because large companies, which are the biggest health insurance clients, often do not have pre-existing condition exclusions.
