Hillary’s trap door

Hillary Clinton has chosen her metaphors well in describing voter concern about health care.

At a Las Vegas town hall meeting on health care Sunday, the Democratic presidential candidate said it’s as if Americans are standing on a trap door that could easily drop them into financial insecurity or bankruptcy at the whims of a health insurance company.

Not only does she have her finger on the pulse of the middle class, she also knows first-hand just how quickly that door could open under her own campaign.

In an interview after the forum, Clinton talked about a different type of trap — the political one that she thinks hurts the momentum for universal health care.

If you ask her how she pays for her $110 billion plan, she never uses the same lingo as party rival John Edwards. Yet both Democrats would pay for their plans in a similar way — in part by eliminating tax cuts for the wealthiest Americans. Clinton wants households that earn more than $250,000 a year to pay more.

“John talks about raising taxes, which I think is a trap,” Clinton said in an interview. “What we’re doing is — the taxes were designed to sunset. We’re not going to continue George Bush’s tax rates.”

In other words, the taxes will go up. It may be a trap, but it’s the very real one that still haunts anyone seeking to re-enter what she calls the “lion’s den” of health care reform.

She said changes in the way Medicare and Medicaid are run and instituting an electronic medical records system would provide enough savings to run the rest of her plan.

Her campaign says Clinton’s “America Health Choices” plan would cover 496,000 uninsured Nevadans and save the average family $2,200 a year in medical costs.

It also dramatically changes the playing field for health insurers. If her plan were in place, Nevadans wouldn’t be worried about United Health Group’s $2.8 billion buyout of the state’s largest insurer, Sierra Health.

“It wouldn’t be a factor,” Clinton said.

“I don’t think we can count on individual insurance companies to do what needs to be done for the rest of the economy. That’s why we need to change the way they do business. We need to give them a new business model.”

After her first health care plan went up in flames in 1994, Clinton devised the State Children’s Health Insurance Program as a way to at least provide greater access to insurance for children.

Expansion of that program — paid for by increasing taxes on tobacco products — was passed by Congress and vetoed by Bush. The House failed to override his veto.

SCHIP would remain a piece of the puzzle, but would likely be altered under the larger health care reform proposal if she were elected, she said.

Clinton spent much of the morning talking health care not just at the staged forum, but in personal time with members of the local Service Employees International Union.

I asked Clinton about various initiatives here to raise the gaming tax, including one by the Nevada State Education Association that seeks to provide more revenue for education.

“I think teachers need to be paid significantly in line with their education and the hard job they do,” Clinton said. “I understand completely why the NSEA would support a revenue stream that would raise teacher’s salaries, because I think that’s a goal that everybody should be supporting. But how they do it in Nevada is a local issue.”

Clinton also took a pass on Sen. Harry Reid’s call for a moratorium on three new coal-fired power plants planned for Nevada, saying she did not know the state’s electricity needs, whether they could be met without the new plants and whether the Public Utilities Commission could place specific demands on the power company.

However, she did speak generally about the place of fossil fuels in an increasingly renewable energy portfolio.

“I think coal should be the subject of a lot of demonstration projects to try to see how clean we can get coal and how we can sequester carbon,” Clinton said. “I’m a big proponent of us doing much more when it comes to alternative energies, but also whether we can get continuing use out of fossil fuels with new technologies and new formulas.”

Clinton is at her strongest discussing the need for health care reform, in part because of her past battles. In her vision, she wins the Democratic nomination and then, en route to the general election, a coalition builds that will make enacting health care reform much easier to achieve after she takes office.

But just like all those Americans worrying about rising costs or losing coverage, Clinton’s general election hopes may very well be standing on a health care trap door.

Contact Erin Neff at eneff@reviewjournal.com or (702) 387-2906.

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