Sept. 18 (Bloomberg) -- Hillary Clinton's new plan to provide health care for all Americans differs more from her 1993 proposal known as "Hillarycare'' than it does from ideas offered by her chief Democratic rivals in the 2008 presidential campaign.
Clinton's proposal, presented yesterday in Iowa, draws on the same four principles that opponents Barack Obama and John Edwards already put on the table: Allowing many Americans the option of paying to join a new government-run plan, requiring insurance companies to accept all applicants and not charge more for those who are ill, giving subsidies to help families afford coverage and raising taxes on upper-income Americans to pay for it all.
"The big message is how similar the plans are,'' said Len Nichols, who worked on health-care issues for President Bill Clinton and is now director of the Washington-based New America Foundation's health program. "These are very smart people who are very ambitious, and they are ending up with very much the same rough contours.''
Clinton's strength, which she invoked frequently during her speech yesterday, is that she's experienced in how not to revamp U.S. health care. During her husband Bill's presidency, she headed a task force that produced a 1,342-page plan that failed amid criticism it would have created a new government bureaucracy and would force people off the insurance they had.
This time, Clinton said her proposal won't require any new government agencies and nobody would have to give up coverage they already have.
'Do No Harm'
"The first rule of medicine is do no harm,'' she said yesterday."We will build on what's working in the system so we will have health care for all, and better health care.''
For all the similarities with her Democratic rivals, Senator Obama of Illinois and former Senator Edwards of North Carolina, Clinton carved out distinctions. She would give small businesses tax credits to defray about half the cost of health premiums for their workers. Medium-sized companies would get a smaller credit.
To help pay for this, Clinton, like Obama, would repeal President George W. Bush's income tax breaks for households earning more than $250,000 a year. Edwards, 54, would repeal the tax cuts starting at $200,000 in income.
She also drew on one idea proposed by Republican Bush -- eliminating the tax break for employer-provided health benefits. Unlike Bush, Clinton would change the exemption only for those earning more than $250,000 a year, limiting it to a set amount.
'She's Gambling'
"She's gambling with some things in the right way -- she's edging toward changing the basic tax basis of health care,'' said Stuart Butler, who works on health issues at the Heritage Foundation, a free-market policy center.
Republicans said Clinton's new plan, like her old, would increase taxes and lead to what former Massachusetts Governor Mitt Romney, 60, called "European-style socialized medicine.''
"It's government plans as opposed to private plans,'' said Romney, a Republican presidential candidate, in a statement released by his campaign yesterday. "It's raising taxes as opposed to holding taxes level. And that's not the right course for solving our health-care problems.''
Among Democrats, the debate on health care may turn on who can best deliver. Clinton, 59, says she gained invaluable lessons from her unsuccessful attempt.
1993 Proposal
Clinton's 1993 proposal would have established strong government control over what sort of health plans would have been available to people and would have required all employers to offer benefits or pay into a fund. Her new plan limits this requirement to large businesses and tries to entice smaller ones with credits to help them cover the costs.
"I have learned how to build a national consensus,'' she said yesterday, speaking at a medical center in Des Moines. "I have been asking a lot of questions and doing a lot of listening.''
The "real key'' to overhauling the health-care system is the ability to bring people together, Obama responded in an e- mailed statement.
"That's how we'll prevent the drug and insurance industry from defeating our reform efforts like they did in 1994,'' he said.
Obama, 46, has put together the most cautious plan of the three Democrats. He wouldn't require that all Americans have insurance, and only insurers that wanted to sell plans through a new "insurance exchange'' would have to agree to enroll everyone who applied at rates not based on their health condition.
Edwards said Clinton is too beholden to health-care interest groups and campaign contributions by their lobbyists to bring about real change.
"I don't believe you can sit down with the lobbyists, take their money, and cut a deal with them,'' he said yesterday in a speech in Chicago.
While offering that criticism, Edwards acknowledged that Clinton's plan looks a lot like his own.
"If imitation is the sincerest form of flattery, then I'm flattered,'' Edwards said.
