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Clinton’s Vague and Bedeviling Insurance Premium Cap

The battle lines on policy going forward from Tsunami Tuesday have been drawn on the question of a health-care mandate.

Hillary Clinton (backed by the influential Paul Krugman) insists that mandates are the only way to achieve universal coverage.

Obama, with a greater emphasis on personal responsibility for adults, promises to make policies universally affordable, but would not garnish wages to enroll anyone in an insurance plan against their will.

It’s an important distinction, both politically and from a policy perspective.

Krugman and others argue that if you don’t enroll everyone, the costs for those in the system remain somewhat higher, elevated by healthy adults choosing not to share in the costs of treating sick ones.

Obama’s argument against mandates is that unless you can first guarantee reasonably priced premiums, you will likely end up mandating the impossible, forcing broke families to spend money they don’t have on insurance they can’t afford.

The crux of the Clinton plan is a promise to cap insurance premiums at a “certain percentage” of income.

I asked Clinton’s two top spokesmen today, Mark Penn and Howard Wolfson, on a conference call for a ballpark figure of what the percentage might be.

They could not answer the question.

They referred me to the policy folks at the Clinton campaign, who were unavailable to take my call.

So here’s the open question to the Clinton campaign: What is the fair percentage of income that any American can be forced to pay for health care?

Is it 10 percent of income? Is it 20 percent? Is it 40 percent?

The devil is in that detail.

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