Hillary Clinton presented her “universal health care” plan yesterday – and early reports have been positive. Many have pointed how it’s similar to plans that John Edwards and Barack Obama have promoted – such as banning insurance companies from denying pre-existing conditions. But the devil is in the details, and Hillary’s plan fails to address some serious questions. Requiring everyone to buy health insurance does not guarantee affordability, and even her pledge to keep costs under control won’t specify what that means. Employer mandates are great, but how do we know it won’t just be a subsidy to private insurance companies? While all the major candidates have promoted some mix of public-private insurance (although Edwards has opened the door to single payer), Hillary’s lack of substance should give progressives pause. Because without details, how can we trust the U.S. Senate’s #1 recipient of health insurance money to go after the real culprit – greedy insurance companies?

“If imitation is the sincerest form of flattery,” said John Edwards, “then I’m flattered.” Like the Edwards plan, Hillary would pay for it by repealing the Bush tax cuts and require everyone to buy health insurance. “Her plan is similar to the one I put forth last spring,” said Barack Obama, “though mine would go further in reducing the punishing cost of health care than any other proposal that’s been offered in this campaign.”

And that’s the standard line being repeated in much of the media. Roger Hickey of Campaign for America’s Future said that all three plans are “generally in the same ballpark” and involve some type of public-private hybrid where private insurance will continue to provide health care – with some regulations and the option to purchase a public plan – and some form of employer mandates.

But despite 15 years of experience on health care policy, it’s shocking how little detail Hillary goes into her much-touted plan. While the proposal she announced yesterday is only intended to be an outline, the effects could be counter-productive – if mechanisms are not put into place to control greed and profit from private insurance.

Take the mandate that everyone buy health insurance. They tried that in Massachusetts, and early reports show that low-income people are getting ripped off with outrageous premiums. “Massachusetts has not figured out what they mean by affordable,” said Hickey. “Insurance plans will sell you a policy, but it’s so bad that it’s hardly worth owning.” Obama’s plan would not require it until the cost of insurance is controlled.

But Hillary’s plan has some mechanisms for affordability, right? Not really. Hillary has proposed giving tax credits for people to buy health insurance – which isn’t much help for extremely low-income people who don’t pay taxes. A better part of her plan is to control the cost of insurance premiums to a “certain percentage” of family income – without saying what that is, and there would be an income cut-off.

Even Governor Schwarzenegger’s health care plan that he proposed in January had an affordability component for low-income people. And under that plan, the “affordable” deductibles were as high as $5,000-$7,500. While I’m not saying that Hillary’s plan would have the same components, these details must be worked out before Democrats agree to support her.

Like the Nunez-Perata bill being currently debated in Sacramento, Hillary’s proposal has a mandate that employers get private health insurance for their employees – or else deposit a percentage of their gross income into a public health fund. Like the affordability “guarantees,” she doesn’t specify what percentage that would be.

Labor unions roundly criticized Schwarzenegger’s plan because his percentage figure – 4% of gross income – was so pitiful that employers would have the incentive to drop their own coverage and pay only a minimal tax. Unless Hillary’s plan contains a higher percentage for employers, it will have unintended consequences.

But while employer mandates are a step in the right direction, requiring business to get private insurance for their employees – without controlling the profit margin of insurance companies – simply subsidizes the people who are driving up the cost of health care.

Hillary’s plan still doesn’t answer that question – and whether she will put enough restraints on insurance companies to make a private-public scheme work. “Her plan will require significant amounts of regulation of the insurance industry,” said Hickey, “and that involves practically setting premium prices and the level of benefits. When you set standards for both of those, you’re squeezing the insurance industry’s profits.”

Just don’t count on it. As anyone who saw Michael Moore’s movie “Sicko” remembers, Hillary Clinton is the largest recipient of health insurance money in the United States Senate (after Rick Santorum lost his seat in 2006.) And unlike Obama and Edwards, she has refused to stop taking money from Washington lobbyists – because “they represent real people.”

“I don’t believe you can sit down with lobbyists, take their money and cut a deal with them,” said John Edwards in response to Hillary’s health care plan. “If you defend the system that defeated health care, I don’t think you can be a president who will bring health care.” While Clinton, Edwards and Obama each have similar plans, the question really comes down to trust – who do you think will control the profit margin of private insurance companies?

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