Health reform: What kind of ball are we playing?



WASHINGTON -- The political gamesmanship is heating up between the White House and Senate Minority Leader Bob Dole of Kansas as they wrestle with the possible impact of the fight over health care reform on the November midterm elections.

In its desire to have legislation that demonstrates to voters that gridlock has been broken, the White House is playing softball.

While reiterating that President Clinton will veto any proposal that doesn't deliver "universal coverage," two ranking spokesmen, White House Deputy Chief of Staff Harold Ickes and White House counselor David Gergen, told weekend television interview shows that Clinton would accept achieving it over several years.

Ickes, asked about the proposal of Louisiana Democratic Sen. John Breaux that would phase in coverage with trigger mechanisms requiring employers to pay a major share of the cost of employee coverage as a last resort, replied that "as long as universal coverage within a reasonable time is provided, I think the president will sign that bill."

Ickes notes that Clinton's own proposal would not bring universal coverage for all immediately and that, in any event, Ickes is not in the business of guessing out loud what the president might do, so his answer can be taken as an invitation from Clinton to Congress to press on with the Breaux compromise on a phase-in and the so-called employer mandates.

It has been implicit ever since the president threatened to veto any bill without "universal coverage" that there would be enough elasticity in the definition to enable him to accept any reasonable variation that could survive the gamut of congressional compromise.

Dole, on the other hand, is playing hardball.

While repeating his aspirations to find a compromise, he continues to dig in against the notion of employer mandates of any kind.

He has dismissed the Breaux triggers as "the biggest gimmick in town," but it just might be the gimmick that can win over recalcitrant Democrats and enough Republicans to carry the day.

Dole denies that he meant in other weekend remarks to threaten a Republican filibuster, but he did say that "we've reached a point where I'm prepared to say, 'OK, let's have a referendum on this in 1994.' Let's let the voters decide. If they want the Clinton health care plan, then they'll vote for their candidates. If they want something else, they will vote for Republicans."

With the party of a first-term president historically losing more than a dozen House seats in the midterm election, Dole naturally is willing to have the November elections cast as a referendum on a Democratic health care bill.

Ickes in his remarks just as naturally balked at that reading, noting that midterm elections are not "a national referendum," but rather "district by district, and . . . each district has its own peculiarities. . . . The legislators will go home and run on their record" that will encompass many other issues as well as health care.

Dole well understands that any compromise that Clinton can embrace as his own is likely to greatly enhance his image as a president who, whatever his other shortcomings, can win the big ones.

His legislative successes on deficit reduction and NAFTA largely compensated for his first-year missteps, and passing health care likewise would help bail him out of his assorted second-year problems.

By the same token, Dole as a politician who still has his eye on another presidential candidacy in 1996 can't afford always to be seen as Senator No.

His hopes of winning support of a bare-bones bill that would chiefly address coverage of persons with pre-existing medical conditions and the ability to transfer coverage from one job to another is slim.

In the end, Dole may take the politically risky course of arguing that no bill is better than any compromise with any kind of employer mandates.

He said the other day that "it may be so bad you'd have to end up in a filibuster, but certainly we're not at that point yet. We're a long way from deciding any strategy."

So he continues to play hardball, while the White House appears to take the opposite tack -- that some bill is better than no bill, especially heading into the November elections.

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