Health Care to the Floor

August 09, 1994

Health care reform, often touted as the most sweeping domestic initiative since Social Security began during the New Deal, moves to the floor of Congress today for what promises to be a harsh, prolonged and confusing debate -- one in which the American public will have difficulty determining until the end-game stage just how ordinary lives are going to be changed if a bill passes.

Citizens who remember last year's titanic struggle over President Clinton's economic plan will not be surprised at the muddled message coming out of this administration. The issue in 1993 was whether the new team in the White House would emphasize spending "investments" to stimulate the economy or deficit limitations that might slow the recovery.

In the end, the president went with the deficit hawks in his administration -- and won both ways. He achieved reductions in annual deficits beyond the most optimistic predictions as the recovery took off despite higher taxes on the rich and gloom-dooming by his big spenders.

This time, Mr. Clinton's proverbial come-back luck is by no means assured. By placing emphasis on "universal coverage" (a concept that grows thinner by the day) rather than cost controls on an industry whose runaway inflation accounts for one-seventh of the American economy, the president has muddled his message once again. No doubt he hopes to win both ways again, which is what his health theorists insist can happen.

As the evidence grows that competing Democratic bills in the Senate and the House will actually raise national spending in the health field, Republicans are increasingly inclined to oppose anything the majority has to offer. When Mr. Clinton first unveiled his program, cautious GOP legislators were talking bipartisanship. Their reading of the public mood now is that the voters do not share the administration's impatience for action this year, before the Democrats predictably lose seats in the November elections.

However this struggle turns out, it has been an educational experience for Congress and for those citizens willing to digest the jargon and the technicalities of the health care debate. Behind all the political argument, there exists a strong consensus for reforms of the insurance system to provide guaranteed coverage for people who are sick, or are between jobs or are self-employed. Even if Congress cannot come to closure this year, President Clinton has put health care at the top of the nation's agenda. And there it should stay until some genuine reforms are adopted.

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