Half-a-Loaf Health Reform

August 26, 1994

Health care legislation has now come down to a choice of no bill at all this year or one that offers only modest first steps toward the sweeping reforms President Clinton had hoped would be the defining achievement of his early White House years. We favor grabbing half a loaf, consisting mainly of incremental health insurance reforms, because it conforms with what is possible in the waning days of this Congress and it is what the country wants.

President Clinton, having unwisely vowed to veto any measure that does not provide guaranteed coverage for all Americans, may prefer to be unbending rather than accept a compromise not to his liking. But before he follows this course, he should listen to advice from some of his closest allies on Capitol Hill -- lawmakers who supported his ambitious original proposal. Let us quote:

* Sen. Harris Wofford, the Pennsylvania Democrat who won an upset victory in 1991 by advocating broad health care reform -- "It's time to make an all-out effort to find common ground. We want to create the expectation and pressure for further steps to be taken by every Congress hereafter."

* Sen. Jay Rockefeller, the West Virginia Democrat and the most fervent cheerleader for the Clinton bill -- "I have to deal with the reality of getting the most I can."

* Sen. Thomas Daschle, the South Dakota Democrat likely to be majority leader in the next Congress -- "Let's not be captive of the rhetorical goals we've laid out [Mr. Clinton take note] if there's a way to make discernible progress."

These pleas, we emphasize again, have special significance because they come from Clinton loyalists. The words resonate even more loudly because they were uttered after Speaker Thomas Foley shook political Washington Tuesday by saying a bill that dealt with just one aspect of reform and didn't bar future improvements would be "worth doing." Indeed it would.

The reform that would draw widest support would change health insurance rules so that persons with pre-existing medical problems or those who change jobs could not be denied coverage. This plus some form of subsidy to help the working poor buy insurance through pooling arrangements could halve the number of citizens who are uncovered and vulnerable to financial catastrophe. It would not be just a Democratic formula but would reflect an approach pushed by the Bush administration.

Unfortunately, there are fervent members of both parties who for ideological or political reasons are so at odds they could condemn Congress to gridlock. We hope President and Mrs. Clinton are not part of that group. The sensible answer would be a sensible bill with broad bipartisan support that would be fiscally credible and a forward step on the long road toward a better health care system for more Americans.

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