WE KNOW what the voters didn't like about President Clinton's health reform proposals -- more control by the federal government, employer mandates, higher taxes to cover the poor and, above all, price controls.
The question is how long the voters will remain satisfied with what they have now.
Two out of three Americans have good health insurance or Medicare, and they assume that their employers or the federal government pay for it.
In fact, of course, the primary payers are working people and the taxpayers, since if there were no employer or government-financed health insurance, wages would be higher and taxes lower.
A related assumption is that in the absence of major health reforms, Americans will continue to enjoy the quantity and quality of coverage they now have. This is a serious misperception.
In recent years they have seen a significant dilution of their benefits -- higher deductibles, higher co-payments, more constraints on choice of doctors and hospitals -- and the outlook is for further restrictions in the years ahead.
The movement toward health maintenance organizations and other forms of managed care has exercised some restraint on costs, but it cannot do so indefinitely. If we want to moderate expenditures for health care, we have no choice but to control the total dollars flowing into the health-care system.
That is the lesson we need to learn from Germany, France, Britain, Canada -- countries that manage to offer health care to their entire populations at a more or less sustainable cost.
True, Americans prefer to rely on the marketplace rather than on governmental price fixing to control the flow of resources into the economy and its distribution among competing goods and services. But there is so much governmental spending on health care -- counting direct appropriations and tax benefits -- that the competitive market model does not fit the realities of the health sector.
Time is running out for the United States to face up to the challenge of providing universal health insurance. Most advanced economies achieved this goal at the end of World War II, if not earlier.
Once the American people realize that the deficit cannot be contained so long as federal health spending keeps growing; that they, not somebody else, are paying the bills; and that reliance on competitive forces will not moderate runaway health costs -- once people finally recognize all that, then health reform will have to be put back on the national agenda.
And next time around, it will have to be enacted.
Eli Ginzberg is director of the Eisenhower Center for the Conservation of Human Resources at Columbia University.