The health-care delivery industries are given a respite. Last autumn, until the Clinton health-care bill failed, they were up in arms, guarding their interests from harm. Now the storm has departed as rapidly as it came.
Since the conservative Republican congressional victory in November, health care has gone off the screen. The Republicans are talking about which programs to abolish, not what to create.
Don't be fooled. The health-care issue is not dead. Small bits of it are wriggling. The rest is dormant -- a virus festering unseen, liable to erupt at some unexpected time.
Hillary Rodham Clinton said that President Clinton still has a health-care program and she is continuing to work on it. She conceded that what can be passed is what she previously dismissed as incremental.
Rep. Bill Archer, R-Texas, incoming chairman of the House Ways and Means Committee, suggests:
Modest insurance changes to protect people with pre-existing conditions, a portability guarantee for people changing jobs, limits on medical malpractice awards, small-business access to group insurance.
Look for congressional-administration cooperation in these areas, or political maneuvering to pass nothing and blame the other side.
Meanwhile, the medical-care delivery business is changing rapidly without law, as a result of the political fuss and the underlying conditions that provoked it.
Enrollment in health maintenance organizations (HMOs) surged 11.6 percent this year to 50.5 million persons and may grow as much next year. The Group Health Association of America says that health-insurance premiums will actually drop as a result of cost cutting by managed-care companies. Wall Street analysts say this really reflects profit cutting through competition.
Cost containment was one of the driving motives of the Clinton health-plan initiative that market forces might accomplish on their own. Many physicians are finding that what they dreaded from government is being done to them by the member companies of the Group Health Association of America.
Big business employers, presumably political conservatives, are driving this change away from traditional patient choice of physicians to the ''managed care'' of the Clintonites.
The other root causes of the Clinton seizure of the health-care issue were declining access to health insurance, the large number of Americans uncovered and the declining position of U.S. public-health standards relative to other countries.
The Census Bureau says that 39.7 million Americans, 15.3 percent of the population, lacked health insurance during part or all of 1993. Large employers are trying to increase that number.
Of some 13 million retirees receiving health benefits from former employers, about 4.5 million are at risk of losing coverage through the companies' escape clauses in the plans. Temporary-service companies created 900,000 jobs since 1992, more than any other sector of the economy. Firms are switching from permanent employees to temps. Temps don't get health insurance.
Market forces left to their own will not cure the problem of lack of health coverage, but make it worse.
It is arguable that U.S. health is good and getting better, with only a pockets-of-poverty problem, including the black and Mexican underclass, undocumented aliens and those who choose poverty by addiction to drugs or failure to imbibe those prescribed. Big pockets.
The American Public Health Association not long ago ranked the U.S. 19th in infant mortality among nations, 15th in maternal mortality and ninth in life expectancy. Who thought No. 1? That was long ago.
Market forces left to themselves will not improve American public-health statistics but make them worse.
Perhaps states will tackle these problems in creative ways. Maryland task force recommends legislation to force companies to make individual health policies more affordable.
Watch to see if the General Assembly does it. Legislatures became more conservative in November and think this is a national problem.
In other words, the health-care industries have been given a respite to address the problems that created the health-care reform momentum of 1993-4, but are not structured to do so and probably will not.
A good bet is that this issue will come roaring back to push the electoral pendulum the other way in two to six years.
F: Daniel Berger writes editorials for The Baltimore Sun.