Don’t Let Health Reform Die

Some detractors are crowing that President Clinton’s health care plan has in effect been killed by an adverse assessment by the Congressional Budget Office. No doubt the proposal requires overhaul; the President himself knows this. But even with all the rethinking and horse-trading to come, it would be an error for foes of reform to assume that trouble for the Clinton plan means the end of reform.

The momentum for restructuring the way health care is delivered and paid for in the United States is stronger than ever. This is true despite the troublesome verdict delivered Tuesday by the Congressional Budget Office. The CBO, whose imprimatur typically is sought by lawmakers wanting objective verification of how much a program would cost, said that the Clinton plan would increase the federal deficit by $74 billion in its first six years. The Administration had lobbied furiously to persuade the nonpartisan CBO that the reform package actually would reduce the deficit by $58 billion between 1995 and 2000. The CBO also determined that the plan’s requirement that employers pay at least 80% of the insurance costs for workers, with employees paying the rest, would be a government “receipt.” That’s a polite way of saying the plan is a big new entitlement program, one that eventually could cost more than Social Security.

But even with all that, the outlook now is good for real health care reform this year. In dramatic contrast to just one year ago, it’s hard to find many Democrats or Republicans who do not acknowledge the necessity of fixing a health care system so expensive that millions of Americans cannot afford to get themselves well, or keep themselves healthy.

Bill and Hillary Rodham Clinton have pushed Congress into the first stage of consensus on what health care reform should entail: some configuration of purchasing pools to give clout to individuals and small businesses seeking better bargains from insurers; prohibitions against denying insurance to those with pre-existing conditions; streamlining administrative rules to cut back on paperwork; placing greater emphasis on preventive care; maintaining a measure of consumer choice in selecting doctors and hospitals.

Serious health care reform, including the difficult problem of cost containment, is still a way down the road. But now at least there is a road.