Clinton Is Right on the Health Issue : Eventual universal coverage is worth fighting for

President Clinton, astute politician that he is, has been signaling for months, and more recently said outright, that he is willing to compromise to a certain degree in order to persuade Congress to pass health care reform. Any significant change that would directly affect the insurance, medical, hospital and legal industries--that is, some of the most powerful in the nation--is a tough sell on campaign-contribution-dependent Capitol Hill. Thus Clinton has gone from saying he would veto any legislation that did not guarantee insurance coverage for all Americans to saying that Congress must simply give its “commitment to cover everyone.”

That’s a good sign of reasonable flexibility, but there are limits. The President cannot be so malleable on this difficult issue as to make health care reform meaningless. Nothing could be worse than for Washington to hand Americans health care reform in name only. Toothless legislation consisting only of goals and hopes and dreams would do nothing to help the 37 million without health care coverage but would do a lot to fuel cynicism about the government’s ability to deliver.

President Clinton should stick to his guns in insisting on real incentives for reform. His health care proposal, which even he concedes will not survive as originally proposed, was based on the key premise that all Americans are entitled to affordable health care. It’s how to get there that few Democrats or Republicans can agree on.

There is a two-pronged concept that has gained currency recently: that a reform bill containing non-controversial elements such as paring down paperwork and fraud would be passed and industry would be given a reasonable period to make health care accessible and affordable; if, after a designated period, certain gains had not been made, then the government would step in with mandates of some sort.

This so-called “hard-trigger” approach is preferable to outright government mandates as first called for by Clinton. The President is said to now be willing to support the hard-trigger approach because it still would push the nation toward health care coverage for all, and because it is probably the most he can politically hope for by this fall.

The details of how all this would work are the subject of furious work and horse-trading on Capitol Hill. But already the health care industry has proven that there’s nothing like the threat of government intervention to inspire private industry reform. The President shouldn’t turn down the heat now. He is right about the issue.