Is Politics Good for Your Health?

Bill Clinton has two key self-inflicted political problems: He seems at times to be at war with himself over just how much he should compromise; he has a history of drawing a line in the sand and then drawing it again, and then again. If the President wants health-care reform this year, he must be flexible, which comes easy to him. But he must fight another instinct to please others so much that the compromise yields him only a Pyrrhic victory, a political score that does not provide better health care for Americans. It’s the latter aim that’s the goal here, and he must not allow Congress to obfuscate that fact.

Clinton remains right in diagnosing the basic elements that must be a part of any true health-care reform. His willingness to compromise on universal coverage--saying that a bill need not immediately cover 100% of all Americans--was sensible, considering that 85% of Americans are already covered by insurance (albeit many not adequately).

The real hang-up, of course, is how to pay for increased coverage. Clinton has proposed that employers be required to provide insurance coverage for their employees, but said this week, “I would not rule out a health bill that didn’t have a employers mandate in it, if we knew that we were moving toward full coverage and we had some evidence that it would work.”

The latter statement was a political bombshell when uttered Tuesday. No doubt there are still stinging memories of how the White House last year left some allies out on a limb, when some House members swallowed hard and cast a politically damaging vote in favor of a controversial Clinton-proposed energy tax--a plan that the President himself later abandoned. Whatever the final compromise, Clinton must find a way to assure his allies that he’s not going to leave them stranded without cover. He’s now made that task harder.

A phase-in of universal coverage is actually preferable to trying to load on everything all at once; the same would be true in how to finance the program. Now Congress and the President must come up with a method of financing that works. Even the political pariah of employer mandates may not be dead, since now even the American Medical Assn. is urging Congress to enact comprehensive reform through employer mandate.

Compromise is not bad, it is inevitable. But compromise cannot be used as the excuse to pass a crucial reform that is no reform at all. The President must keep reminding Congress that better health care has a price tag, and so-called “reforms” that don’t convincingly address how the nation will pay for them are bogus.