Now the Men-in-Waiting Start Duking It Out

All presidents aspire to leave their mark, and should Bill Clinton wish to swing for the fences, historically speaking, one issue would truly test his mettle. That is the project he abandoned in 1994, the reform of American health care.

The cause is good and the need glaring. Not only are medical entitlements facing early insolvency; the estimates of Americans lacking health coverage continue to range from 25 million to 40 million, many of them children.

Alone among major industrial democracies, the United States does not provide universal health care. Yet our gold-plated and inequitable system costs significantly more per capita than any other. Its benefits are unequally distributed and the system itself offers latitude for unseemly profiteering. Private health insurance underwriters siphon up to 12 to 15 cents of every dollar in administrative costs while exercising inappropriate, profit-driven power over doctors and hospitals. For-profit companies are rapidly taking over community hospitals built by taxes and charities, sometimes for a song, and running them to benefit stockholders.

Harry Truman and Lyndon Johnson, alone among modern presidents, tried to make medical care accessible for all, regardless of means or status. The task is as incomplete today as when Bill Clinton quit the field two years ago. What better use could he make now of the next four?