Health Care End Game
Jude Wanniski
August 29, 1994


Amidst our euphoria over defeat of comprehensive health care legislation this year, we still have to worry that the White House and Democratic leaders are planning to impregnate us with Rosemary's Baby: An innocuous sounding "incremental" bill that will merely enact the insurance reforms "that everyone agrees have to be done." We can already picture President Clinton giving us his best "Gee whiz, aw shucks" crooked grin, apologizing to the country for having "broken his promise" to veto legislation that is not up to his and Hillary's standard of universality, and telling Senate Minority Leader Bob Dole publicly that he is willing to eat crow and accept whatever measly little bill the Congress can produce in the 3+ weeks of legislative session that remain before the mid-term election break. Of course, Dole must at all costs prevent this measly little bill from being enacted. There will be nothing innocuous about it.

After all, Ira Magaziner, the Clinton health guru, has stated that the administration really never had to submit a 1500-page bill to do what it wishes. As long as they have the basic framework enacted, government regulation could do the rest. With two years left in the White House, there is plenty of time for the gestation of Rosemary's Baby. Fixing "portability" and "pre-existing conditions" in a "gee whiz," simple little bill would dictate the direction of health care reform, and by 1997, it would be impossible to undo the damage. Every piece of the system is critical, which is why any incremental approach must begin with the right piece. If we enact the tail of the animal this year, there is not much choice of what will follow in increments. The tail of a dog becomes a dog. The tail of a crocodile becomes a crocodile. If the direction of the incremental reforms leads toward a government-directed system, that is all Hillary and Ira will need. The objective must be to interpose the mid-term elections, with the GOP promising in the new Congress a market-directed system that empowers individuals. The White House and the Democratic leaders certainly don't want that to happen, so they will take anything, or at least anything that gives Ira and his regulators some traction.

When all is said and done, Senate Majority Leader George Mitchell has not pulled "the Mitchell bill" from consideration. He merely sent his troops home for two weeks, after persuading six GOP senators to defect on the crime bill. He needed a respite from the pounding that the health care legislation was taking on the Senate floor and is now using this week to build the public relations platform from which to float a "minimalist" compromise. When President Clinton does his "Aw shucks, gee whiz" routine, breaking his veto pledge "for the good of the country," how can the Democratic senators desert him? How can the dastardly Republicans refuse to permit a vote on even teeny-tiny health care reform? Of the six GOP senators who defected on the crime bill, three are already prepared to defect to whatever "incremental, minimalist" bill that George Mitchell cooks up. Dole has also left himself exposed, by continuing to say he's ready to compromise on insurance reforms in the few weeks left to the legislative session. He really has to be prepared to tell the President that he wouldn't even vote for his own bill if the President says he would accept it, on the grounds that 3+ weeks is not enough time for the country to focus on the Dole-Packwood plan and evaluate it. Unless the Republicans begin building this fire-break now, victory will slip through their fingers as it did on the crime bill, with much more serious consequences.