This monumental silliness is the “employer mandate” proposed in George Mitchell’s health-care bill. It is all that’s left of Bill Clinton’s dream of “universal” coverage. And it is symbolic of the frantic, almost hallucinatory, turn the health-care debate took last week: the Democrats’ last, best effort to regulate one seventh of the American economy is built on a mirage. Even Mitchell’s own staffers advise not to take it too seriously. “The CBO [Congressional Budget Office] says the [mandate] probably won’t be needed,” said one. True enough. But that’s only if $985 billion in subsidies – to help people buy health insurance – is approved. And that will happen only if a tax on high-cost insurance premiums is approved. Nobody thinks it will be.
Nor should it be – under these circumstances. This exercise, like the crime bill before it, is an embarrassment. It is marked by slapdash, panic-stricken dealmaking. It is riddled with vanity provisions, fripperies introduced by individual members who’ve been saving up their pet notions through years of Republican presidents and are disgorging them now that an amiable Democrat finally lives down the street. At various times – nobody’s quite sure what’s in or out at any given moment – there have been provisions in the Mitchell bill that would: bring back mandatory health alliances, undo many restraints on malpractice suits and give the government the power to name the number (and specify the race) of medical specialists trained in every state. It also gives the predictable breaks to Democratic interest groups – and creates enough new regulations to employ the 252,000 bureaucrats Clinton has promised to pare.
The general hysteria has touched off a half-crazed, over-the-top bloviational fiesta. The First Lady was right to scorch Texas Sen. Phil Gramm for saying Clinton-Mitchell was “socialized medicine.” It isn’t (it’s just sloppy social engineering). But the Clintons themselves have gone off on a sanctimony bender, questioning the motives of any and all who disagree with them. In fact, they trot out the Democratic equivalent of “socialized medicine” – the hoary claim that their health opponents voted, or would have voted, against social security and Medicare. This is not only demagogic, but a bit tone deaf: spending on entitlements, especially vestigial health-related ones like Medicare and Medicaid, is out of control. Much of the opposition to Clintoncare comes from reasonable people – of both parties – who believe that if we extend the social safety net once more, it should be done more carefully than in the past. The legislation should be drawn in a way that neither saddles Americans with ridiculous regulations (like the Mitchell mandate) nor balloons the national debt. As a result, Republicans and moderates seemed to be getting the better of the debate in the Senate last week. They talked facts; Democrats talked emotions. Even Phil Gramm’s usual churlish mopery played better than Ted Kennedy’s incomprehensible effusions.
There was some hope for sanity at the weekend. Both sides suddenly were courting the moderates, whose forces were growing. A bipartisan bill was introduced in the House (though moderate Democrats were disappointed that they couldn’t even get Republicans to support a modest cigarette tax). In the Senate, some new faces – unlikely suspects, like the usually liberal Sen. Ben Nighthorse Campbell – were showing interest in the centrist approach. While the president’s dream of universality was likely gone, a responsible step in the right direction was still possible.
But only with clear presidential leadership. Bill Clinton lost the crime bill because he couldn’t control congressional Democrats. Over the years, they’ve become accustomed to indulging their worst instincts – their pet projects, their special-interest palliatives – secure in the knowledge that whichever Republican was president would veto their wildest flights of fantasy. It was up to Bill Clinton to let them know that the game would have to be played more soberly with a Democrat in the White House; he hasn’t. (A basic rule of politics: the opposition is expected to be partisan. The president is expected to be above all that.)
On health care, this president and – more to the point – the First Lady have courted the most extreme Democratic health-care cultists and boycotted the moderates of both parties. “When we did the clean-air bill, Democrats, Republicans and the administration sat down in one room and worked it through, line by line,” says Dave Durenberger, a GOP moderate. “We asked Mitchell to do that this time. He refused.” The White House has let congressional sorts like Mitchell run this show. The Clintons have pouted and postured, but not led. As a result, they are poised to lose two wars – crime and health – that a more subtle, sophisticated, and less partisan, politics might have won.
