Magazine article The New Yorker

GHOSTBUSTERS; Comment; Comment

Magazine article The New Yorker

GHOSTBUSTERS; Comment; Comment

Article excerpt

A spectre is haunting the leading candidate for the Democratic Presidential nomination. It was with her last week when she outlined her health-care proposal, and it was no wispy phantom. It was an apparition solid enough to attract the notice of political reporters inured to paranormal phenomena by long months on the campaign trail.

DES MOINES, Sept. 17--Senator Hillary Rodham Clinton unveiled a plan on Monday to guarantee health insurance to all Americans, but in a way carefully designed to avoid the political flaws in her failed proposal of 1993-94.

That's how the Times led its Tuesday story from Iowa. But whether the collapse of the most ambitious domestic policy initiative of the (Bill) Clinton Administration is a horrid fiend, red of eye and gnarled of hand, or more of a winsome Friendly Ghost, like Casper, depends on one's point of view. Senator Clinton, naturally, is of the Casper school. In her Des Moines speech, she said she had "learned some valuable lessons that have shaped how I approach health-care reform today." Her opponents for the nomination, naturally, would prefer that voters see her experience as something more apt to be repeated than learned from. "The cost of failure fourteen years ago isn't anybody's scars or political fortune," John Edwards said. "It's the millions of Americans who have now gone without health care for more than fourteen years." And Barack Obama said, "The real key to passing any health care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change."

What this kind of (still relatively civilized) political jousting should not be allowed to obscure is that--within the Democratic Party, at least--a broad consensus for change has already emerged. Clinton's proposal comes nearly eight months after Edwards's and four months after Obama's, but all three are remarkably similar, and those of Edwards and Clinton nearly identical. She and her staff used the extra time to advantage: her program is the most expertly packaged and tidiest of the three, and manages to sound at once nonthreatening and far-reaching. If you like the health plan you've already got--and, gee, who doesn't?--you keep it. If you don't like it, or if you're uninsured, you can choose from the same menu of private plans offered to members of Congress. Or you can opt for a new public plan modelled on Medicare. You can't be blackballed or socked with unaffordable premiums on account of having a "preexisting condition." You can buy a gold-plated executive policy if you wish, but you'll have to pay the difference yourself, with post-tax dollars. Whatever you choose, you have to take it upon yourself to choose something--the "individual mandate" that policy wonks talk about. It's like having to get car insurance. Clinton estimates the cost of all this at a hundred and ten billion dollars a year--a third of the annual bill for Medicare. The bulk of it would come from letting the Bush tax cuts on incomes over a quarter of a million dollars expire on schedule.

There's a lot more detail, of course. And by the time the Clinton plan--or the Edwards plan or the Obama plan--got fed through the congressional wood chipper, it would probably make Rube Goldberg's craziest invention look like the Lever of Archimedes. But it would do two important things. First, it would end the disgrace of America's being the only advanced capitalist democracy on earth that does not guarantee health care to its citizens. Second, with any luck, it would create a slow-motion showdown between private and public health insurance. …

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