WASHINGTON _ President Bill and Hillary Rodham Clinton will
embark in early fall on the sales job of the decade, a quest to
sell Americans on a health care reform plan that is acknowledged
even by its architects as a multibilliondollar social
Now that the national task force headed by Hillary Clinton has
been disbanded, and much of its hammer-and-chisel work done, the
Clintons and their political advisers are quietly hard at work
planning a campaign-style assault on a skeptical public.
There will be catchy and (they hope) reassuring slogans, a
massive fund-raising drive to subsidize the public relations
blitz and perhaps another take-it-on-the-road trip across America
for Clinton to explain his ideas to real people.
But what people will be most interested in, at least
initially, is achieving a far better understanding of Clinton's
proposal than they have now, if recent polls are a guide. The
Clinton team so far has provided the public just a glimpse of the
general mechanics of the plan, and a fragmented glimpse at that,
delivered in sporadic news snippets over the past six months.
According to health care experts who worked on the task force,
the bedeviling details are still being worked on. Those
activities include all-important exercises in crunching the
numbers, the ones that will be useful in answering the two
questions everybody seems to have: "How much will reform cost
me?" and "Will I get better, or worse, health care than I have
Even members of Congress from the president's party, who would
be on the front lines of drumming up support for the plan, say
they are starved for specifics on a plan expected to cost the
government anywhere from $30 billion to $90 billion.
U.S. Rep. Pete Geren, D-Texas, who has been listening for
months to people's concerns about health care at town hall
meetings, said that Clinton has been slow to bring Democrats in
on the big picture.
Only in the last two weeks have administration officials begun
to hold private briefings with members of Congress. When Geren
asked task force member Judith Feeder, an official in the
Department of Health and Human Services, for an outline of the
plan on paper, he was told none was yet available.
"It's good that they're finally reaching out," he said. "It's
unfortunate that it's taken this long."
The message from the White House for Geren and the rest of us
is, "Stay tuned until mid-September," when the president is
expected to unveil his health care reform package at a joint
session of Congress.
Until then, here is what is known about the grand reform of
the U.S. health care system as the Clintons see it:
It is based on an idea called "managed competition," which
combines the American tradition of a market-driven health care
industry with the power of government to manage some aspects of
the market for the public good. It stands in contrast to the
preferred model among congressional liberals, a government-run
health care system such as Canada and Britain have.
The Clinton plan would impose not insignificant government
controls on the marketplace to meet two social goals:
guaranteeing health coverage for all citizens and keeping cost
escalations in line with inflation. Necessarily, some of the
power that the insurance and medical industries now exercise over
access and prices would be curtailed, and government would have a
far greater say in availability, cost and quality control.
The present, fragmented system of health insurers and
providers would be replaced with a more governmentally "managed"
one. Everyone would belong to new local "health alliances,"
quasi-public agencies that would be organized by state and by
major metropolitan area. For instance, rural Texans might belong
to a statewide alliance while urban dwellers in the Metroplex
might belong to a Dallas-Fort Worth alliance. …