WASHINGTON - Seven years ago, America seemed ready for serious health-care reform. Indeed, some say it was his promise of health-care reform that helped President Clinton get elected the first time. The people were ready, and Hillary Clinton - the smart one with the patience and the commitment - was primed to deliver.
Then, the whole thing blew up, and neither Hillary nor health-care reform has fully recovered.
Now here comes Sen. Paul Wellstone, D-Minn., with a plan to reform health care. Don't liberals ever learn?
Well, Wellstone thinks he has learned a thing or two from that early '90s disaster. The first lesson, he said at a small press conference on the Capitol grounds the other day, is that "you have to have a proposal that fits the mood of the country - and that the people can understand."
The Clinton effort failed on both counts. Hillary Clinton wanted health-care reform that covered the then estimated 38 million Americans without health insurance. The people - or so it seemed to me - wanted health-care reform that would reduce the premiums they feared were soaring out of control. The package that came out of the closed-door White House gatherings of experts was so complicated and so unexposed to the normal give and take of big legislative initiatives, nobody knew - or knows to this day - whether it was any good.
Wellstone's second lesson - really a permutation of the first - is that you can't have major health-care reform unless you build a movement to demand it.
And the third: Have a good idea, but "never fall in love with a piece of legislation."
Here's the core of Wellstone's good idea: A universal health-care plan broad enough to warm the cockles of a liberal heart - but with the specifics left, in good conservative fashion, to the individual states.
And here is what he hopes is his special stroke of genius for getting it enacted: He's making common cause with the Service Employees International Union, the nation's largest union of health-care workers. The union will take the lead in building grass-roots support for reform across America - a process that may take a couple of years and, coincidentally, free it from the politics of a presidential election.
The rallying cry: "Health care for the people as good as Congress provides for itself."
Wellstone says he hasn't even started looking for co-sponsors of his bill, preferring to wait until there's a groundswell for reform. But in general, families earning less than $25,000 a year would pay no more than 0.5 percent of their income for health insurance; those making between $25,000 and $50,000 a maximum of 5 percent, and those making above that no more than 7 percent. The federal government would provide a match of 70 percent or 75 percent to the states that agreed to provide universal coverage.
And Wellstone doesn't care how they do it. Would some states choose the single-payer Canadian-style plan Wellstone himself was favoring seven or eight years ago? Fine. A single-payer consortium of states? No problem. Employer mandates? Whatever.
The only requirement would be that the states would have to offer affordable health care by the end of 2005.
Wellstone says his proposal would cost as much as $700 billion over 10 years or, as he put it, a third of the projected budget surplus. But surplus or not, he thinks it would be money well spent. And if his grass-roots scheme generates the sort of political pressure he has in mind, the money would be spent. After all, the people's health is worth something.
The need for thoroughgoing reform - and not just reduced premiums - should be obvious by now, Wellstone says.
"Back in 1993-94," he said, "we had high unemployment and some 38 million people without health insurance. Today, with employment at record highs, we have 45 million people without insurance. Forty-five million people without any coverage whatsoever - and we're not even talking about it?"
If Wellstone and the Service Employees International Union have their way, we'll be talking about it, all right.
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