Health care compromise could help Clinton image


WASHINGTON -- As the fight over health care reform moves from the various committee battlegrounds toward consideration on the House and Senate floors, one question hangs over all the debate and strategy:

Will President Clinton in the end hold firm to his threat in his State of the Union address to veto any "legislation that does not guarantee every American private health insurance that cannot be taken away" -- or, in legislative shorthand, universal coverage?

As health care reform wended its way through the committee process and four of them moved four different versions out, the critical matters regarding that threat have always been what would constitute a guarantee, on what timetable, how it would it be paid for and what indeed would constitute universal coverage.

In the hope or anticipation that Clinton in the end would waffle on actually setting in place a date certain for all Americans to be covered, the concept of a "trigger" was born -- merely specifying a time when, if all or nearly all Americans were not covered, further steps would be taken to move toward that goal.

Clinton has already given hints that he would swallow hard and take whatever Congress came up with that could be interpreted as more or less meeting his stipulation of universal coverage. But without the "employer mandate" to pay 80 percent of the insurance premiums included in his proposal and in three of the four committee bills, the goal of covering "every American" may be doomed. The holdout on that financing method is the bill of the Senate Finance Committee, regarded as probably reflective

of the Senate sentiment in general.

Both the president and the first lady, who heads the health care task force, have been sticking to their guns so far. But as both have learned in the Clinton administration's tough but ultimately successful battles for deficit reduction and NAFTA, compromises have to be made and some promises broken along the way.

With the Democratic leadership's task still ahead to meld the committees' work products into legislation to go to the House and Senate floors, the time is still some weeks away before the president has to fish or cut bait on swallowing what Congress serves up to him or spitting it out in the first veto of his presidency.

But looking down the road, there is a way Clinton can compromise if he has to and at least have a chance of salvaging his political image in the face of his firm position on a veto last January. It goes to the power of the presidency itself, and who exerts it.

In most earlier administrations, the latter question has seldom come up. The president is the president, although during Ronald Reagan's White House years there often was speculation that others, such as James Baker, regularly pointed him in a certain direction and pushed him out the door on a skateboard.

In this administration, however, first lady Hillary Clinton has played such a conspicuously forceful role that an impression has spread fairly widely that she is about as close to being a partner in the presidency as anyone ever has been, and certainly more than any previous wife of a president. Even Eleanor Roosevelt was not as engaged in pushing a centerpiece of FDR's agenda.

That prominence for Hillary Clinton has been hailed by feminist ,, groups and others, but it sometimes has come at the price of a diminution of Bill Clinton's image as the solitary leader. That is where the opportunity comes in for Hillary Clinton to serve by playing the "bad cop" in standing firm against further compromise on health care.

If she digs in her heels on health care and insists the veto should stand if there is no employer mandate, the president can then back away from the veto by playing the "good cop." He will be able to say he wants to achieve some progress in health care reform and will take half a loaf, overruling his wife and demonstrating who's in charge.

Doing so would be a gimmick, but it also would have a political up side. The fact is, Hillary Clinton has become the one individual regarded by many voters as exerting power rivaling her husband's. Health care could be an opportunity for President Clinton to show, in that quaint old phrase, who's wearing the pants.

Copyright © 2021, The Baltimore Sun, a Baltimore Sun Media Group publication | Place an Ad