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Why Clinton Can't Afford to Wimp Out on Health Care


Washington -- White House press secretary Dee Dee Myers recently said that President Clinton will sign a health-care bill if it provides "universal coverage" by a "date certain." Asked what fraction of Americans would have to be included before coverage qualified as "universal," she replied, "We're just not going to talk numbers."

I don't want to pick nits, but I had always thought the word "universal" was a number -- specifically, 100 percent, as in "100 percent of Americans."

Ms. Myers doesn't appear to be free-lancing here. There are other signs that President Clinton is hastily installing an escape hatch in his famous threat to veto any health-care bill lacking universal coverage.

The New York Times recently quoted an anonymous official as saying Mrs. Clinton is willing to compromise on the issue because "she doesn't want to blow her husband's presidency after two years in office. And face it, that's what this is."

This is the sort of melodramatic analysis that underlies calls for Mr. Clinton to compromise. He must deliver a bill of some kind, it is said, because (a) Americans so badly want health care reform and (b) he has staked so much prestige on reform.

As for (a): Health-care reform is like cutting the deficit; everyone loves it in the abstract but grows suddenly ambivalent when it assumes concrete form. What triggers this mood swing is the news that there's no free lunch. Universal coverage means taxes, either implicit (employer mandates) or explicit. And making a large dent in health-care costs means rationing, either implicit (some HMOs) or explicit.

Mr. Clinton might have explained all this from the beginning, and explained also why the goal warrants the cost (which it does). But he never did. So, barring some last-minute burst of presidential pedagogy, the health-care bill Congress finally produces will face a public-relations problem: If it pleases many voters by providing real coverage, it will outrage many voters by costing real money.

In sheerly political terms, supporting a health-care bill that actually passes is no better than being in the role Mr. Clinton would occupy after a veto: the champion of universal coverage -- in the abstract.

Which brings us to (b): the amount of Mr. Clinton's prestige riding on health care, and the damage supposedly done to his image if he fails to pass a bill. The main problem with Mr. Clinton's image isn't a perceived failure to get things done. It's a perceived willingness to do anything to get something done -- sacrifice any principle, cave in to any interest group. In short, people think he's the kind of guy who would, under pressure, back off from a principled threat to veto something.

White House advisers surely know that a veto retreat would exacerbate this part of the president's image problem. But do they really sense the magnitude of the problem? Mr. Clinton's cloying eagerness to please has now reached the status of national joke, and it threatens to become a global joke.

This week, he went to the G-7 summit, abandoned a ballyhooed trade initiative in the face of French opposition, but walked away with the Miss Congeniality trophy; a Washington Post article summarized the other leaders' reactions to him with this headline: "Machiavelli He Isn't: Clinton Wants to Be Liked, Not Feared."

Obviously, this reputation isn't a political asset. Democrats on the Senate Finance Committee so casually disregarded the president's demand for universal coverage because they know he's not a force to be reckoned with.

One way to stop, or at least slow, this trend of growing disrespect is for Mr. Clinton to prominently do something tough and principled, something that invites antagonism and ignores pleas for compromise. Like, for example, stand up now and unequivocally, irreversibly repeat his veto threat.

In addition to shoring up his reputation, this maneuver would raise the chances of getting universal coverage this year. The game theorist Thomas Schelling once noted that the key to bargaining is to conspicuously surrender your freedom: In a game of chicken, rip out your steering wheel and toss it out the window in full view of the driver you're heading toward. President Clinton has very little time to lock in his course before Congress concludes that he's once again bluffing and locks in its own course.

Of course, there is the principled argument against a principled stand: Mr. Clinton might have to deliver on his veto threat; and -- politics aside -- getting no health-care bill would be bad for the nation.

Well, maybe. But at this point the chances of coherent legislation emerging from Congress are 50-50 at best. Even if he signs no bill, Mr. Clinton will still have moved the debate to a new level, and he still can do what he said he would do in the event of a veto: Start all over again in 1995. And this time he can give us an intelligible plan and honest discussion of its costs and benefits.

In the meantime, with an unflinching veto, Mr. Clinton will have accomplished what his presidency most needs: In the face of intense pressure, and with the whole world watching, he will have stuck to his guns.

TRB is a column of The New Republic, written this week by Robert Wright.

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