Politics can't be lopped from health care debate


WASHINGTON -- Both President Clinton and Senate Minority Leader Bob Dole have well-earned reputations as smart and tough political operators. For that reason, the appeal each of them made at the National Governors' Conference in Boston to put politics aside to achieve passage of health care reform was about as realistic and believable as trying to make Boston clam chowder without the clams.

The president could not be blamed for feeling a twinge of nostalgia in pleading for bipartisanship from the governors' group. It has usually achieved a fair amount of it, including when Clinton as governor of Arkansas was its chairman. And it would no doubt be helpful for the Democratic and Republican governors to agree on a health care compromise.

But it is in Congress where the decisive action will take place. And if one thing is clear now after months of hearings, news conferences and talk show appearances by spokesmen for the administration, for both parties and for the various interests involved in the fight, it is that political considerations cannot possibly be stripped from the debate there.

Clinton in his speech to the governors tried to make it sound as if the politics of health care was merely a distracting cloud over the discussion, rather than the heart of it as the administration presses for a major and comprehensive overhaul and the Republicans and the insurance industry argue for modest changes to meet the most glaring shortcomings of the system.

Clinton called on critics of his plan to "take the political air out of the balloon and ask ourselves what will work for ordinary Americans." In so doing, he insisted that if those critics would only look at the experience of the health care plan in force in Hawaii since 1974, which like his own recommendation seeks to cover everybody, they would see "what works" and go along.

But in pitching for an end to political posturing Clinton did a bit of his own, calling on others "not to posture for the next election with rhetoric" -- an obvious reference to Dole, who is weighing a challenge to Clinton in 1996.

Dole agreed that "we need to move past the rhetoric," adding that "I don't think that television commercials or organized attacks on Pizza Hut, which happens to be headquartered in Kansas [Dole's home state], or others who dare speak out against the administration's proposal helps the process one bit."

The ad in question, which pointed out that the company had health coverage for overseas employees but not in this country, is only part of the political war of the airwaves being fought by opposing sides in the health care fight. In criticizing "the ratcheting up of the rhetoric by the White House and the Democratic National Committee," Dole acknowledged that "I guess the Republican Committee had a little ad, too," not to mention the insurance industry's high-profile "Harry and Louise" ads criticizing the Clinton plan.

Still, for all the rhetoric involved in deploring the opposition's rhetoric, Dole insisted he and the 40 Republican senators he says support his plan want to cooperate with the president, and Clinton seemed before the governors to indicate a little give in his stand for universal coverage.

"I am open to any solution to this," he said at one point. He could take a bill, he said, that did not have the employer mandates that Dole and other Republicans oppose so strongly "if we had something that moved toward universal coverage." That language suggested he might accept more gradualism in achieving the goal of covering all Americans. Earlier, Hillary Clinton on ABC News predicted that her husband would not have to use his threatened veto because "I don't think Congress will pass a bill that does not at least have some plan to get to universal coverage."

It would be dandy if some workable compromise could be struck without political rhetoric. But the political stakes are great in the outcome, not only for Clinton and Dole in '96 but also for all the opposing interests fighting tooth and nail over the details. So the political rhetoric, exaggerations and scare tactics will continue, no matter how much the combatants say they deplore it all.

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